Who and What Motivates Our Work?

Children with severe speech and motor impairments comprise a particularly vulnerable group. Most prevalent among their many different diagnoses is Cerebral Palsy (CP), the most common cause of childhood physical disability. Approximately one-third of children with CP have such severe motor impairments that they cannot use speech as their primary mode of communication. Thus, AAC is essential to support their communication needs. The most common form of AAC used by children and youth with CP is aided communication, which entails using symbols or letters presented on boards or electronic devices, which can be accessed in various ways (e.g., eye-gaze, switches). Children with severe impairments are at risk of not fulfilling their potential and being excluded from participation in activities and interaction with peers and in their communities. Their competencies are often not recognized by others, including professionals, because they are often perceived as difficult to assess. It is also often assumed that a severe communication disability implies severe cognitive limitations. Tools for assessment need to be developed that are appropriately adapted and culturally valid. Given that many children can use AAC to show their capability and competencies, it is critical to focus on environment-based assessment and intervention, such as assistive technology and communication aids. Strategies and tools can enable learning and give children a voice and choice, allowing them to play and engage – in turn, promoting positive developmental outcomes and, ultimately, the potential for self-determination.