Transcript Strategies for Literacy and Language Development for the Young

AAC
Augmentative Alternative
Communication
Cindy Nankee
CESA #3
WATI Consultant
[email protected]
Agenda
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Share assessment experiences
Showcase low, mid & high tech AAC
Communication Symbols
Ideas for Using AAC
Set Up Success
Educational Opportunities
Planning Communication Boards – the
80/20 rule
• Boardmaker
Session Objective
• Participants will increase knowledge of low to high
tech AAC materials, devices and software.
• Participants will increase knowledge of AAC
implementation in therapy, in the classroom, in the
home and in the community.
• Participants will understand strategies for success
in using a communication system
• Participants will increase knowledge of AAC
resources.
• Participants will create materials using
Boardmaker software
Name some ways we communicate
Crying
Eye contact
Sounds
Words
Pointing
Falling asleep
Screaming
Silence
Communication
boards
Picture exchange
system
Voice output
systems
Gestures/signing
Hair-pulling
Body position
Augmentative/Alternative
Communication
AAC
*refers to the ways (other than speech) that are
used to send a message from one person to
another (ASHA, 2005)
Examples
• Communication boards/books/picture symbols
• Voice output communication devices (VOCAs) now
referred to as (SGD) Speech Generating Device
• Picture Exchange Communication System (PECS)
• Morse Code
• Eye Gaze
AAC is not….
“Giving up” on speech
Only for those of a certain IQ
Only the job of the speech-language pathologist
Just “HIGH TECH” devices
A “one-time only” endeavor
AAC can be a vehicle for developing:
expressive language
receptive language
literacy
control over the environment
communication initiation
Which leads to…
• increased academic success
• increased participation in
social situations
• increased self-esteem
• increased job
opportunities
• And more…
Individuals Who Might
Benefit from Visual Tools…
– Pre-Readers
– Communication
Delays/Disorders
– English Language
Learners
– Attention Deficit
Disorder
– Comprehension
Problems
– Learning
Disabilities
– Developmental
Delays
– Traumatic Brain
Injury
– Down Syndrome
– Autism Spectrum
Disorder
– And many more…
Assessment
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ASNAT
AT Checklist/AT Wheel
STAGES
ATLAS
Evaluware
TASP Test of Aided-Communication
Symbol Performance
• Communication Matrix
– www.designtolearn.com
– Online Free/hard copy $8.00
Online Communication Matrix
• The Communication Matrix is an
assessment tool designed to pinpoint
exactly how a child is currently
communicating and to provide a framework
for determining logical communication
goals.
• This online version was designed especially
for parents
• The parent version is designed to be "user
friendly"
• Results on a one page Profile
Showcasing Low to High Tech AAC
The WATI Continuum
Communication board or book
Eye gaze frame
Simple voice output device
Voice output device with levels
Voice output device with icon sequencing
Voice output device with dynamic display
Devices with speech synthesis that use typing
Communication Boards Should
Include...
• Vocabulary that reflects all 4
categories
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Wants & Needs
Exchanging Information
Social Interactions
Social Etiquette
• Using the available symbols, could you
communicate about an activity in all
categories?
Communication Boards
http://www.ange
lfire.com/pa5/as/
asteachersites.ht
ml
Communication book
www.autismshop.com
Placement of Communication
Boards
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Mount on Wheel Chair
On Desk/table
On locker
On Wall/ by bathroom/ sink
Play areas
Work area
Kitchen area
Eye Gaze Frame
Simple Voice Output Device
AbleNet
www.ablenetinc.com/
BIGmack Switch
(800) 322-0956
Voice Output Device with Levels
http://www.amdi.net/
www.attainmentcompany.com
Voice Output with Icon
Sequencing
Pathfinder,
Prentke-Romich
Company
http://www.prentrom.com
Voice Output with Dynamic
Display
Mercury
DV 4 and MT 4
E-Talk
Palmtop
Tango by Blink Twice
www.blink-twice.com
Speaking Dynamically Pro
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AAC Software with speech output
