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Collaborative Practices Related to Augmentative and Alternative Communication: Current Personnel Preparation Programs.

Although speech-language pathologists (SLPs) are typically responsible for the treatment of communication problems, the development and implementation of augmentative and alternative communication (AAC) interventions requires the expertise and involvement of additional educational team members (e.g., general and special education teachers, physical therapists, parents). Effective collaboration by these team members is necessary to develop and implement appropriate AAC interventions for students with disabilities. However, it is unclear if university preservice training programs for SLPs are providing appropriate knowledge and skill training in the collaborative skills that are critical to the appropriate provision of services to students who require AAC. This article discusses specific collaborative skills required for AAC service delivery and examines available information about the state of the profession with regard to preprofessional preparation in collaboration skills for team members. Data from a pilot survey of the preservice professional training experiences in the area of collaboration for SLPs and special and general educators who teach students who use AAC are presented, as is information from university faculty who currently teach AAC courses. Suggestions are provided regarding further examination of issues related to preservice training for team members who provide AAC services to students in schools.

Communication problems of school-age students can impede learning, discourage participation in academic and nonacademic activities, and cause difficulties in establishing and maintaining normal peer relationships and deeper friendships. For students with severe communication difficulties, the appropriate use of augmentative and alternative communication (AAC) systems represents a means by which students can increase meaningful participation in school environments and improve academic and social outcomes. Although speech-language pathologists (SLPs) are typically responsible for the treatment of communication problems, the development of appropriate AAC interventions represents a formidable task that will require the expertise of SLPs and their collaboration with numerous school personnel.

The 1999 amendments to the Individuals with Disabilities Education Act (IDEA) included a requirement that efforts designed to facilitate the access of students with disabilities to the general education curriculum be documented (Individuals with Disabilities Education Act Regulations of 1999, [sections] 300.347). This mandate has significantly affected the provision of services to children with severe disabilities and communication disorders in that increasing numbers of students who may require AAC intervention are being served in inclusive classroom settings. Consequently, the need for personnel (e.g., SLPs, general and special educators, physical therapists) to work as a cohesive team in planning and implementing AAC interventions is even more critical.

The goals of this article are twofold:

1. To discuss the state of preprofessional preparation of team members in general AAC skills as well as in collaborative skills required for AAC service delivery; and

2. To present data from two pilot studies, one that surveyed the preprofessional training experiences of SLPs and special and general educators who work with students who use AAC in regards to collaboration, and one that surveyed university faculty regarding the inclusion of content and experiences related to collaboration in AAC courses contained within preprofessional training programs for SLPs.

TEAMING AND AAC

Lloyd, Fuller, and Arvidson (1997) defined AAC as "the supplementation or replacement of natural speech and/or writing" (p. 1). They further described AAC as both a process and a field where professionals across disciplines (e.g., speech-language pathology, general and special education, physical therapy) work to facilitate the improved communication of individuals who display significant problems using oral speech and/or written expression through "symbols, strategies, and techniques" (p. 1). Because the various components of AAC interventions are often multifaceted, the field of AAC involves multiple disciplines with their related theoretical orientations and research bases.

The goal of AAC for individual students will be realized when the students increase their meaningful communication and participation across school and home environments. This goal may be best reached through effective collaboration among school personnel during AAC planning and implementation. When considering the communication needs of a child requiring AAC, the SLP must involve other team members within the school in the design of an appropriate AAC system. Beukelman and Mirenda (1998) pointed out that a team' will be required to provide information on the sensory, physical, cognitive, and language abilities of the individual, and they noted that "few individual AAC specialists are capable of assessing and intervening in all these areas; therefore, it is nearly always necessary to involve a team of individuals to provide appropriate AAC services" (p. 126). For example, although an SLP may have the expertise to assess the appropriate communication mode for a student, other team members (i.e., child's teacher and parents) may be more aware of specific communicative opportunities and vocabulary needs within school and home environments. In creating a team, team development and structure, as well as relationships with other school personnel, are of critical importance to successful AAC assessment and intervention.

