Augmentative Communication

AUGMENTATIVE COMMUNCATION Page 1 of 11

AUGMENTATIVE COMMUNICATION

Enkidu Palmtop Enkidu Handheld Enkidu Tablet Discover Complete Portable IMPACT Portable IMPACT Portable IMPACT Computer Access

AudiSee iCommunicator ChatBox Assistive ChatPC-II Assistive Communication Communication Device Device

Augmentative Communication refers to ways other than speech that are used to send a message from one person to another. We all use techniques to enhance or clarify our messages, such as facial expressions, gestures, and writing, as part of our daily lives. People whose communication is difficult or impossible for unfamiliar partners to understand must rely heavily on such standard techniques, as well as on some specialized approaches developed especially for individuals with significant speech disabilities. For some individuals, these strategies are complete alternatives to speech; typically, however, these strategies are additions to the use of speech. This area of practice is often referred to as augmentative or alternative communication (AAC). Using AAC devices enables individuals to participate more fully in their social roles, including interpersonal interaction, learning, education, community activities, employment, volunteerism, care management, etc. (http://aac.unl.edu).

Above are pictured some examples of augmentative communication devices that are available for purchase (descriptions of the devices are provided later). Augmentative communication devices help individuals in producing and/or understanding speech. The technology can range from a board with pictures representing a student’s daily needs to sophisticated electronic speech synthesizers. Speech output devices may be simply devices for storing and playing back prerecorded speech or may be true speech synthesizers that use segments of words, called diphones, to produce words. Computers can be equipped with speech synthesizers, and there are portable electronic devices that can produce speech (www.neatinfo.net/equipment-main- pages/augmentative.html).

Augmentative communication became accepted as a “mainstream” approach in the mid-70s and was the result of a variety of factors, including changes in how sign language was viewed, emerging technologies, and public policy shifts that were more inclusive of individuals with significant disabilities. However, there was then-and is to some extent, now-fear that intervention with any augmentative approach would negatively impact the development of speech. Based on a review of published and unpublished intervention studies, Silverman (1980) wrote, “Teaching a person to use a nonspeech communication mode does not appear to reduce his or her motivation for speech. Subsequent research has led to the following: “To the degree that natural speech is physically possible, there may be improvement in speech after the introduction of AAC. In some cases, the utilization of speech is unchanged. In almost all reported cases, the quantity and quality of communication is AUGMENTATIVE COMMUNCATION Page 2 of 11 improved with AAC. And when speech is used with AAC approaches, not only does communication increase, but so do social interactions, school performance, self-esteem, and employment opportunities (Light & Binger, 1998).

Options in AAC Approaches Augmentative communication approaches include those that use only one’s physical self to communicate, and do not require external aids. These approaches are referred to as “unaided” AAC, and may include the use of vocalizations, sign language, eye blinks that spell out words utilizing Morse code, and gestures. Approaches that utilize an external “system” such as a keyboard, communication book or voice output device are called “aided” AAC. These AAC devices are one form of “assistive technology.” Ideally, an individual with significant communication disabilities will use a combination of unaided and aided methods, sometimes called a “multi- modal approach,” in order to have access to effective and efficient communication at all times.

While it is rare for an individual to be unable to be understood by anyone, at anytime, for individuals with significant communication disabilities even familiar partners may have a problem understanding a message that has an unexpected topic. Unfamiliar partners may have even more difficulty if the communication mode is nonstandard. While sign language may be efficient and effective when both partners have been trained, sign language is not understood by the general public. AAC devices provide a means for communication through easily understood symbols, words and letters, and/or voice output.

Assistive technology devices for communication can range from “low-tech” (e.g. simple, low-cost devices that may be constructed by a speech-pathologist, educator, or parent) to “high-tech” (e.g. complex, expensive devices, usually incorporating computer technologies). High-tech devices include sophisticated “dedicated” communication devices developed for the sole purpose of serving as a communication aid. There are literally hundreds of devices that are now commercially available, with a range of capabilities and prices. Low-tech communication systems often do not have voice output. These systems may include communication notebooks and/or boards. A popular system used is the “PECS” system, the Picture Exchange Communication System. This approach appears particularly useful for establishing requesting behaviors, and helping children understand that communication through more standard means (i.e. handing the adult a laminated picture representing “eat” rather than biting herself to indicate she’s hungry) can be an effective communication strategy (Beukelman & Mirenda, 1998).