www.mayer-johnson.com
Windows and Mac
Create personalized dynamic,
multilevel, talking boards
• $649.00
Type and Talk speech Synthesis
Tablet PC Speech Assistant
www.herbi.org
Terms/definitions
• VOCA – Voice Output Communication
Device
• SGD – Speech Generating Device
Companies handling dynamic
display devices
• www.dynasys.com DV4, MT4, MightyMo,
DynaWrite
• www.prentrom.com Pathfinder, Vantage,
Vanguard, Springboard
• www.aacconnections.com Mercury,
MiniMerc, Enkidu
• www.blinktwice.com Tango
• www.attainmentcompany.com E-talk
More on
Communication Symbols
1. Like
2. Again
3. Show me
4. Whole
5. Past
6. Fast
7. Correct
8. Short
9. Tomorrow
10. Word
11. Communication
12. That’s crazy!
Communication Symbol
Guideline
– REAL OBJECTS
– TANGIBLE SYMBOLS
– TOBIs (true objectbased icons)
– COLOR PHOTOS
– BLACK & WHITE
PHOTOS
– LINE DRAWINGS
– PICTURE
COMMUNICATION
SYMBOLS
– TEXT W/ PICTURES
– TEXT & LETTERS
Object Communication
System
www.adaptivation.com
Tangible Symbols
• Tangible symbols are objects or pictures
that stand for or represent something
about which we need to communicate.
A T.O.B.I. can be a line drawing,
photograph etc. which is cut out in
the actual shape of the item it
represents
When Billy gets home from
school…
Line Symbols
Picture Communication Symbols
Text with Pictures
Communication Board with
words/letters/numbers
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In Therapy
In the Classroom
In the Home
In the Community
Behavior Regulation
Why Use
Visual Tools and Strategies…
Hodgdon, 2002
Give students information about their activities
Prepare students for what will or will not happen
Reduce the anxiety that comes from the unexpected,
especially during transition times
Help students understand the concept of “finished”
Provide the structure for appropriate behavior and
participation
Support communication and conversation
AAC in Therapy
Schedules and Calendars
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Tools to Give Information
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Tools to Make Choices and Requests
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Tools for Protesting and Rejecting
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Tools for Behavior Regulation
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Picture Schedules
 What is it? A visual representation of a
span of time or of a specific activity.
 When? They can be used to help cue a
child as to what comes next (e.g., put on
snow pants, put on boots, put on coat, put
on mittens)
 How? Mount picture symbols or labeled
photos on magnetic board, tag board with
Velcro, or tape and have the board with
you during that activity. Model use of it so
the child can eventually perform the task
independently.
www.autismshop.com
Tools to Give Information
“Behavior problems emerge because what the student is
expecting and what is really happening are not the same.”
Linda Hodgdon, 2002
•Calming down board
•Rule Cards (“When I get to the gym, I sit on the red line.”)
•International NO
•Lightning Bolt
•Activity Termination Symbols
•Social stories w/ or without picture supports
•Card to hold (WAIT)
Making Choices and Requests
Hodgdon, 2002
*Student may need to LEARN what it means to make a
choice
*Start with highly desirable choices
*Choices often motivate the student to communicate
*Offer immediate reinforcement for their choice
*Choice-making can be practiced multiple times per day
*Adults can structure the choices provided
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What to choose, what to
choose…
Which snack to eat
Which toy to play with
Which seat to sit in
Which person to walk with
Which cereal to buy
Which washcloth to use
Which job to do
Which CD to listen to
Which book to read
Tools for protesting or rejecting
"All Done“ Card
http://www.cesa7.k12.wi.us/sped/autism/assist/asst13.htm
"Wait" Card
http://www.cesa7.k12.wi.us/sped/autism/assist/asst13.htm
Teaching NO
"First-Then" Card
AAC in the Classroom
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Same as in Therapy
Vocabulary
Literacy Boards
Literacy Activities to expand language
– Customize books
– You don’t have to talk before you read
– Reading comprehension increases if you are able to
talk about it
Vocabulary
Literacy Boards
 What is it? A single page containing pictures/words
specifically relating to a particular story
 Why? Used to identify key characters of the story,
along with messages like “turn the page,” “more” or
other story-specific comments
 When? Use before, during, and/or after a story to
help lead discussion and help the child fully
understand the vocabulary and concepts within the
story
 How? Model use by pointing to characters, comments
as you talk/read about them
Snack
Time
Boscobel ECH
Lily Rider, Louise Hebel
Snack
Time
Boscobel ECH
Lily Rider, Louise Hebel
School to
home note
Boscobel ECH
Lily Rider, Louise Hebel
Software to expand language
skills
• Laurette
• Stages choice
• Pixwriter
AAC in the Home
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Same as Therapy and classroom
Create boards for playing games
Follow a recipe
AAC systems with infrared can be used to
control anything that can be operated with
a remote
– Channel surf the TV
– Purchase a infrared mini controller and automate small
appliances (lights, fans, computer, robotic vacuum)
– Control infrared toys & switch adapted toys
Playdough recipe with Pixwriter
AAC in the Community
• Same as Therapy/Classroom/Home
• Make choices at the
restaurant/library/
• Make comments about: sporting
events/movies/concerts/
plays/festivals/fashions
• Create shopping lists
?? Remember ??