AAC COMPETENCIES

The degree to which the team works as a cohesive unit will be a key factor in the provision of effective AAC interventions. Consequently, elements that assist team members in working collaboratively need to be identified, as do the ways in which preprofessional training and professional development can facilitate the acquisition of collaborative knowledge and skills for individual team members. To better understand the role of successful collaboration in AAC, the individual competencies within the areas of speech-language pathology, special education, and AAC that AAC team members must have need to be identified.

Lloyd et al. (1997) discussed Beukelman and Cumley's (1992) three primary levels of preprofessional preparation in AAC:

1. preparation to acquaint appropriate professionals with AAC,

2. advanced training for more primary service providers, and

3. special preparation for those individuals who work as AAC specialists and consultants.

Collier and Blackstien-Adler (1998) noted that "transdisciplinary team function was a new experience for all clinicians and may take longer to develop than the acquisition of AAC knowledge and individual skills" (p. 256).

In the late 1980s the American Speech-Language-Hearing Association (ASHA; 1989) identified and published guidelines related to specific AAC competencies for SLPs. Locke and Mirenda (1992) reported, "It seems clear that these professionals [SLPs] have access to clear and precise guidelines concerning their expertise and contributions to teams that deliver AAC services" (p. 200). The authors noted that although the roles of occupational and physical therapists who work with AAC have also been clarified, information was still lacking concerning the AAC competencies needed by special educators. Consequently, Locke and Mirenda conducted a study of special education teachers to identify their roles and responsibilities in AAC service delivery. Survey responses revealed that the participants were involved in a variety of team structures (i.e., multidisciplinary, interdisciplinary, and transdisciplinary) and that the majority had responsibilities commonly expected of educators (e.g., adapting the curriculum, assessing cognitive disabilities). In addition, roles and responsibilities that might be less commonly associated with educators (e.g., vocabulary selection, determining communication needs of the child) were also reported. The teachers also indicated that clarification of individual team member's roles and more time for meeting as a team were factors they considered important to improving AAC service delivery. Another survey was conducted by Soto (1997) of a group of special education teachers who taught students with severe disabilities. Soto concluded that in general, the respondents felt communication training represented an important instructional target for their students and that collaboration between educators and SLPs was necessary for facilitating such training. Soto (1999) used focus groups to (a) determine factors that were indicators of and barriers to successful programs and (b) identify skills needed by educational team members who were serving students who used AAC in inclusive settings. She identified a need for skills in collaborative practice within AAC service delivery by the teams, which included teachers, inclusion support personnel, instructional aides, and SLPs. Clearly, regardless of the discipline of an individual team member or the educational setting of the student, individual members will need specific competencies for their primary role as well as skills in team participation and effective collaboration.

EFFECTIVE COLLABORATION

Although the very nature of AAC intervention requires collaboration, the integrated service delivery model that is increasingly being used in speech-language pathology services in particular requires well-planned collaboration across diverse disciplines. However, a consensus concerning what constitutes effective collaboration among team members has yet to be determined. Critical collaborative program elements identified by Prelock, Bricker, Miller, and Reed (1991, as cited in Creaghead, 1994) include initial recruitment of interested participants, shared commitment and responsibilities of the team members, in-service training, support from school administrators, and scheduling. According to Coufal (1993), collaboration refers to individuals interacting on an equal basis and using problem solving to accomplish a shared goal. Yoder (1992), who contended that "all disciplines must share responsibility if we are to create and implement a scheme for effective partnering" (p. 303), also stated,
   A shared language (good communication) is at the core of successful
   teamwork. The team needs a system of common definitions and terminology in
   order to communicate with each other while developing the scheme. We all
   need to "talk the same talk," which must be meaningful to the lay public
   (potential partners). (p. 303)


