Speech and language therapists usually work in:

• clinics
• health centers
• schools, and
• hospitals

as part of a multi-disciplinary team.  When a patient (adult or child) is experiencing a lot problems in expressing themselves, a speech and language therapist may introduce a communication aid that can either boost or replace speech.

Speech problems that hppen with cerebral palsy are associated with:

• bad respiratory (breathing) control as a result of weak muscles
• laryngeal (The larynx is sometimes called the voice box, because it contains the vocal cords) and soft palate dysfunction (The roof of the mouth has a bony front part, called the hard palate, and a soft part in the rear, called the soft palate. The soft palate arches at the back of the mouth to form a curtain between the mouth and back part of the throat), and
• articulation disorders that result from imprecise movement of the oral-facial structures.

The incidence of dysarthria (problems articulating words due to emotional stress or to paralysis, incoordination, or spasticity of the muscles used in speaking.) varies in relation to the type and degree of motor handicap in the person with cerebral palsy. Other communication disorders (e.g., hearing loss, language delay or disorder) may also be associated with cerebral palsy.

Speech and language therapists may also be involved very early on if a child has feeding, drinking or swallowing problems. If speech is difficult, or if there are any other problems with language, the speech and language therapist will work towards using programs to tackle the specific difficulty.

Some children with cerebral palsy have delayed language because they may not be able to play and explore like non-disabled children. Not being able to be understood by the people around him can influence the child's intellectual development, especially if parents don't take the extra time needed to understand their child's attempts at speech. Speech and language therapists will work with teachers, occupational therapists and parents to encourage proper learning activities.

Speech and language therapists might also supply communication devices, which help a child who is having major problems with language or speech. The use of sign language, symbol speech, or a communication aid will often reduce the frustration that a person feels if they can't communicate their wishes and desires.

Children may benefit from picture boards or other communication devices that allow them to point to a picture to let people know what they want. For school-age children or older people with CP, there are a los of augmentative communication devices (machines or programs designed to help people with speech problems communicate better), including shorthand typing programs and computer-assisted speech devices. A speech-language therapist can give useful advice on the kinds of equipment available. 

Parentsoften might misunderstand augmentative communication. They might think that oral speech and language skills won't be a part of the therapy program any more, and that the communication ''aids'' or devices will replace the oral communication skills the child already has. Parents fear that machines will make their child ''lazy'', and that he will totally depend on the machine to communicate. Because of this misunderstanding, parents might not agree right away to having their child learn other types of communication. To reduce some of these myths, think about similarities between augmentative communication used by typical communicators and individuals with communication disorders:

• lots of people use taped voice messages to pass on information (e.g., answer phones);
• business men and women use templates for written messages that are frequently sent; and
• drivers depend on road signs with picture symbols to pass on meanings.
• Augmentative communication devices can have taped voice messages to pass on information (e.g., ''Hello. How are you today?'');
• a template with words on a special subject (e.g., science: beaker, burner, observation) can be developed and used to complete class and homework assignments; and
• picture symbols can be used to get across a single-word or complete-sentence (e.g., a black & white picture of a burner means to place the beaker on the burner and heat the substance).

Augmentative Communication Devices:

Augmentative communication devices are tools that help people communicate more easily and effectively. These tools can range from a board with pictures representing a student's daily needs, to electronic speech synthesizers. This technology can help a child with disabilities feel more independent and join in activities with other children.

Manual communication boards are an inexpensive and practical way a person can communicate. The term "manual" means that the system does not involve any mechanical parts. An object such as a toothbrush, a photograph, a symbol, and/or printed words can represent the person's message. For example, Boardmaker is a program that can be used to create a communication board. Using Boardmaker, communication boards can be personalized to coincide with the child's daily routine.

BIGmack:  The BIGmack is a lightweight, easy-to-transport device that allows a message or a series of messages to be prerecorded. When the child touches a botton on the machine, the message is played back. When the prerecorded message corresponds to the classroom activities, the child can participate more.

Dynavox:  The Dynavox is an augmentative communication device that helps the user with output communication. To create a message, the child selects a menu with a specific category by touching the screen. The categories on the screen are similar to folders on a computer. When you open a folder, or category, subcategories are listed. Categories for a 10-year-old-boy might be school, home, and sports. The category "school" might be broken down into school subjects, school routine, people at school, etc. Those subcategories are broken down even further. The neat thing about the Dynavox is that the categories can be personalized to match up with the child's life and every day activities. For children who are learning how to communicate using the Dynavox, categories can be broken down into broad categories. Some children with cerebral palsy may not be able to use their hands well enough to use a device such as the Dynavox to talk. If this is the case, a switch can be hooked up to the machine with which they can use their hands, feet, head, or chin to push. If child has a visual disability, they can activate the device with a switch when the needed word or phrase is heard.

Delta Talker: Like the Dynavox, early or more advanced communicators can use the Delta Talker. This device look like a computer keyboard, but instead of writing words and sentences, different pictures and words are put together to make a sentence. The Delta Talker has picture and word keys in addition to the letters of the alphabet that allow it to produce over 4,000 sounds, words, and phrases. For children that are not able to target a specific area, a switch can be hooked up to the Delta Talker. Even with the assistance of a switch, this device is more complicated than the Dynavox.

Augmentative Communication Devices are making big advances, as computer technology allows more powerful and easier to use designs. It is rewarding that everyone can get the most out of technology.

For More Information visit the following web sites:

http://www.admin.state.mn.us/assistivetechnology/matln_website/resources.html

Boardmaker: http://www.mayer-johnson.com/main/index.html

BIGmac:  http://www.ablenetinc.com

Dynavox:  http://www.dynavoxsys.com/

Delta Talker:  http://www.prentrom.com

Below is a link to the story of a young women who was able to overcome her communication difficulties with the help on an augmentative communication device.

http://www.asha.org/public/speech/disorders/aac-growing-up-with-aac.htm