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Wednesday, Oct 22, 2014

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Trembly 1

Noah Trembly, whose mobility and verbal communication are limited by cerebral palsy, shows students how he communicates using a device that translates symbols into speech for him.

Photo courtesy of: John McCarthy

Trembly2

Trembly wears a reflective adhesive dot on his forehead called a headpointer. It works much like a cursor on a computer, locking on to the images that he selects and translating them into the desired speech.

Photo courtesy of: Noah Trembly

Trembly 3

Trembly’s alternative communication device, called an ECO2, was developed by Prentke Romich Co., a global supplier of electronic communication devices based in Wooster, Ohio.

Photo courtesy of: Prentke Romich Co.

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This instructor’s lessons on alternative communication come through loud and clear


In the fast pace of everyday life, humans perform many functions almost as if on autopilot. Verbal communication – second nature to most of us – is a vital part of our interactions. But imagine if your every sentence, every word, required 10 times the patience, time and deliberation you put in to communicate now.

Enter Noah Trembly. Trembly, age 37 and a resident of Athens, is a wiz at computer programming and graphic design, and he has worked in the art world for years. He now works an ambassador for Prentke Romich Co., a global supplier of electronic communication devices based in Wooster, Ohio. He has received a grant from the company to participate in an alternative communication program unique to Ohio University.

Trembly teaches alongside John McCarthy, associate professor of communication sciences and disorders, part of the university’s College of Health Sciences and Professions (CHSP). Alternative communication is of particular interest to McCarthy, and Trembly is an expert. 

Trembly also has cerebral palsy, which severely limits his mobility and verbal communication.

“Noah is an extraordinary man, and I feel fortunate to have had the chance to work with him,” said McCarthy of their experience in educating students together. “He’s an extremely intelligent guy.”

Trembly and McCarthy have introduced students to the human element in the field of augmentative and alternative communication (AAC), which encompasses the numerous approaches used to assist people who have difficulty with verbal communication.
Part of what makes Trembly exceptional, McCarthy says, is that despite his physical challenges, he was able to get access to education, language and communication at a young age, thanks largely to his supportive family.

“He’s very fortunate that he had a family that’s just incredible advocates for him,” said McCarthy. “And they just continually hung in there for him. They were really at the forefront of a movement at the time that was really advocating for people with disabilities.”
Trembly uses a power wheelchair for mobility and a computerized synthesizer, called an ECO2, developed by Prentke Romich, that monitors his head movements and allows him to create speech. To properly use the ECO2, Trembly wears a reflective adhesive dot on his forehead. This dot, called a headpointer, works much like a cursor on a computer, locking on to the images that Trembly selects and translating them into the desired speech. This technology is the most advanced AAC product ever developed by Prentke Romich.

Like the many individuals who use AAC devices, alternative communication and the need for it are unique to every person. Some, like Trembly, use AAC due to a disorder originating from birth, such as cerebral palsy or autism. Others may use it in later years to combat the debilitating effects of a stroke or other type of brain injury. AAC devices alleviate communication barriers, making it easier to express needs and wants.

Trembly’s ECO2 enables him to communicate by translating icons that he selects into words, phrases and sentences. It also saves and stores conversations. The device’s icons tap into a person’s natural tendency to associate multiple meanings and interpretations with individual images. It employs a learning process that promotes independent and effective communication.

Because ECO2 allows the user to create and record previous conversations, Trembly has numerous amounts of words and combinations in his electronic vocabulary.

“He has about 5,000 words that are coded with those picture symbols that he uses most of the time during the day,” said Jennifer Monahan, a regional consultant for Prentke Romich. “He’s added so many words to his device that he’s probably closer to 6,000 or 7,000 by now.”

Monahan has known Trembly since 2007. Shortly after they met, she hired him as an ambassador for the company. Trembly helps her with events and she occasionally sends him out to schools to meet with kids.

“Pretty much anytime there’s someone else who needs to learn how to use a communication device, he is a role model,” Monahan said.
Because he had worked closely with the company and lived near a university that offered an AAC class, Trembly was selected by Prentke Romich in the fall to participate in a unique pilot project designed to educate students about AAC users.

“Right before [Prentke Romich] came to me with this proposal of this position, I’d recently stopped looking for a job that paid,” said Trembly. He spoke through his ECO2 by selecting responses that he had prepared in advance to written questions that an interviewer had provided.

“I was planning on working in the AAC field as an advocate and as someone who could help other people,” Trembly said. “So they said that they wanted to give me an actual paying job in the field. I was really excited to be a part of the project.”

Many users of AAC are people who, like Trembly, haven’t been working but could.

“I think [Prentke Romich] wanted to try and tackle that with some type of internship program that they could test out and potentially replicate,” said McCarthy of the project. “We’re the first to try out this kind of internship here, so we’re trying a lot of different things so that we can tell other programs.”

To help the students better understand his type of communication, Trembly would sometimes share his ECO2 screen with the class so everyone could see him as he composed his messages. He also kept office hours so students could sign up to speak with him one on one. This allowed the students to become more comfortable with him and better understand his unique approach to communication.

“I enjoyed it,” said Mackenzie Snyder, a communication sciences and disorders senior and one of Trembly’s students. “It was really interesting actually getting to talk to him and see how he communicated and … see what his device was like. I thought it was a really good experience for me.”

Trembly and his students also met outside CHSP for group discussions. They would often go to Baker Student Center or another public space.

“We really believed it was important to have people exposed to individuals who require AAC or just anyone who is different,” says speech-language pathology student Jennifer Kutney. “We think that people would be a lot more comfortable approaching someone like Noah if they see him out in the community and it’s not such a novelty to see someone need a device like that. We wanted Noah to be very visible to the campus throughout the process.”

Trembly works roughly 15 hours a week at Ohio University and continues to work closely with McCarthy. They are currently trying to extend the work they did in the classroom to an online class, and are looking into computer access into other platforms, like mobile devices. 

As Trembly’s one-year grant is ready to expire, he and McCarthy have also been exploring options to keep Trembly around after this year and extend his role at Ohio University.

“Our goal is after the first year of employment that [Prentke Romich] sponsors, then the university will take over and continue the employment for that person,” Monahan said. “It sounds like OU is really hopeful that they will continue employing him … so then we can share this with other universities and encourage them to do this same kind of thing.”

In the meantime, Trembly is involved in a variety of other projects. He is vice president of a state organization called Ohio AACTS (Ohio Assistive and Augmentative Communication Technology Services) and a member on the Athens City Commission on Disabilities.

“He’s just got an amazing attitude,” Monahan says of Trembly. “And he stands up for other people.” She described a trip Trembly took with her last year to the Ohio State House in Columbus to testify on behalf of children whose parents were being denied Medicaid funding for communication devices.

Trembly has been surprised by where his path has taken him in the past year.

“I didn’t know that I would be actually teaching instead of just being [McCarthy’s] assistant. I never imagined that I would end up in the field of education. You’ll never know where life might take you.”

Na’Tyra Green is a student writer for Ohio University’s College of Health Sciences and Professions.