It is important to note that recent changes in IDEA require collaboration between general educators and special educators in instances (a) where a child is included in general education classes and (b) when he or she may possibly be placed in general education settings. This makes the need for collaboration even more critical, no matter what models of service delivery involving SLPs and educators are used within a school. Current models recommended for use include a transdisciplinary approach for the design and implementation of services for students with severe disabilities (Baine & Sobsey, 1983), integrated service models for use with students with severe disabilities (Campbell, 1987) and for those with speech and language needs (Banigan, Koslowski, & Johnson, 1995), and a collaborative problem-solving model for promoting the inclusion of students with mild to profound disabilities (Salisbury, Evans, & Palombaro, 1997). Although a variety of models may be used within schools, the involvement of a group of team members who must collaborate to plan and implement appropriate services for students with disabilities is common to all of them.

Harn, Bradshaw, and Ogletree (1999) noted that the knowledge required of SLPs and the skill demands placed on them have expanded. This is in part due to changes in typical caseloads, which now include school-age students who may be in need of AAC service delivery in a variety of educational settings, including early childhood special needs classrooms, full inclusion within general education classrooms, cross-categorical classrooms, and self-contained special education classrooms. The range of AAC service delivery settings and models was discussed by Zangari and Wasson (1997). Depending on the setting, there may be variations in the constellation of team members who participate in planning AAC interventions for children with severe communication disorders. Additionally, differences in service delivery models may change the dynamics of the AAC team.

However, regardless of the AAC service delivery model used, Beukelman and Mirenda (1998) noted that "one common goal unites these efforts: to enable people to communicate to the best of their abilities" (p. 125). Coufal (1993) indicated that the process of collaboration in part will be determined by the "nature of the problem and the individuals involved" and be "shaped according to the needs of the participants" (p. 2). Consequently, when considering a school-age child who needs AAC, an SLP, special and general educators, caregivers, and other related services personnel (e.g., occupational therapist) must be involved in planning and providing appropriate AAC services.

PREPROFESSIONAL TRAINING

As noted previously, school personnel who work with students who need AAC will require two distinct sets of knowledge and skills: those related to AAC and those related to collaboration. In addition, these professionals will be expected to effectively merge their knowledge and skills when working with other team members. Consequently, an examination of the manner in which preprofessional training programs for SLPs, general and special educators, and other related services personnel include content and experiences related to AAC and collaboration within AAC service delivery is warranted.

Training in AAC

Ratcliff (1999) conducted a review of the literature that in part supported justification for preservice training in AAC, including legislative mandates, current service delivery practices, and the need for preprofessional training and methods for enhancing training. Although Ratcliff (1997) had indicated that only three institutions in the United States offered preprofessional training in AAC during 1977-1978, she reported increased offerings of ACC courses at more than 100 institutions, according to Lloyd et al. (1997). Koul and Lloyd (1994) conducted a survey to locate institutions in the United States that offered special education or speech-language pathology coursework that included content related to AAC. Respondents indicated that 24% of special education programs had such courses, as did 62% of speech-language pathology programs. Koul and Lloyd came to the following conclusions:
   Examining training of the faculty who teach AAC courses, analyzing the
   content of free-standing AAC courses across programs, standardizing the
   content of primary AAC courses, and studying the nature and type of
   available clinical internships are some of the issues that can provide
   qualitative insight into professional preparation programs. (p. 19)


Light and McNaughton (1993) and Thompson and Guess (1989) called for teachers of students with more significant disabilities to have increased preprofessional training related to alternative communication systems.

A study of ASHA Educational Standards Board (ESB)--accredited institutions that provide preprofessional preparation for SLPs revealed that 67% of the responding institutions offered a course in the area of AAC (Ratcliff & Beukelman, 1995). Although 15% of the institutions offered more than one course in AAC, 18% did not include an AAC course within speech-language pathology preprofessional training. However, of this 18%, 8% did provide some AAC training in related courses. Although the authors indicated that there were increased offerings of AAC courses, they also reported that "students do not appear to be obtaining an appreciable number of clinical clock hours in AAC, hands-on training with AAC technology, or exposure to the interdisciplinary nature of AAC" (p. 61).