Individuals who may benefit from AAC The most common congenital causes of severe communication disorders include mental retardation or developmental delay, cerebral palsy, autism, specific language disorders and developmental apraxia of speech. People who have acquired disabilities as a result of traumatic brain injury, stroke, multiple sclerosis, and spinal cord injury may also benefit from the use of a communication device.

Some factors to consider when developing a functional AAC system  First, a communication assessment should be conducted on the individual to determine strengths, needs, interests, etc.  The person’s ability to use and comprehend the devices. The communication system needs to be developed around the person’s needs and abilities.  The person’s physical abilities also need to be considered. Should the system be portable or stationary? Does weight matter?  The vocabulary of the system should represent the person’s interests as much as possible.  Cost  Are devices available in the family’s native language?  Motivation: no matter how high-functioning the person is or how elaborate the system is, if there is no motivation, the system will not be used strategy (Beukelman & Mirenda, 1998). AUGMENTATIVE COMMUNCATION Page 3 of 11 Funding Issues Various sources for funding exist, including Medicaid, Medicare, Part B, TEFRA, Private Insurance, Federal/State Rehabilitation, Special Education, Veteran’s Administration, Worker’s Compensation, and Credit Financing. Below are state contacts for contacting the nearest agency handling Vocational Rehabilitation, Worker’s Compensation issues, and the Veteran’s Administration (http://www.empowermentzone. com/funding.txt).

Alabama...205/242-8000 Alaska...907/465-2111 Arizona...602/542-4900 Arkansas...501/371-3000 California...916/322-6740 Colorado...303/866-5000 Connecticut...203/566-2211 Delaware...302/736-4000 District of Columbia...202/727-1000 Florida...904/488-1234 Georgia...404/656-2000 Hawaii...808/586-2211 Idaho...208/334-2411 Illinois...217/782-2000 Indiana...317/232-3140 Iowa...515/281-5011 Kansas...913/296-0111 Kentucky...502/564-2500 Louisiana...504/342-6600 Maine...207/289-1110 Maryland...301/974-2000 Massachusetts...617/727-2121 Michigan...517/373-1837 Minnesota...612/296-6013 Mississippi...601/354-7011 Missouri...314/751-2000 Montana...406/444-2511 Nebraska...402/471-2311 Nevada...702/885-5000 New Hampshire...603/271-1110 New Jersey...609/292-2121 New Mexico...505/827-4011 New York...518/474-2121 North Carolina...919/733-1110 North Dakota...701/224-2000 Ohio...614/466-2000 Oklahoma...405/521-2011 Oregon...503/378-3131 Pennsylvania...717/787-2121 Rhode Island...401/277-2000 South Carolina...803/734-1000 South Dakota...605/773-3011 Tennessee...615/741-3011 Texas...512/463-4630 Utah...801/538-3000 Vermont...802/828-1110 Virginia...804/786-0000 Washington...206/753-5000 West Virginia...304/558-3456

The following steps are recommended in creating a funding strategy for individuals in need of AAC.  Survey the funding resources that are potentially available to the individual.  Identify potential funding sources for the various activities in an AAC intervention.  Prepare a funding plan with the AAC user and family members.  Assign responsibility to specific individuals(s) for pursuing funding for each aspect of the AAC intervention.  Prepare necessary documentation for the funding request. Be sure to make all requests in writing so a written record is available if an appeal is necessary.  If the initial request is denied, appeal (with AAC users permission) for reconsideration, or identify new funding sources.  Proceed to a hearing (with the AAC users permission) is appeals are denied, or identify new funding sources.

Despite careful planning, families and potential users may have to wait to receive services while funding is sought (Beukelman, Yorkman, &Smith, 1985). Similarly, after the AAC team has completed assessment and made assistive device decisions, an AAC user may face a lengthy wait while additional third-party payment for the device is secured. Unless private funds are readily accessible, the "least dangerous assumption" with regard to funding is that such time lags will occur. Therefore, the AAC team must plan during assessment to 1) institute an interim system or device; 2) seek minor funding for equipment rental, which itself may take considerable time to obtain; 3) use an equipment loan service if one is available; and/or 4) arrive at some other creative solution to circumvent this constraint. AUGMENTATIVE COMMUNCATION Page 4 of 11

