Chair of the Governing Board of 'ASSIST - Assistive Technologies' Foundation

deputy representative of UNICEF in Bulgaria

state expert, Inclusive Education Directorate, Ministry of Education and Science, Bulgaria

Head of the "Integration of People with Disabilities" Department, Ministry of Labor and Social Policy, , Bulgaria

secretary-general of State Agency for Child Protection, Bulgaria

chairperson of NAPWCSES (National Association of Professionals Working in Centers for Special Educational Support)

professor emeritus at University of Oslo, Norway

President of ISAAC (International Society for Augmentative and Alternative Communication)

President of AAATE (Association for the Advancement of the Assistive Technology in Europe)

Professionals’ views are valuable as aligned with evidence-based practice that integrates current research evidence, professional expertise and client perspectives. This presentation will focus on a study exploring professionals’ viewpoints on components of a person-centered AAC intervention for those with dementia. Using Q-methodology, professionals with relevant experience (n=61) were recruited to rank and sort a set of 37 statements electronically on a grid from least agree to most agree. Statements were associated with the elements of person-centered care; an electronic life story conversational aid; AAC outcomes; and an AAC outcome measure for people with dementia. By-person varimax rotation was used for factor analysis. Professionals were mainly speech-language therapists (n=25) with specialization in AAC (n=19). Three viewpoints emerged: (i) people with dementia should be supported in authoring their own life story content, (ii) conversational partners should use person-centered language style with AAC strategies, (iii) developing social connection with people with dementia are important interaction goals. This presentation will highlight considerations for crafting future person-centered AAC interventions for people with dementia. ====================== Here is the link to sign up for the free e-book : Fast Facts: Dementia and AAC (includes a free downloadable resource). https://karger.com/books/book/3316/Fast-Facts-Dementia-and-Augmentative-and

Many hospitalized patients have substantial difficulty communicating with those around them. Temporary or permanent loss or impairment of communication is difficult on the patient and on the family. It hinders recovery and creates a great deal of frustration for all involved. We created a tool that provides basic guidance designed to enable communication with the hospitalized patient in a variety of ways. These tools make immediate communication possible. It is actually an online guide that can be accessed via the Center's website. The Guide is built in the form of a flowchart and uses simple “yes and no” questions to direct the user towards a simple solution that can be downloaded. Use of the Guide does not entail registration or entering of personal information, and it is free of charge. In the presentation we will explain the sequence in which the main elements of the Guide was created, show the tools and demonstrate how to use the Guide.

Alternative and Augmentative Communication (AAC) boards are usually created by a SLP, which is her specialty. Symbol boards are built by combining appropriate symbols from an international list of symbols into a unique board for a particular person. Here, for the first time in Israel, a kit of communication boards was built for Legal Aid lawyers to use in civil proceedings in the representation of people with disabilities, who have difficulty expressing themselves in speech or organizing the message. The boards were adapted to the professional legal vocabulary, and to the work of the lawyers. In addition, a number of unique symbols were developed for this purpose. The boards will help a person to conduct a civil legal process, and will allow the lawyers and the court to communicate better with that person and to promote the legal process. The kit includes a series of boards for various civil procedures, with adjustments according to the types of procedures, for representation in situations of communication challenges. The project was developed by an expert team, as a project of the Legal Aid with the support of the Ministry of Justice. The boards will be at the service of the lawyers in the Legal Aid, in meeting with clients with disabilities and in the courts.

Evaluating the effects of AT/AAC interventions is a fundamental yet often neglected aspect of any service delivery process. This contribution aims to highlight recent trends in outcome assessment, underscoring the challenges and opportunities this activity presents for service providers and their users. Special attention will be given to assessing the effects of AAC interventions, with a presentation of the Family Impact of Assistive Technology Scale for Augmentative and Alternative Communication (FIATS-AAC). References: https://rehab.jmir.org/2023/1/e51124 https://doi.org/10.1007/978-3-031-40858-8_49-1

