ABSTRACT
Visual aided augmentative and alternative communication (AAC) consists of books or technologies that contain visual symbols to supplement spoken language. A common observation concerning some forms of aided AAC is that message preparation can be frustratingly slow. We explored the uses of fMRI to examine the neural correlates of visual search for line drawings on AAC displays in 18 college students under two experimental conditions. Under one condition, the location of the icons remained stable and participants were able to learn the spatial layout of the display. Under the other condition, constant shuffling of the locations of the icons prevented participants from learning the layout, impeding rapid search. Brain activation was contrasted under these conditions. Rapid search in the stable display was associated with greater activation of cortical and subcortical regions associated with memory, motor learning, and dorsal visual pathways compared to the search in the unpredictable display. Rapid search for line drawings on stable AAC displays involves not just the conceptual knowledge of the symbol meaning but also the integration of motor, memory, and visual-spatial knowledge about the display layout. Further research must study individuals who use AAC, as well as the functional effect of interventions that promote knowledge about array layout.
Subject(s)
Brain/physiology , Communication Aids for Disabled , Space Perception/physiology , Visual Pathways/physiology , Visual Perception/physiology , Adult , Cerebral Cortex/physiology , Female , Functional Neuroimaging , Healthy Volunteers , Humans , Learning , Magnetic Resonance Imaging , Male , Memory/physiology , Pattern Recognition, Visual/physiology , Young AdultABSTRACT
PURPOSE: The purpose of this article is to summarize the research on the possible benefits of care coordination for children with special health care needs and explore potential roles for physical therapists in care coordination, including roles as primary care coordinators, members of interprofessional teams, advocates, and researchers. KEY POINTS: The medical home model is described. Benefits of care coordination are reviewed. Potential roles for physical therapists in care coordination are outlined. The barriers to care coordination are reviewed and recommendations to reduce barriers and better prepare therapists for care coordination are offered. CONCLUSION: Therapists need to be aware of and adapt to change in care models to be the provider of choice.