Tips for Choosing Augmentative Communication Devices The following tips are general guidelines to help individuals evaluate communication devices. While every person is different, these tips will apply to almost all users of communication aids.  Look for solutions that are easy to use. Computerized dynamic display screens allow individuals to compose messages using familiar methods which eliminates memorization of complicated codes and increases speed.  Choose portable devices. Portability allows nonspeaking individuals to take their “voices” anywhere.  Consider flexible devices. Look for devices that offer a variety of access options.  Require excellent voice quality. Sound projection and quality are obviously important. See if the voice output can be personalized.  Look for a device that “grows” with the user. Think about an individual’s needs a few years down the road. Can vocabulary be added and used quickly? Can the person use vocabulary independently?  Choose durable, reliable devices. Can the device withstand the stress of daily usage? Look for reliability. Make sure the battery life lasts long enough to meet a user’s needs.

Below are some devices purchasable on the internet.

Enkidu Palmtop Portable IMPACT Augmentative Communication Device NEW: Palmtop Impact now includes the full Mayer-Johnson symbol set and an expanded 128 MB storage card! Palmtop Impact is the smallest and most affordable of our communication devices, yet it offers all of the features supported by its larger cousins. Weighing just over a pound, the Palmtop offers unparalleled convenience and portability. The Palmtop is ideally suited for mobile users, but it can also serve as an unobtrusive mounted device for users with limited mobility. The Palmtop features a rugged, rubberized sleeve with integrated rechargeable speaker (nylon carrying case not included). If you need a "dedicated device" communication aid, a Medicare-approved Palmtop Impact-D version is also available. Both versions of the Palmtop offer the full range of great Impact features. The hardware utilized for Palmtop Impact (and Impact-D) is a portable computer (an HP iPAQ) running Microsoft's Windows CE operating system. Here are some technical specifications on the Palmtop: Weight: 0.4 lbs (computer alone) 1.1 lbs (in molded sleeve) Size: 5.1" by 3.3" by 0.6" (computer alone) 5.5" by 3.7" by 2.6" (in molded sleeve) Screen: 2.3" by 3.0" 240 by 320 pixels 65,000+ colors Ports: SecureDigital Card, infrared, USB/serial, headphone Battery: Rechargeable lithium-ion 6-10 hour life (depending on usage) Inputs: Touchscreen, scanning, rocker button Peripherals: AC power adapter, USB/serial cradle, molded rubber housing with rechargeable speaker AUGMENTATIVE COMMUNCATION Page 5 of 11 Enkidu Handheld Portable IMPACT Handheld Portable IMPACT combines a large keyboard (80% of full size) with a touchscreen to provide additional methods of message production. The expanded touchscreen means that you can have more (or larger) onscreen buttons, allowing for more varied augmentative interfaces. With its nylon carrying case, the Handheld can be used effectively while standing or sitting. If you need a "dedicated device" communication aid, a Medicare-approved Handheld Portable IMPACT-D version is also available. NEW: Handheld Impact now includes our new rechargeable speaker, the full Mayer-Johnson symbol set, and an expanded 128 MB storage card!

The hardware utilized for Handheld Portable IMPACT (and IMPACT-D) is a portable computer (the NEC MobilePro 780) running Microsoft's Windows CE operating system.

Here are some technical specifications on the Handheld: Weight: 1.8 lbs. (computer alone) 3.2 lbs. (in carrying case) Size: 9.6" by 5.2" by 1.1" (computer alone) 11.0" by 7.0" by 3.5" (in carrying case) Screen: 7.5" by 2.8" 640 by 240 pixels 256 colors Ports: Compact flash, PC card, infrared, USB, serial, headphone Battery: Rechargeable lithium- ion 6-8 hour life (depending on usage) Inputs: Touchscreen, keyboard, scanning Peripherals: AC power adapter, USB cable, carrying case, external speaker, speaker cable, splash guard Enkidu Tablet Portable IMPACT The rugged Tablet Impact has a large touchscreen (sunlight-readable display optional) and a sturdy nylon case so you can feel comfortable using it almost anywhere. With a full-sized VGA screen, the Tablet offers even more real estate for buttons, making it ideal for phrase- and symbol- based communication pages. If you need a "dedicated device" communication aid, a Medicare- approved Tablet Impact-D version is also available. NEW: Tablet Impact now includes our new rechargeable speaker, the full Mayer-Johnson symbol set, and an expanded 128 MB storage card! AUGMENTATIVE COMMUNCATION Page 6 of 11

The hardware utilized for Tablet Portable IMPACT (and IMPACT-D) is a portable computer (the Fujitsu PenCentra 200) running Microsoft's Windows CE operating system.