In a study of preprofessional programs for SLPs, Moore, Kovach, Donaldson, and McGann (1998) compared the effects of a program that included stand-alone AAC coursework and AAC coursework with related field experiences. The program with clinical field experiences linked coursework in AAC with intensive practicum experiences. Results indicated that students benefited from training experiences that included such experiential learning activities. A survey by Balandin and Iacono (1998) related to the knowledge of AAC among practicing SLPs in Australia indicated a "lack of interest in obtaining further information of AAC and an unwillingness to enroll in further education [which] highlighted the need for collaboration among the professional organization, training institutions, and employment bodies in ensuring adequate levels of knowledge and skills among speech pathologists" (p. 239).

Clearly, available preservice training in AAC was limited in the past but appears to be coming more incorporated into preprofessional training programs in speech-language pathology and special education. This may help in providing the respective service providers (i.e., SLPs, special educators) with basic or more advanced core content related to AAC; however, it is unclear to what degree any of these programs are including knowledge of and training in collaborative skills.

Collaboration Training and Experiences

It is not clear to what extent preprofessional preparation programs for SLPs, special and general educators, and related services personnel provide training that involves classroom and clinical experiences in collaboration. In terms of special and general education preprofessional training, Hudson and Glomb (1997) stated,
   Although both special education and regular education preparation programs
   provide preprofessional teachers with the technical expertise for their
   respective areas of certification, few programs provide both special
   education and general education majors with instruction in interpersonal
   skills and collaboration strategies. (p. 442)


Quigney (1998) spoke about the need for collaborative preprofessional instruction for general educators and special educators. Much of this same rationale may be applied to the need for training in collaborative skills for SLPs and classroom teachers. In addition to describing university programs with collaborative programs, Quigney highlighted the need for the following:
   (a) training and extensive practice in collaboration skills, (b) providing
   models of the collaborative process, (c) university/local school
   partnerships, and (d) information sharing of areas of expertise. (1998, p.
   22)


Korinek and McLaughlin (1996) asserted:
   Despite the expectation that educators and related service professionals
   will collaborate to problem solve concerning students with special needs,
   and despite the desirability of interdisciplinary team training, most
   preservice preparation has been largely unidisciplinary. While exceptions
   exist, opportunities to learn and practice problem solving in an
   interdisciplinary team context have been limited in typical preparation
   programs. Students are often expected to work effectively with colleagues
   from other disciplines once they graduate into professional positions, yet
   get little modeling or practice for collaborative roles. (p. 41)


Baine and Sobsey (1983) also noted that although professionals from a range of disciplines may receive their preprofessional training at the same university, they may be isolated within this training and have few opportunities to practice collaboration across disciplines. They recommended changing current preprofessional training programs for teachers and other related services personnel to provide increased opportunities for transdisciplinary collaboration. It should be noted that the Council for Exceptional Children (CEC, 1998) identified basic skill and knowledge competencies in the areas of communication and collaboration that beginning special education teachers should possess upon graduating from their preprofessional training programs. These included an understanding of how to develop individual programs for students and the ability to use collaborative strategies with team members such as general educators and families. Although many preprofessional teacher preparation programs in special education may use the CEC competencies as the basis for the structure of their training programs, it is unclear how many embed actual training experiences in transdisciplinary collaboration as part of the coursework.