Identifying beginning communication attempts in persons in a minimally conscious state: Implications for health care practitioners // Individuals in a minimally conscious state (MCS+) are characterized by fluctuating alertness and varying degrees of self-awareness and environmental recognition. They may sporadically follow simple, one-step commands and exhibit inconsistent responses to yes/no questions. Their use of objects can be functional yet incongruous, vocalizations may be irregular, and their intentional communication skills can vary widely. These inconsistencies make it difficult for health care practitioners to recognize and interpret early neuro-behavioural signs indicative of alertness, awareness, and communication attempts, leading to potential misinterpretations or overlooked cues. In this presentation, based on the research of Kuyler et al. (2022; 2023), I will discuss two studies: a scoping review on unaided communication methods (Kuyler et al., 2022) and a synchronous online interview with primary caregivers of individuals in an MCS+ state (Kuyler et al., 2023). I will highlight key early communication signs that healthcare practitioners should recognize. By equipping practitioners with the skills to observe and interpret these early behaviours, we can facilitate appropriate responses and strengthen initial communication attempts in this vulnerable population. References Kuyler, A., Johnson, E. & Bornman, J. (2022). Unaided communication behaviours displayed by adults with severe cerebrovascular accidents and little to no functional speech: A scoping review. International Journal of Language and Communication Disorders, 57(2), 403- 421 https://doi.org/10.1111/1460-6984.12691 Kuyler, A., Johnson, E. & Bornman, J. (2023). Multimodal communication reported by familiar caregivers to build communication capacity in persons who are minimally conscious. International Journal of Speech-Language Pathology, 25(4), 523-539. https://doi.org/10.1080/17549507.2022.2096926

Cerebral palsy (CP) is the most common cause of motor impairments in children. The incidence is about 2 per 1000. Approximately one-third of children with CP have no or very little speech and are in need of augmentative and alternative communication (AAC). This comprise both children who need AAC due to motor impairments, either as an alternative or a supplement to speech, as well as children who in addition to the motor impairments have severe cognitive impairments. Children with CP can therefore be found in all three AAC user groups: the expressive group, the language support group, and the alternative language group. In Norway, all children with CP are followed at the pediatric habilitation centers, which have national coverage. With parental consent, information from this follow-up is registered in a national medical quality registry, the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP), which currently comprise 96% of all children with CP in Norway. It the talk, results from the follow-up of children with CP and need for AAC will be presented, as well as a presentation of our newly launched national guidelines on the identification, assessment, and follow-up of communication in children with CP.

We will delve into the results from the health economic study that was commissioned by Tobii Dynavox and conducted in Sweden by Augur, an independent company, and Health Economist, John Moshtaghi-Svensson. The study explored the impact of high-tech AAC on individuals with cerebral palsy (CP), autism spectrum disorder (ASD), and amyotrophic lateral sclerosis (ALS) and their caregivers as well as the substantial return on investment that these devices offer to society. But this isn’t just about technology—it’s about human potential, societal gains, and driving policy changes to secure the necessary funding to make high-tech AAC accessible for all who need it.

This session explores how two AAC tools—TD Snap Aphasia and TD Snap Express—can be tailored to support a wide range of communication needs, from aphasia to autism and intellectual disabilities. Each tool meets users where they are, with TD Snap Aphasia offering a streamlined layout for individuals regaining communication skills and compensating for deficits, and TD Snap Express providing a context-based setup that suits users who benefit from quick, theme-based communication in everyday settings. Success in AAC is unique for every individual. For some, it may be creating a simple sentence; for others, it’s the small act of showing a preference or signaling discomfort. Recognizing these milestones, however subtle or different from initial expectations, is essential for both the AAC user and their support network. Progress is a shared journey—each step, no matter how small, boosts confidence and connection for everyone involved. Join us to explore how TD Snap solutions can be flexibly applied to celebrate progress at every stage, helping families, caregivers, and professionals create a positive, responsive environment that encourages each AAC user to grow and communicate in their own way.

Let's talk about how you can support prospective AAC users through their AAC journey in the best way possible. In this talk Becky will explain the main considerations during assessment stages, access method options, content types, and so much more. You can watch the presentation here: https://youtu.be/lhcFl8s3h3Y

Angela Pencheva will present her new book, “My Struggle for a Bit of Independence”, published by Kibea Publishing House: https://kibea.net/book/3414. This is Angela’s third published book. She is also the author of the autobiographical book “My Life: To Have a Left Thumb”, as well as the poetry collection “My Confession”.