Here are some technical specifications on the Tablet: Weight: 2.0 lbs. (computer alone) 3.1 lbs. (in carrying case) Size: 8.9" by 6.5" by 1.3" (computer alone) 9.5" by 7.0" by 3.5" (in carrying case) Screen: 6.2" by 4.6" 640 by 480 pixels 256 colors Ports: Compact flash, 2 PC card, USB, infrared, serial, headphone, PS/2 (keyboard) Battery: Rechargeable lithium-ion 5-8 hour life (depending on usage) Inputs: Touchscreen, scanning, external keyboard (not included) Peripherals: AC power adapter, serial cable, carrying case, external speaker, speaker cable AUGMENTATIVE COMMUNCATION Page 7 of 11 Discover Complete Computer Access

Discover is the flexible, robust computer access solution that includes: * Choice of input methods to match users’ individual access needs * Complete keyboard and mouse alternatives optimized for various ability levels * Setups geared to match many software programs * Integrated speech software that aids in making correct selections and lets users communicate as they work

AudiSee What is the AudiSee Audiovisual-FM System? • The AudiSee is a technological breakthrough in assistive listening devices. It provides students with a hearing loss the opportunity to access the entire message, by combining their remaining hearing capabilities with visual cues. • Several studies have demonstrated that the combination of visual and audio cues is strongly correlated to message comprehension. How does it work? • The AudiSee system is intended for oralist people with hearing loss i.e. people with a hearing loss that communicate through spoken language and who usually have a Cochlear implant or hearing aids. The teacher wears a headset with a miniature camera and a microphone. The image and voice of the teacher is then transmitted to a small monitor placed on the student's desk or to a standard TV set placed in front of the classroom. In the classroom, what affects the hearing-impaired student most? • Surrounding noises (other students, chairs and desks moving) • Difficulty in seeing the teacher's face due to: The teachers movements Distance between the teacher and student Poor lighting Fatigue due as a result of efforts from deciphering the teacher's speech Why use the AudiSee System? The AudiSee allows the student to: Have uninterrupted access to the teachers face; Use his/her remaining hearing capacities through the use of their current FM system or the AudiSee system; Devote less energy on deciphering the message, therefore leaving more for learning; Be less stressed by knowing that he/she now has complete access to what is being said in class. The AudiSee allows the teacher to: Move around the class freely; Address all the students in the class, instead of being obliged to stand in front of the student with a hearing loss; Develop a privileged bond with a hearing-impaired student; Avoid having to repeat instructions. AUGMENTATIVE COMMUNCATION Page 8 of 11

iCommunicator Augmentative Communication System The iCommunicator™ software program, provides a multisensory, interactive communication solution for persons who are deaf or hard of hearing and other persons who experience unique communication challenges. The program is offered as an alternative rather than a replacement for sign language interpreters. The iCommunicator uses continuous speech recognition (CSR) to translate speech to text and/ or sign language in real time. Systematic professional training is strongly encouraged to maximize use of the unique features and capabilities of the system. The end user must be completely trained in the operation of the iCommunicator system to achieve positive outcomes. Adequate supports will need to be available for the end user with regard to technical assistance/support. Managers of the iCommunicator system should possess computer literacy skills necessary to use and maintain the system and train both end users and speakers in the unique features of this communication access technology.

ChatBox ChatBox and ChatBox-DX, voice output communication devices, combine the use of meaningful pictorial images with the latest technology to enable people who cannot speak to communicate easily and quickly with their families, friends and others. The newly enhanced ChatBox is designed for use by any individual who experiences cognitive and language limitations, brain disorders, cerebral palsy or conditions that result in temporary loss of speech. The addition of a deluxe model, ChatBox-DX, opens up a world of capabilities to individuals with visual difficulty or very poor motor skills. Both models can be programmed for the appropriate vocabulary, voice and native tongue of their user. They can be utilized effectively by individuals of any age as a primary aid to daily communication or as a "first" communication aid from which one transitions to a more flexible system. ChatBox and ChatBox-DX are affordable, entry-level devices which introduce a non-speaking individual to electronic voice aids. They are the only low-cost communication devices that use Minspeak, a language system based on combining multi-meaning icons to generate naturally spoken output via words, phrases or sentences. By organizing vocabulary around activities and situations, the beginning aided communicator is provided with sufficient vocabulary for use at home, school, work or play.