The focus is not on the technology
(low or high) rather, it is on
communication, the academic
activity and language.
??
Remember
??
The following section from CCE Creating Communication Environments
– Partner that knows how to
prompt, model, elicit
language, pause
Partner
Environment
– Environment that’s
conducive to communication
by the child
Communication
Activity
– Activities that focus on
communication
Arrange the Environment to Increase
the Likelihood of Communication
Common Strategies….
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Use motivating materials and activities
Materials should be in view but not accessible
Student should need assistance with some materials
Provide small or inadequate amounts of materials
Sabotage
Provide something the student doesn’t like/want
Use communication boards/devices & visual tools
Increase Communication by being
a good communication Partner
Accept and respond to ANY communication
attempt
 Provide descriptive feedback instead of
praise
(“You wanted paint. Here’s more paint.”)
 Be silent when appropriate
 Be aware of use of figurative language
(“take your seat” vs. “sit”)
 Use a prompt hierarchy
Prompt Hierarchy
• Environmental Cue
– PAUSE
• Open Question
– PAUSE
• Prompt OR Request for Communication
– PAUSE
• Full Model
– PAUSE
• Incorporate descriptive feedback into
each step
Prompt Hierarchy Step #1
Environmental Cue
• Set up the environment to signal to
the student that an activity is about
to begin.
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Ringing bell
Lining up at the door
Art materials prepared but out of reach
Desired items visible but inaccessible
Cutting the pizza, e.g.
• After student responds, provide...
Descriptive Feedback
Prompt Hierarchy--Pausing
Pause after every step
• Focus your attention on the student
(expect communication!)
A
N
• PAUSE
D
• After student responds, provide...
Descriptive Feedback
Prompt Hierarchy Step #2
Open Question
• If the student does not respond to
the pause by making a response:
– Ask a WHAT, WHY, WHO, WHEN, WHERE, OR
HOW Question
• “What do you want?”
• “Whose turn is it?”
• “Where does that go?”
• AND then…...PAUSE
• After student responds, provide...
Descriptive Feedback
Prompt Hierarchy Step #3
Prompt or Request Communication
• Provide a prompt to students
– Choices, carrier phrase, initial sound, visual cue
OR
• Request Communication
– “Tell me what you need.”
– “Tell me what goes next.”
• AND then……PAUSE
• After student responds, provide...
Descriptive Feedback
Prompt Hierarchy Step # 4
Full Model
• Provide a full model for student
– Use student’s AAC device
– Use developmentally appropriate model
• AND then…...PAUSE
• After student responds, provide...
Descriptive Feedback
PAUSE
Pause Pause Pause Pause Pause
Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause!
Pause
In other
words…PAUsE!
Prompt Hierarchy—WHY?
 Gives student the necessary time to
process information and to formulate
a message to communicate
 Provides a structure for adults that
encourages communication
 Can be customized for individual
students
 Organized least to most
CCE video
• Visual Strategies – Susan Stokes
www.wati.org CESA 6 - 12/20 CESA 9
2/26/07
• CCE (Creating Communication
Environments) WATI Consultants
• Get A Grip On Communication
www.wati.org Cesa #2- 1/26 and 4/24
• DynaVox – www.dynavoxsys.com
• PECS (Picture Exchange Communication
System) Green Bay 1/4 & 5; Milwaukee
4/23 &24 www.pecs.com
Creating a Communication
Environment
(CCE)
Partner
Environment
Communication
Activity
CCE is for staff
struggling with the
implementation of
AAC systems including
language boards and
low tech to high tech
devices, across the
school environment.
