Page 208 - Handbook of Electronic Assistive Technology

196 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

and/or visual difficulties, careful observation and interview information can reveal pat-
terns of intellectual functioning.

Activity and Participation

Participation in the context of the ICF model is described as ‘involvement in a life situa-
tion’ (WHO, 2001a,b). It has been proposed that the aim of the selection and provision of
an AAC system is to increase an individual’s participation through involvement in activi-
ties within the home and work environments, leisure pursuits and the building and main-
tenance of relationships through social interaction. As a result of this, clinicians working
to select and implement an AAC system must ensure that they are aware of the individual
client’s goals and needs for a communication system. This will include understanding the
range, type and frequency of activities undertaken and then ensuring that any AAC sys-
tem is functional in the context of these activities. This may include ensuring that an AAC
system is available to the user when it is required, either through the system being easily
portable or through its being mounted to a chair, or ensuring that the relevant vocabulary
is available quickly and easily within the selection set. The type and range of activities
in which an individual participates can be determined through informal discussion, or
through a range of structured measures which allow in individual to give their opinion on
which activities they would like to increase their participation in.

Environmental Factors

It is known that a range of environmental factors play significant roles in the adoption,
implementation and use of an AAC system: from the physical environment and its adapta-
tion, through personal, cultural and societal attitudes, to the support networks around an
AAC user (Lund and Light, 2007). One key environmental factor is the attitude toward AAC
of the potential user and their support network (i.e., family, carers, therapy and education
support, etc.). Even before the process of selecting and customising an AAC system begins,
clinicians should ensure that they have taken into account the extent to which an individ-
ual and their support network may be ready to discuss the need for such systems. Where an
AAC system is being implemented to replace a person’s speech, for example, in changing
or deteriorating conditions, such discussions may be highly emotive and it is important to
be aware of the sensitivity required in discussing the introduction of an AAC system.
The attitudes and confidence of those supporting an AAC user are also known to play
a key role in the successful implementation of a communication system. For children
starting out with AAC, it has been proposed that attitudes toward and confidence with
technology in general may have an effect on potential outcomes for children using AAC
systems (Clarke et al., 2016), with those less confident in the use of technology being less
likely to actively engage with supporting the system. Conversely, increased internet lit-
eracy and the availability of information about AAC systems, coupled with many devices
being based on mainstream hardware, means that many families and professionals will
have an increased familiarity with the range of AAC systems available and may feel more