Harn et al. (1999) posited that SLPs are trained as "generalists" in that many of them do not complete any clinical training within public school settings and thus have limited preprofessional exposure to teachers and other related services personnel (p. 166). Such experiences will be critical to preparing them for the collaborative nature of their later work in public schools. Ratcliff and Beukelman (1995) investigated university speech-language pathology preprofessional programs with AAC coursework to determine whether the programs' primary AAC course was interdisciplinary in nature. Interdisciplinary was "systematic offering of content areas relative to AAC by a department other than the speech-language pathology departments" (p. 64). Only 22% said that offered AAC courses were within an interdisciplinary program, and an average of 91% of students enrolled in AAC classes were speech-language pathology students. Table 1 provides available information and general descriptions of university preprofessional training programs that include training in collaboration and/or collaborative field experiences for preservice SLPs and general and special educators.

TABLE .1. University Programs That Provide Interdisciplinary Collaboration in Training Programs
Authors/Investigators         Program description

Hudson & Glomb (1997)         * Teacher education program at
                                Southern Utah University designed
                                to teach preprofessional majors to
                                work collaboratively together to
                                adapt classroom instruction for
                                students with learning disabilities
                              * Trained students using case
                                studies, simulations, and role
                                playing to practice active
                                listening skills and to
                                collaboratively develop plans for
                                adaptations
                              * Later field-based practice allowed
                                the students to practice skills in
                                school environments

Korinek & McLaughlin (1996)   * Described the implementation of an
                                Intervention Assistance Teaching
                                (IAT) model with preprofessional
                                graduate students from a range of
                                school-related disciplines (e.g.,
                                special and general education,
                                counseling, and school psychology)
                              * Project was implemented during the
                                clinical experiences/student
                                teaching portion of the students'
                                respective programs
                              * Program included case studies,
                                simulations, and large-group
                                discussions
                              * Evaluation of the project indicated
                                that after the collaborative
                                training, the preprofessional
                                participants were able to isolate
                                appropriate targets for
                                intervention, identify possible
                                interventions, and implement the
                                demonstrated problem-solving
                                process to construct appropriate
                                action plans
                              * Noted that collaborative training
                                could be incorporated into
                                preprofessional programs through
                                coursework and systematic field
                                experiences

Gerke (1994)                  * Curriculum model proposed for use
                                in developing transdisciplinary
                                teams in rural areas
                              * Model focused on the cross-training
                                of doctoral students from different
                                disciplines (e.g., special
                                education and communication
                                disorders) through both role
                                release and interactive
                                collaboration

David & Smith (1987)          * A collaborative training program

                                for teachers of children with
                                severe learning difficulties and
                                speech pathologists who were
                                enrolled, respectively, at Westhill
                                College and the City of Birmingham
                                Polytechnic in Great Britain
                              * Student speech pathologists were
                                paired with teachers to provide
                                services to children with severe
                                learning disabilities
                              * Recommended a need for evaluation
                                and training in collaboration
                                within various stages of
                                professional development
Lloyd & Pufpaff (1999)        * Transdisciplinary AAC program at
                                Purdue University where both
                                special education and
                                speech-language pathology students
                                take AAC classes
                              * Multiple AAC classes are available,
                                as well as a practicum in which
                                students provide services to at
                                least one client who uses AAC
                              * Students were able to participate
                                in transdisciplinary AAC
                                assessments in the local schools
Stuart (1999)                 * Described a preprofessional model
                                program at New Mexico State
                                University where the university
                                and the local public school worked
                                together to facilitate the use of
                                AAC in public school classrooms
                              * Speech-language pathology students
                                were required to have an
                                introductory course in AAC and two
                                semesters of AAC experience
                              * One of the most positive aspects
                                reported was the students and
                                school personnel increased
                                awareness of how much was involved
                                in the program


Various methods were used in the different programs to facilitate the acquisition of collaborative skills by the preservice students, including the pairing of student SLPs and teachers (David & Smith, 1987), case studies, simulations (Hudson & Glomb, 1997; Korinek & McLaughlin, 1996), and role playing (Hudson & Glomb, 1997) within training at the undergraduate, master's, and doctoral levels. Such programs offer models for use in the examination of possible means by which collaborative training and experiences can be provided within preservice programs for individuals who will be providing services to students who use AAC.