Creating a Communication
Environment
(CCE)
• A four part sequential intervention
• A team is required (teacher, SLP, Para, OT, PT,
Parent)
• CESA #2 Milton Wisconsin
• $600. per 3 person team, $50. per additional
team member
• Jill Gierach, CESA #2 WATI consultant
• Shelly Weingarten, CESA #1 WATI consultant
• www.wati.org training link
Get A Grip on Communication
• 2 part training – assessment &
programming
• Severe and profound multiple
disabilities
• Special educators, SLP’s, OT’s,
Paraprofessionals, Parents
• $225
• College credit
• www.cesa2.k12.wi.us registration forms
DynaVox Trainings
www.dynavoxsys.com
• DynaVox Local Trainings
– Introductory and Advanced Trainings
• Online Programming Tutorials
– Video and slide presentations
• DynaVox Virtual Classroom
– an online learning environment that features a
live instructor
Picture Exchange Communication
System (PECS):
• PECS allow the child to spontaneously initiate a
communicative interaction by actually exchanging, or giving
a visual representation system to another person.
• By making a physical exchange with another person, the
child develops a concrete understanding that
communication is an actual exchange of information
between two or more people
• The PECS program is composed of various phases or levels,
starting with simple, concrete communicative exchanges
and moving to more abstract communication.
• Visual representation systems which can be used:
miniature objects, T.O.B.I.s, photos, real drawings, line
drawings, written words.
Visual Resources for Enhancing
Communication
from the Indiana Resource Center for Autism
www.iidc.indiana.edu/irca
*Attainment Company, Verona, WI 800-327-4269
www.attainmentcompany.com
*Autism Resource Network
www.autismshop.com
*Don Johnston Company, Volo, IL 800-999-4660
www.donjohnston.com
*Imaginart Communication Products, Bisbee, AZ 800-828-1376
www.imaginart.com
*IntelliTools, Inc., Novato, CA 800-899-6687
www.intellitools.com
*Mayer-Johnson Company, Solana Beach, CA 800-588-4548
www.mayerjohnson.com
*Pyramid Educational Consultants I nc., Newark, DE 888-732-7462
*Silver Lining Multimedia, Inc., Poughkeepsie, NY 845-462-8174
*Slater Software, Inc, Guffey, CO 719-479-2255
• Planning
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– Assessment & Design
Boardmaker
Speaking Dynamically Pro
PixWriter
Microsoft Word Table
www.imaginesymbols.com
80/20 Rule
Augmentative Alternative
Communication is 80% planning and
20% programming
Assessment
• Evaluware
– Computerized assessment
– Assesses size/spacing/visual
preferences/auditory preferences
• TASP
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Hard copy assessment
An easy-to-use tool for assessing symbolic skills,
Design communication boards
Help select Aug Communication device
Set appropriate AAC goals
Serves as a tool to benchmark progress in aided
communication performance.
Designing Communication Boards
• Physical considerations:
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Size of symbols
Spacing between symbols
Physical access to all locations of board
Landscape vs. Portrait orientation
Designing Communication Boards
• Visual considerations:
– Color vs. black/white
– Color background
– Size & spacing
Designing Communication Boards
• Language/Cognitive Considerations:
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Type of message (single word vs. phrase)
Type of symbol (Photos, line drawings)
Amount of vocabulary to be displayed at a time
Organization
Brandenburg, S., & Vanderheiden, g.C. (1988)
The Vocally Impaired: Clinical Practice and Research pp. 84-135
Arrangements for
Communication Displays
Activity-Based
Category-Based
Grammatically
Correct-Based
Alphabet and Word
Based
Activity-Based Displays
• For use with a specific activity (block play,
cooking, office help)
• May necessitate repeating of symbols
across multiple displays
• Should include comments and social
etiquette messages
• General left-to-right progression (personaction-attribute-object-location)
• Should include problem-solving messages
Category-Based
Displays
• Groupings are based on categories with
vocabulary items arranged according to
familiar categories
• May include a main board (e.g., I want to
tell you a joke) with branching subtopic
messages
• Requires knowledge of categorization and
the hierarchy of language
• Difficult to express relational concepts, or
complex thoughts, and difficult to use
appropriate syntax
Grammatically-Correct
Displays
• Groupings are based upon some knowledge
of grammar
• Provide a way to generate more complex
thoughts, to develop linguistic and literacy
skills
• Includes semantic arrangements,
grammatical arrangements, or a modified
Fitzgerald Key
• Makes it possible for communication
partners to model language (augmented
input/aided language stimulation
Alphabet or Wordbased Displays
• Groupings are based on the alphabet
• May include combination word-symbol
messages
• Effective use depends on the
student’s prior knowledge, future
goals, and the message selection
techniques being used
Color Coding
will allow
user and
facilitator
to locate
symbols
more easily
www.aacintervention.com Tip of the month
Goosens’ Crain & Elder Color Coding System
Communication Displays for Engineered Preschool Environments (1994)
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Verbs…………………..Pink
Descriptors………..Blue
Prepositions……….Green
Nouns…………………..Yellow
Miscellaneous……Orange
– “WH” words, exclamations, negations, etc.