ChatPC-II ChatPC-II is Saltillo Corporation’s latest device combining the latest in electronic technology with powerful language capabilities. Built upon a powerful PocketPC computer, ChatPC-II offers a brilliant, color dynamic display along with both synthesized and digitized speech output. ChatPC-II has is a self-contained, truly portable communication device. This small device weighs only 17 oz. and includes a touch screen, amplified speaker and extra battery - all nestled in a protective rubberized case. ChatPC-II contains numerous features for adapting the vocabulary for the specific communication needs of the individual using the device. Approximately 8,000 Mayer Johnson PCS symbols are included for customizing and creating your own pages. You can also use the included PC Editor software to create pages and to import photos and other images from a computer. ChatPC-II also contains two preprogrammed starter vocabulary sets, which can save hours of setup time. A rubberized ‘body armor’ protects the ChatPC-II and enhances its ruggedness, sound quality and battery life. The body armor contains both a high quality audio amplifier and an additional battery that doubles the battery life of the PocketPC computer. General Features -Software and hardware volume control -On/off switch and auto power-down -1 hour to several hours of recorded speech (depending on sound quality) -DecTalk synthesized speech -Can hold thousands of customized communication pages -The device is accessed by finger touch - no stylus required. (Note: a stylus is helpful for programming because of the small size of the controls). AUGMENTATIVE COMMUNCATION Page 9 of 11 -Rechargeable (Lithium-Ion) battery. -Screen size: 4" (diagonal) -12 month warranty -Size: 3.5" x 5.8" -Weight: 17 oz. Brand New Features-In addition to the many features found on previous versions, ChatPC-II offers many new features including: -An improved color display which is easy to read inside or outside – even in direct sunlight -A powerful Ipaq palmtop computer -An additional battery that doubles the battery life of the Ipaq -All of the Ipaq features (stylus, connectors, control buttons) are accessible when the Ipaq is in the body armor -Storage memory has been doubled -Now contains approximately 8,000 Mayer-Johnson PCs symbols Customizing the ChatPC-II ChatPC-II includes many customizing capabilities that help you fine-tune the unit for the individual tastes and needs of the operator. The size, color, background and font of the keys can be customized for visual and cognitive perception. The touch-screen can be adjusted to meet the fine motor skills of the user. The messages and symbols on the keys can easily be changed. Pre-Loaded Vocabulary ChatPC-II includes two starter vocabulary sets, including VocabPC, a program designed for individuals with moderate cognitive disabilities and includes commonly-used carrier phrases, situational vocabulary and naming words. Plenty of space is left for customizing for individual needs. An implementation and instruction manual is included. Velocity, an optional vocabulary set is also available for ChatPC-II. Multiple Keyboard Options Although ChatPC-II is primarily a graphical system, it also has a spelling page for direct text generation. The user can easily navigate between the graphical and spelling pages. Graphical pages can be set up with a number of different keyboard layouts: 2x2, 2x3, 3x3, 3x4, 4x4, 4x5 and 5x5. PC Editor Software All customizing and programming can be done right on the ChatPC-II itself. However, software is included which allows all of the editing and customizing to be performed on a Windows computer. The PC Editor program also provides an easy means of importing photos and other graphics to be used as symbols on the ChatPC-II. Cables and instructions are included for downloading the vocabulary to the ChatPC-II. Carrying Case An optional carrying case is available for the ChatPC-II. The carrying case comes with both a shoulder strap and waist belt and has a clear plastic access panel so that the ChatPC-II can be used while inside the carrying case. Velocity Software Velocity is a new configuration designed for elementary school-aged children by Christine Scally (MS, CCC- SLP). Consistent organization and informative visual aspects of Velocity's design help the augmented communicator take advantage of its extensive content. It can provide fast and effective conversation in almost any situation. Its activity-based organization provides for fast and flexible conversations.

Program Information There are many programs that contribute to child augmentative technique users and their communication partners. These programs research on the impact of augmentation on communication interaction performance. Many observations are reported and are put into each program to make them specific to the level of severity.

