FIP: Oregon Project Rehabilitation of Communication
Skills in Dementia through AAC
PI: Melanie Fried-Oken, PhD
Melanie Fried-Oken, PhD, of the Oregon Health & Science University, will draw on the skills of a community-based educator to teach licensed long-term care providers how to use an augmentative and alternative communication (AAC) strategy for persons with Alzheimer's disease. The technique, already proven effective in a previous randomized controlled trial (RCT), involves creating boards with pictures that help residents in residential care facilities remember what they want to say. Improved conversational quality is associated with reduced caregiver stress and burden and improved quality of life for people with Alzheimer's disease.
Read more about Dr. Fried-Oken's Field-initiated Project (FIP): Oregon Project Rehabilitation of Communication Skills in Dementia Through AAC. Dr. Fried-Oken depicts graphically via a logic model how her RUA project will extend the work of her FIP. The logic model was included with the narrative of her RUA proposal.
Since starting work in May 2007, Dr. Fried-Oken reports that the RUA is up and running. Progress for the first quarter is detailed in their first interim report, which includes copies of the instrumentation approved by the university's Institutional Review Board (IRB); Dr. Fried-Oken is using a questionnaire and observation form to assess the impact of the training. The questionnaire was available in Spanish. Project staff has met with all of the Alzheimer's Care Units to randomize the training schedule across the sites, and prepared the training materials for the long-term care providers.
Dr. Fried-Oken provided an update to the work as of November 1, 2007. With that report, she included a copy of the consent form they are using, and images of the clipboard used in the research, as it looks open and closed. Further progress through January 31, 2008, is detailed in her third interim report.
In their final report, Dr. Fried-Oken and her colleague, Charity Rowland, PhD, address the utilization outcomes that were proposed, and discuss research activities that were implemented to meet the project's specific aims. By the end of the 12-month project period, the community-based educator delivered the training to 93 licensed long-term care providers in 9 facilities. Fried-Oken and colleagues found that the boards improved conversational quality. The effect of training showed a general trend of a significant increase immediately after training and then a sharper decline in percent correct over time for those who were trained. The report concludes with a discussion of future implications.
The authors report that
the RUA can be viewed as a model demonstration project. First, the initial FIP objectives were derived from consumer-driven problems with opportunities for communication that were observed in clinical practice. The FIP research results fostered data-driven "best practices." The RUA translated results from the FIP into language that is accessible and provided supporting materials that were, indeed, manipulable [creation of SpeechKITS] by the intended audience. This, in turn, transferred knowledge that ultimately improved the lives of people with disabilities. It is possible to change the content of this RUA, AAC for persons with AD, and to use the same methods to obtain similar results with different populations, and perhaps beyond healthcare to other disability domains (such as education, employment). Certainly, the staggered treatment approach is a successful, objective way to measure training effects. It supports one of NIDRR's strategic goals, the promotion of effective use of scientific-based knowledge, technologies, and applications to inform disability and rehabilitation policy, improve practice, and enhance the lives of individuals with disabilities.