Some preprofessional training programs are making efforts toward improving the preparation of school personnel to work more collaboratively with varied populations of students. However, there appears to be limited available information on (a) the extent to which specific training in collaboration in AAC service delivery has been provided to teachers and SLPs and (b) the current role of collaboration in preprofessional programs in the field of AAC. Therefore, we developed two pilot questionnaires based on the data obtained from the preceding literature review as an initial step in obtaining information in these areas.

PILOT INVESTIGATIONS

The purpose of the first pilot was to investigate the training in AAC collaboration for teachers and SLPs working with children who use AAC. The purpose of the second pilot was to investigate interdisciplinary training in university programs that provide AAC coursework to determine whether content related to collaboration and experiences working in collaborative teams were included. It should be noted that the questionnaires used were limited in scope and that the primary purpose of both pilots was to provide information that could be used to develop more extensive surveys in the areas of preprofessional training in AAC.

Survey 1: Methods Related to Practitioner Questionnaire

The first questionnaire was developed to obtain information from practitioners (i.e., SLPs and general and special education teachers who work with students using AAC) regarding training pertaining to AAC and collaboration. The questionnaire included information on training in collaboration and teaming within their respective preprofessional training programs.

The questionnaires were distributed to seven SLPs, four special education teachers, and one general education teacher who were known by the researchers to have had past experience with or who were currently working with children using AAC. Questions eliciting demographic information included the following:

* What is your position and for what period of time have you provided AAC services?

* In what settings do you or have you provided AAC?

* Approximately how many children have you worked with who use AAC?

* What types of disabilities were associated with these children?

The survey also included (a) several open-ended questions regarding factors that the respondents felt accounted for productive collaboration as well as problems or barriers to collaboration and (b) questions regarding preprofessional training in collaboration and teaming (e.g., Did you have training in your preservice program that dealt with collaboration and teaming? If you did, please describe. How could preservice training facilitate successful AAC collaboration?).

Four SLPs and five teachers (four special education teachers and one general education teacher) completed the questionnaire. The respondents reported that they had provided AAC services within a range of 6 months to 15 years. Eight of the nine respondents were between 5 and 15 years old. The respondents had provided services in general education classrooms, self-contained student environments, and other student environments (e.g., lunchrooms, group homes). The number of students served by the respondents ranged from 1 to more than 100; however, seven of eight respondents reported working with between 20 to more than 100 students. The disabilities presented by the students included autism, mental retardation, cerebral palsy, and traumatic brain injury (Table 2 provides more specific demographic information).

TABLE 2. Demographic Information for Pilot Study 1 Respondents to the Questionnaire
                                                  # of children
Parti-    Position respondent    Providing AAC    using AAC served
cipant    listed                 services (yrs)   by respondents

1         Speech-language             12          Approximately 30
            pathologist
2         Teacher                    10-15        No response
3         Speech-language              5          Approximately 30
            pathologist
4         Teacher                     11          20
5         Special education       No response     Approximately 40
            teacher
6         Speech-language             14          More than 100
            pathologist
7         Special education           10          Approximately 40
            teacher
8         Classroom teacher           1/2         One student
9         Speech-language              7          "Very many"
            pathologist


All but one of the participants listed time as a contributor or barrier to successful collaboration. This was usually in reference to time for meetings or time to learn about AAC systems. Additional factors that affected the success of (or that were barriers to) collaboration included issues related to training (e.g., responses concerning collaboration, AAC, and devices), the team members' ability to agree and work together (e.g., goal development, the child's needs, location of services), and attitudes of team members (e.g., regarding motivation, involvement).

