 |
 |
|
||||||
|
|
|
 |
|||||
 ![[Horizontal Rule]](/webart/nav_rule.gif){kind=small}            Click here to learn about |
 ![[----------------Horizontal Rule----------------]](/webart/hrule.gif){kind=small}  Article 2: Nagi’s Taxonomy of DisabilityWhat exactly is the purpose of an AAC assessment? To get a sense of current thinking from the field, I spoke with communication specialists who said:2
A Broad Perspective Table I (not included) presents definitions and critical indicators from Nagi's Taxonomy of Disability, a widely accepted permutation of the World Health Organization's approach to classifying disabilities.3,4 This framework can assist in our international effort to clarify AAC assessment issues. According to Nagi, one need not go beyond examining a person to identify the presence and extent of his/her pathology, impairment and limitations in function. Communication, by its very nature however, is a relational concept. Thus, AAC intervention lies primarily at the level of Disability. Our unique challenge is to increase functional communication and assist people to develop or retain their connections with family and their memberships in society. Assessment efforts therefore should focus primarily on indicators at the level of Disability. Table II (not included) uses Dysarthria (i.e., difficulty speaking caused by paresis of the oral mechanism) as an example of Nagi's continuum across levels. Historically, professionals have focused most of their time and expertise at the levels of Pathology and Impairment. Not surprisingly, most available assessment tools in communication disorders address indicators at those levels. Also, professional training programs have emphasized intervention at these levels. In graduate school, I was taught to observe and measure semantic, syntactic, phonologic, and pragmatic aspects of an individual's language, and to assess speech-motor behaviors, articulation, phonological processes, voice and hearing. Results of these component analyses enabled me, as a speech-language pathologist, to diagnose, describe different types of dysarthria and suggest ways to remediate problems. However, these data told me nothing about how to help a person who was unable to speak manage everyday communication tasks, never mind participate in a regular education classroom or employment situation using AAC devices/techniques. Nagi's taxonomy makes it easy to understand why the field of AAC was due to emerge. Within the past two decades, an international shift in emphasis has occurred across health care, education, and social-based programs. Disability rights movements and technology have challenged long—held mindsets and moved people with disabilities into the mainstream of their families, communities and society. An increasing number of public policy mandates and laws now insure the stability of this shift. People with severe communication problems need help to participate in conversations, express opinions, talk on the phone, write, go to school, maintain a job, live independently, and so on. AAC is the intervention area charged with solving these communication problems. As such, the primary focus in the field of AAC is at the level of Disability with a secondary focus at the level of Functional Limitation. AAC intervention shall be judged as successful (or not) on the basis of what consumers, professionals, funding agencies, and the general public perceive as the value of our services, technology, and tools. Assessments provide the information needed to plan and implement interventions that lead to successful outcomes. At the level of Disability, the consumer and his/her partners have the information most essential to the assessment process. We need valid, reliable ways to measure these critical indicators.5,6 However, we are simply not oriented–at least not yet–to assess people at the level of their disability–where it counts the most!
This article appears in ACN Volume 7, # 1. You may order this issue by clicking on Ordering Home Page Online Ordering 
|