The following is an overview of the steps in the instructional program needed to teach the use of an introduction strategy to someone who uses Augmentative Alternative Communication (AAC).

1. Specify the goal and complete baseline observations. Before you start instruction you must assess the individuals’ use or lack of use of an introduction strategy when meeting new people in real world situations. Define the specific goal for instruction and obtain the individual’s commitment to learn an introduction strategy and the commitment of the facilitators to support the instructional program. 2. Select introductory messages. Select appropriate introductory messages for the individual to use when meeting new people in a variety of relevant situations. AUGMENTATIVE COMMUNCATION Page 10 of 11 3. Teach facilitators to allow the individual the opportunity to use an introduction strategy. Teach the facilitators how to provide opportunities for the individual to use an introduction strategy and insure that the facilitators to continue to provide opportunities after instruction is completed. 4. Teach the individual to use an introduction strategy. Supplement instruction in the real world with practice and role play situations that stimulate the natural environment. 5. Check for generalization. Check that the individual has generalized use of an introduction strategy to a variety of real life interactions. 6. Evaluate outcomes. Meet with the individual and his or her facilitators, as appropriate, to determine the outcomes of the instructional program and to ensure that the individual and the facilitators are satisfied with these outcomes. 7. Complete Maintenance checks. Complete periodic checks within the natural environment after instruction has been completed to ensure that the individual continues to use an introduction strategy spontaneously when meeting new people.

Partners in Augmentative Communication Training, otherwise known as PACT, is a communication interaction facilitation program for child augmentative technique users and their communication partners. Based on contemporary research and clinical experience these preliminary intervention guidelines are directed toward development of more functional and rewarding conversational interactions for child augmentative technique users and their communication partners. The aforementioned critical points were carefully considered and the following eight assumptions made: 1. Prescription of augmentative communication techniques should be supported by an intervention program facilitating conversational communication interaction. 2. Intervention should involve the augmentative technique users and the primary communication partner. 3. Intervention should address critical communication needs and pertinent communication context. 4. Intervention programs must include assessment guidelines designed to identify target intervention behaviors and to monitor progress. 5. Intervention programs must be individualized to meet the needs and abilities of each augmentative technique user and partner. 6. The general goal of intervention should be to facilitate the most functional communication possible, given the constraints of the augmentative techniques and the user/partner abilities, rather that to mirror normal conversational processes. 7. The specific goals of intervention should address facilitation strategies for communication functions, mode selections, and discourse behaviors. 8. Intervention should address pertinent psychological issues (Culp & Carlisle, 1988).

Annotated Bibliography Beukelman, David R. and Mirenda, Pat. (1998). Augmentative and Alternative Communication. Paul H. Brookes Publishing Co. page 148 & 169 Presents a comprehensive approach to designing and providing augmentative and alternative communication (AAC) services for individuals with various congenital and acquired communication disorders, including those associated with cerebral palsy, autism, aphasia, and traumatic brain injury. It contains new chapters on literacy development and team building, plus more assessment forms, additional case examples, and references to available products, software, and Web sites.

Culp, Delva M. and Carlisle, Margaret. (1988). Partners in Augmentative Communication Training. Communication Skill Builders Inc. page 5-7. Exellent in improving communication between young augmentative technique users and their partners. Applicable for children who have severe expressive communication disorders, receptive language skills at or above the two-year level, and ability to use augmentative techniques with at least 20 symbols.

Light, Janice C. and Binger, Cathy. (1998). Building Communicative Competence with Individuals Who Use Augmentative and Alternative Communication. Paul H. Brookes Publishing Co. page 48-50 Offers goal-setting, teaching, and coaching methods for professionals and communication partners of people who depend on augmentative and alternative communication (AAC) systems. This step-by-step plan focuses on use of AUGMENTATIVE COMMUNCATION Page 11 of 11 an introduction strategy, nonobligatory turn taking, and asking partner-focused questions. Includes troubleshooting guidelines, techniques for adapting the instruction model to teach new skills, and forms for judging progress, plus case examples of children, adolescents, and adults. www.empowermentzone.com 10/31/03 Introduction to Funding Resources www.aac.unl.edu 10/31/03 Augmentative & Alternative Communication Centers www.neatinfo.net 10/31/03 Augmentative Communication Devices