Resources for Culturally and Linguistically Affirming AAC - https://sanfranciscostate1.padlet.org/gsoto37/resources-for-culturally-and-linguistically-affirming-aac-u91z14o134w35jfk

PWA represent a marginalized group in our society; they experience significant healthcare inequities along the rehabilitation path, when compared to their peers without aphasia. The literature is ripe with stroke recovery studies that unequivocally exclude PWA due to their aphasia! Compared to stroke survivors without aphasia, PWA experience more adverse events, longer hospital stays, higher mortality rates, higher rates of depression and social isolation, and lower functional independence. There is a pervasive lack of AAC supports during the early stages of stroke recovery. This is analogous to stroke survivors not receiving a wheelchair, walker, or cane if they need mobility support. This creates a recipe for adverse events during the hospital stays, making successful patient-provider communication and healthcare decision-making impossible for some. Considering these harrowing challenges, this talk will review recent work that disputes the long-held notion that AAC interferes with language recovery in people with chronic aphasia [PWcA] —and that it can be successfully adapted for people with all types of aphasia and for all communication purposes. An overview of steps to move the field forward will be offered, including collaborating with key partners, including stroke survivors, family members, and clinicians.

Post-stroke aphasia can affect a person’s ability to use and understand language, and can have a debilitating effect on everyday interactions, interpersonal relationships and participation in many valued life activities. AAC systems and approaches that require semantic and grammatical skills are often minimally successful to improve communication of a person with aphasia. In this presentation, I will argue to AAC can help persons with aphasia, but that a broad conceptualization of AAC is needed that includes unaided methods and partner support strategies. The goal of AAC intervention should likewise be broadly conceptualized in terms of regaining and maintaining relationships, opportunities for meaningful participation and adaptation to new roles. The pragmatic skills and world knowledge of a person with aphasia typically represent strengths that can be harnessed. The functional classification system by Garrett et al. (2020) will be used as a framework to identify potential intervention strategies for different groups of adults with aphasia. Reference Garrett, K. L., Lasker, J. P., & Fischer, J. K. (2020). AAC supports for adults with severe aphasia and/or apraxia. In D. R. Beukelman & J. C. Light (Eds.), Supporting Children and Adults with Complex Communication Needs (Fifth, pp. 553–603). Paul H. Brooks Publishing.

We present several case studies on the use of AAC in the education, communication enhancement, and interaction of students with multiple disabilities with their environment and others. We share success stories, strategies, and best practices, demonstrating how AAC can be personalized to meet the needs and abilities of each student at the center.

We will present data on several cases of AAC use with late talking toddlers. While the literature often does not consider late talking toddlers as obvious candidates for AAC, we have found that, in the right circumstances, AAC can have quick positive outcomes on communication, both spoken and aided. We used AAC with late talkers following a failed spoken language intervention. We will share our rationale, our approach, and the findings from several children.

The communication needs of patients with amyotrophic lateral sclerosis (ALS) change over time with the progression of the disease. Augmentative and alternative communication (AAC) and should be considered from the beginning of care and should be monitored and adjusted regularly. This presentation will discuss evidence-based standards of care to support optimal implementation of AAC from onset of first symptoms to end of life in order to maximize independence at each level. Low-tech and high-tech AAC supports, including off the shelf and dedicated systems, to consider across the continuum will be reviewed.

In general education institutions, there is a lack of awareness and appropriate training regarding what AAC is, who can benefit from these tools and technologies, and how they are applied in practice. Regional Centers for Support of the Process of Inclusive Education (RCSPIE) play a key role as supportive structures to advance this process, including enhancing the capacity of teachers and parents to use AAC. As part of the "Voice for Every Child" project, 13 RCSPIEs across the country established professional communities to support specialists and teachers working with children with communication needs and requiring AAC. The report tracks the impact of the application of these Professional Support Communities over the course of an academic year.

