Rosana Cruz
Meet Rosana
Rosana is a delightful and hard working nine year old. She has spastic quadriplegia cerebral palsy. She is non-ambulatory and uses a power wheelchair. She can vocalize some vowel sounds and uses vocal inflection, but has no intelligible speech. Rosana lives in Watsonville, CA with her mother and brother.
The Clinician’s Report
Shannon McCord is an Assistive Technology Specialist and Orthopedically Impaired Specialist. She has a Ph.D. with an emphasis in augmentative and alternative communication (AAC). She works part time for the Pajaro Valley School District in Watsonville, CA, and provides services through her private practice. Her entire caseload is augmented communicators.
Rosana’s Strengths and Challenges
When Shannon first met Rosana, she attended a preschool classroom for children with moderate to severe needs. Although Rosana had no speech, she had an incredible desire to communicate. Rosana was independent and preferred to get things on her own and do what she wanted. Spanish and Mixteco, the Spanish dialect used by her mother, were spoken at home. Rosana was being introduced to English at school. At that time, it was assumed that Rosana had some cognitive delays.
Her First PRC Device and Early Vocabulary
Rosana first received a Vantage Plus when she was in kindergarten. Because of her limited ability to understand English, she started out on a hybrid 45- location one-hit vocabulary with both Spanish and English. All of her initial words required just one hit. She used it immediately to participate in circle activities, using typical early academic vocabulary such as the days of the week and the names of colors.
Access Method
Rosana has functional control of her right hand, which she uses to access the keys on her Vantage.
Therapy Strategies
Shannon sees Rosana twice a week in her classroom. She focuses on helping Rosana participate in grade level curriculum as well as refining her language and writing. At times, Rosana chooses to work through recess to keep up. Shannon also consults with Rosana’s speech pathologist, who works with Rosana twice a week. After some time working with Rosana and her Vantage, her speech pathologist commented that it was just like teaching language, but the voice was being produced by the Vantage.
Communication Now
In first grade, Rosana used her Vantage to request assistance, using utterances such as “get pencil please” or “help chair please.” Rosana is now in third grade. Shannon feels Rosana has no cognitive deficits, and that she is reading at grade level. Her language for communication is growing, thanks to the Unity vocabulary in her Vantage. She now uses 84 key locations and uses sequences of icons to generate words in English. According to Shannon, Rosana is reluctant to use pronouns, but can do so when requested. She has some difficulty with word order, which is not unusual for a child who has grown up without intelligible speech. Shannon purchased a new bed for Rosana, and Rosana said, “bed new,” followed by “I have.” She then repeated her message, using standard word order. She also said, “Shannon thank you bed.” Rosana is learning to use “-ing” verbs, and is adding many small details to her sentences, including words like “to,” “a,” “the,” and “my.” She wrote about going to the university class Shannon taught, saying, “Saturday I went you class.” She participated in a Jeopardy game that day during class saying, “What is triangle?” The message Rosana uses when she drops her pencil has progressed from “get pencil” to “get pencil please,” and is now, “Rosa, get my pencil please.” Shannon feels that Rosana’s communication has become much more sophisticated, and that Rosana can now find many words with very little effort and remarkable speed. Rosana reviewed the draft of this case study and wanted to add, “I’m going my home now. I’m not going Sylveria, the babysitter. Now grade third. I can read and multiply. Good bye.”
How the Device Has Changed Rosana’s Life
Recently, Rosana received a new Vantage Lite. She continues to benefit from the same language organization of Unity, and now is enjoying the new look and software features of the Vantage Lite. In addition to using her Vantage Lite to talk, Rosana uses it to leave phone messages. Her use of the Vantage Lite for classroom participation has increased as well. One day she didn’t have access to her desk because her wheelchair needed to be charged. The class activity involved copying down words written by the teacher, and then writing the definition. Because her laptop wasn’t available, she used the Unity vocabulary in her Vantage Lite to write the words and the definitions. This was actually much faster for her than typing the words in her laptop. Rate of communication is important to Rosana when keeping up with grade level work. She now uses her Vantage for many classroom activities. Rosana demonstrates her resourcefulness in using her Vantage to “read” directions for her homework that she types into her device. This helps Rosana be more independent doing her schoolwork at home.
Rosana at AAC Camp
When Rosana attended Bridge Camp, she wanted to meet the other campers and have access to their names. Shannon created an Activity Row on the Vantage for their names, and taught Rosana how to add them.
Rosana in School
Rosana’s teacher encourages Rosana’s participation in class activities. During choral reading, Rosana follows along with her finger, and vocalizes “ah” accompanied by appropriate inflection. If Rosana loses her place in the text, or fails to vocalize, her teacher pauses and asks, “Rosana, are you with us?” When it is Rosana’s turn to read, her teacher asks her to read the next three words using her Vantage or to tell her a couple of words from the sentence. Her responses give the teacher an impression of what Rosana can read.
Rosana’s ability to communicate with her Vantage has earned her the respect of her classmates. She understands most of the directions given in her classroom. In the rare event that Rosana needs help with comprehension, the challenging content will be repeated for her in Spanish. Rosana is now able to attend a general education classroom that is English only, and she understands at grade level.
Shannon feels that the Vantage is not only the key to helping Rosana continue at grade level and be an active participant in her class, but that the ability to communicate is critical to Rosana’s future independence. Rosana is learning about street safety and is also learning to ride the bus and how to tell the bus driver where she wants to go.
The Parent’s Perspective
Rosana’s mother Fidencia sees a difference in their lives at home since Rosana started using her Vantage. Before getting the Vantage, communication with Rosana was difficult. She was sad and cried often because her mother could not understand what she wanted to eat or do. Fidencia was very frustrated because she did not know how to help her daughter. These communication challenges and Rosana’s inability to communicate her feelings and express simple wants and needs affected every part of their lives.
Since Rosana received her Vantage three years ago, communication between Rosana and her mother has greatly improved, and so has their relationship. Her mother is now able to understand what she wants and needs and is surprised and pleased with all the words that Rosana knows. “Rosana seems older and more independent,” says Fidencia. “She is able to go to her room and do her homework on her own, and has also begun to read books.”
Her mother also appreciates that Rosana is a very intelligent little girl with a lot to say. She is now able to talk with others and tell them about her life. Rosana also tells her mother that she loves her and even bosses her brother around. In addition to her improved communication, Rosana does not need to go to the doctor as often and is eating better and gaining weight. “She is ‘mucho contenta’ …very happy,” says Fidencia. And that makes her mother happy too.
Videos
-
Learning to Make Sentences
-
Using the Vantage to Write
-
Time to Chat
-
Playing Hangman
-
Learning to Use "A" and "An"