The majority of the respondents indicated that they had received little to no specific training in collaboration and teaming in their preprofessional training programs. Two respondents did indicate that they had received some lecture content in their preprofessional programs related to collaboration, but as one indicated, teams were discussed in "terms of who is involved ... but not in terms of how to work together and share information and negotiate roles and responsibilities." When asked about training in teaming and collaboration in their preservice programs, four respondents indicated that they had attended conferences or workshops dealing with collaboration and AAC; however, it was unclear whether these had all been prior to these respondents' professional employment. The practitioners stated that preprofessional training could be used to facilitate successful AAC collaboration by teaching the rationale for the need for teaming and collaboration, identifying different roles and responsibilities of individual team members, and teaching specific skills in collaboration (e.g., conflict resolution, problem solving, negotiation of roles, identification of common goals).

As previously stated, the small number of participants and the diversity of their experiences does not allow for generalizations. However, the results did reveal several factors that may affect collaboration. These factors could be used in investigating competencies targeted by preprofessional programs. In addition, the results indicated that this pool of individuals did not receive substantive content related to collaboration and AAC during their preservice training. The participants did also provide suggestions for preprofessional training programs regarding facilitating collaboration in AAC service delivery.

Survey 2: Methods Related to University Faculty Questionnaire

A second questionnaire was developed and provided to 10 university faculty who taught preprofessional courses or portions of courses in AAC. Information requested from each of the faculty respondents included whether:

1. each included content about AAC in one or more courses,

2. collaboration/consultation or team training were included in the course content, and

3. students received specific clinical training opportunities to participate in collaborative consultation, classroom instruction, or AAC teaming.

Nine of the 10 individuals who were sent the university faculty questionnaire responded to the questions regarding the inclusion of information on collaboration/consultation or team training in the course content and specific clinical training opportunities to participate in collaborative consultation, classroom instruction, or AAC teaming. All of the participants indicated that the AAC coursework they participated in included information about collaboration or team training. Some respondents indicated that this included specific activities and assignments dealing with collaboration and teaming. (It should be noted that some respondents indicated that the AAC course was an elective.) The responses regarding inclusion of content related to collaborative consultation, classroom instruction, or participation on an AAC in preprofessional training were more varied. Respondents indicated that AAC clinical experience varied with student externships and university clinical assignments. The amount and nature of these experiences varied by program; however, some of the AAC faculty did report about course or program participation with schools that allowed for collaborative experiences. For example, one respondent provided information about externship sites where students participate in multidisciplinary team assessments. Several of the respondents indicated that there is a need to increase activities that provide students with specific clinical training opportunities to participate in collaborative consultation, classroom instruction, or AAC teaming.

Although the limited nature of this pilot does not allow for any type of generalization, these individuals each indicated the importance of teaming within the area of AAC. In addition, they described innovative programs in AAC teaming and pointed to the possibilities of collaborative experiences available in some preprofessional training programs within the United States.

The field has much to learn from current preprofessional programs that are addressing the issues of teaming and collaboration within the area of AAC. However, more comprehensive information is needed concerning (a) the number of preservice students in special and general education and speech-language pathology preprofessional programs who are provided with meaningful training in collaboration and preparation in collaborative clinical experiences, and (b) how these programs may serve to facilitate improved communication for the heterogeneous group of students who use AAC.

SUMMARY

Both of these pilot questionnaires provided information that may facilitate the development of future research to assist preprofessional programs and continuing education venues in continued development and validation of training programs in collaboration and AAC. Additional research areas/ questions that have evolved from these pilot studies and from the review of the literature include but are not limited to the following:

1. descriptions of successful collaboration models, specifically, collaboration used within AAC service delivery;

2. descriptions of how AAC collaboration skills differ from AAC knowledge;

3. information on specific opportunities to work with other disciplines in preprofessional training;

4. examination of the differences in collaboration opportunities provided in the preprofessional training of general educators, special educators, and SLPs; and

5. outcomes resulting from preprofessional training in AAC and collaboration.