This report will present the experience of resource teachers, speech therapists, and psychologists from the Regional Center for Support of the Inclusive Education Process in Gabrovo in introducing and using augmentative and alternative communication (AAC) tools over the past three years. Practical strategies that specialists have adapted to meet the needs and abilities of children and students with complex communication needs in kindergartens and schools will be shared.

The children’s book with symbols, "The Tale of Sami, the Impatient Little Elephant," aims to support the inclusion of children with communication challenges in kindergarten and encourage interaction with their peers using communication aids. Sami's story illustrates how augmentative and alternative communication helps children express their thoughts and feelings and communicate freely with their friends. The tale promotes cooperation and mutual support. The book also contains fun challenges through which all children can explore communication with symbols and learn to use them.

The current presentation focuses on the practical application of AAC in working with children with complex needs—motor, sensory, cognitive, language-speech, emotional-behavioral, and other challenges. The introduction and successful implementation of AAC is a dynamic process influenced by numerous factors. Cases of children with complex needs are associated with many challenges, among which communication skills often take a back seat. However, practice and various scientific fields demonstrate that finding a functional means of communication is the primary "driver" of child development and full participation in life. This is why, in such cases, AAC should be among the first strategies considered in the context of education, care, and therapy. A functional assessment of needs, a client-centered approach, modeling, support, and a great deal of patience are the key "assistants" for the successful introduction and use of AAC. This presentation includes the case of a child with a rare genetic syndrome, exhibiting significant motor, praxis, sensory, and cognitive difficulties, and the outcomes achieved through systematic AAC use over the past five years.

Communication for individuals with severe communication disorders is a lifelong challenge. This group includes both children and adults facing multiple difficulties and diverse diagnoses, such as autism, Down syndrome, cerebral palsy, intellectual disabilities, aphasia, and many others. Difficulties in understanding and expressing themselves impact not only daily life but also the learning of new skills and knowledge, as well as handling various and unforeseen situations. Developing communication skills from early childhood is crucial for the harmonious development of each individual. Amid the growing need for a modern and established method for finding suitable ways and tools to enhance these skills, we will discuss the Training Program in Communicator 5 for speech therapy practice and the specific aspects of introducing and using Augmentative and Alternative Communication (AAC) as a means of communication and learning. The training program was developed by the foundation "ASIST – Assistive Technologies" as part of the project "Development of Communication and Learning Skills for Children and Youth with Severe Physical Disabilities through Eye-Gaze Control Technologies," implemented with the financial support of the European Social Fund, Operational Program HRD, under the procedure "Discover Me." It has been integrated into Communicator 5 and includes a wide range of interactive activities. It can be used for assessing functional abilities necessary for both learning and communication. The program offers effective individual learning plans and development of communicative skills for children and youth with severe speech and fine motor impairments. In the speech therapy sessions at the Center for Special Educational Support (CSES) – Dobrich, I work with 14 children using this training program. Working through these key modules provides children and youth with the opportunity to communicate, learn, and have fun simultaneously. Daily exercises aimed at developing their skills build confidence for better communication in everyday life.

The talk presents the skills and needs of children and students with special educational needs for learning and communication through augmentative and alternative communication (AAC) and eye-control systems. It follows different levels of development and selection of AAC tools to support the corrective and educational work of the specialist. The focus is on honoring the most beautiful human right – the right to choose.

The presentation content focuses on showcasing case studies of students with special educational needs from the authors' professional practice. The team outlines key challenges faced by children and students with impaired or absent expressive speech, both in their educational journey and in their personal relationships and social interactions. The presentation traces the positive changes that occur in the lives of the students as a result of interventions aimed at introducing and enhancing AAC skills as an established model of communicative functioning. It examines the contrast between the periods before and after mastering communication abilities, learning, meaningful leisure activities, and social interactions in diverse situational scenarios facilitated by the AAC system. In conclusion, findings emphasize the urgent need to scale the concept and attitudes toward implementing AAC methods at local and national levels. Presentation team: Katalina Petkova – Special Education Teacher, CSES, Plovdiv Todorka Kaloferova – Special Education Teacher, CSES, Plovdiv Maria Petrova – Special Education Teacher, CSES, Plovdiv Dimitar Kozarev – Psychologist, CSES, Plovdiv