As collaboration and teaming are essential to the successful delivery of AAC services, it will be critical to determine how disciplines within institutions of higher education can work together at the preprofessional level to best educate future professionals to employ best practices in AAC service delivery and collaboration. Hudson and Glomb (1997) recommended that special education and general education majors jointly take courses in collaboration. They also identified the following topics for inclusion in such courses:

* perspectives and attitudes of different personnel,

* nonverbal communication skills,

* oral communication and listening skills, and

* use of collaborative strategies (e.g., negotiating and resolving conflict and resistance).

The content area suggestions presented by Hudson and Glomb should be examined within future research investigating preprofessional training in AAC and collaboration for SLPs, special and general educators, and related services personnel.

CONCLUSION

In recent decades the use of AAC intervention strategies, including the increased availability of assistive technology, has resulted in new communication opportunities for individuals with severe communication disorders. These opportunities have increasingly required teams of professionals to work together with students who use AAC and their families to improve the students' effective communication. Although the literature is replete with articles and studies that have reviewed related issues of AAC service delivery and the role of collaboration when providing AAC services, additional information is needed for continued improvement of the education of SLPs, special educators, and related service personnel who provide services to these students. One continued area of concern is the identification and development of the competencies of the various disciplines of professionals that provide services to individuals who use AAC (American Speech-Language-Hearing Association, 1989; Collier & Blackstein-Adler, 1998; Locke & Mirenda, 1992; McCord & Soto, 1998; Soto, 1999). Our review of the literature highlights the need to define the competencies all team members need to have. In addition, no matter what the discipline or the subsequent roles and responsibilities taken by team members, all individuals providing AAC services need skills in successful collaboration when working on AAC teams. One key aspect to assuring competencies in AAC knowledge, including successful collaboration, is the preprofessional training of AAC team members. Results from our review of the literature and the two pilot questionnaires reported here suggest that preprofessional training may vary and that more specific information is needed regarding comprehensive training in the area of collaboration as related to AAC for a variety of disciplines. The provision of preprofessional training that provides experiences with interdisciplinary teams and AAC collaboration is in line with current developments in higher education. Training that addresses school and clinical experiences must include performance-based instruction where students are evaluated not only on their knowledge of content but also on their ability to apply that knowledge. In both preprofessional training and continuing education, there is a need to understand the effects of varying types of classroom-based and clinical instruction on the development of general collaboration skills as well as on those skills specifically related to collaboration and AAC. In order for children with severe communication disorders to receive optimal services, it is imperative that team members be able to collaborate successfully. Preprofessional training programs and continuing education venues need to continue to address and research this issue.

AUTHORS' NOTE

The authors would like to thank the participants of the two pilot surveys. In addition, we would like to thank Kerri Bower for her assistance with the manuscript.

REFERENCES

American Speech-Language-Hearing Association. (1989). Competencies for speech-language pathologists providing services in augmentative communication. Asha, 31, 107-110.

Baine, D., & Sobsey, R. (1983). Implementing transdisciplinary services for severely handicapped persons. Special Education in Canada, 58(1), 12-14.

Balandin, S., & Iacono, T. (1998). AAC and Australian speech pathologists: Report on a national survey. Augmentative and Alternative Communication, 14, 239-249.

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Paris A. DePaepe, PhD, is an assistant professor of special education in the School of Teacher Education at Southwest Missouri State University. Her research interests include the personnel preparation of special educators and challenging behaviors of students with severe disabilities. Lisa A. Wood, PhD, is an assistant professor in the Department of Communication Sciences and Disorders at Southwest Missouri State University. Her research interests include language and literacy development of children who use AAC. Address: Paris DePaepe, School of Teacher Education, Southwest Missouri State University, 901 S. National Avenue, Springfield, Missouri, 65804.
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Author:DePaepe, Paris A.; Wood, Lisa A.
Publication:Communication Disorders Quarterly
Article Type:Statistical Data Included
Date:Jan 1, 2001
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