Planning is Ongoing
Continue to Adjust Variables
• Expand vocabulary
• Increase size & array of symbols
• Increase settings: home/community/other
people/times in a day
• Differ communication:
requests/labeling/commenting/questions
• Multi symbol utterances
• Accessible/portable
• Bridge up/down hierarchy
Summary of Ideas
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Calendars
Schedules
Vocabulary
Worksheets/Quizzes
(matching/fill in)
• Math/Reading/
Science/SS
• Social Stories
• Community
• Picture supported
story/newsletter
• Literacy board
• Weather Board
• Snack placemats
• Games (bingo)
• Certificates
• Greeting Cards
Category Worksheet
Kristin Whitfield
DynaVox educational specialist
Boardmaker Software
• Picture communication symbols used
to create communication boards,
device overlays, worksheets, picture
schedules
• Teacher Tool
• www.mayer-johnson.com
• $299.00
Boardmaker Plus Software
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This is Boardmaker plus voice
Create interactive Activities
Minus SDP bells and whistles
Student/classroom Tool
www.mayer-johnson.com
$399.00
Boardmaker with Speaking
Dynamically Pro Software
• SDP is a speech output program
• Use to create dynamic, talking, multilevel
communication boards
• Teacher Tool
• Individual Student Tool
• www.mayer-johnson.com
• $649.00
Boardmaker Tutorial
Word
Table
with
ClipArt
http://www.imagineSymbols.com
• 4000 symbols include emotions,
animals, verbs, nouns, computer
technology, and many more. Imagine
Symbols are available for download
for non-commercial use.
Created in Word with
Free Image Symbols
http://www.symbolworld.org
• This is a great site for nonreaders. Everything is in
symbols. Stories, news, recipes,
personal care, and much more. There
is even a newsletter that is similar to
News 2 You.....but it's free.
www.widgit.com
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Resources on symbol use
Symbols for literacy
Products
Webwide – see websites with symbol
support
References
American Speech-Language-Hearing Association website: www.asha.org
Burkhart, L. 1993, Total Augmentative Communication in the Early
Childhood Classroom, p.38
Binger, C. & Kent-Walsh, J. (2005). Evidence-Based Language Supports
for Children Using AAC: Increasing Expressive Communication.
Closing the Gap conference, Oct. 2005, Minneapolis, MN.
Casey, K. & Kornfeld S. (2004). Developing language-rich light tech AAC
systems for young children. Closing the Gap, October/November
2004, 23 (4).
CESA 4 & 5 Cumley, J. and Pallaske, M., CESA 1 & 2 Weingarten, M. and
Gierach, J., Creating Communication Environments training, 2005
DynaVox educational specialist Whitfield, K., Planning for and supporting
Meaningful Participation and Learning for children and Adults Using
AAC
References
Hodgdon, L., Visual Strategies For Improving Communication: Solving Behavior
Problems in Autism: Improving Communication with Visual Strategies,
QuirkRoberts Publishing, www.usevisualstrategies.com P.O. Box 71
Troy, MI 48099-0071
Hodgdon, L., Solving Behavior Problems in Autism: Improving Communication with
Visual Strategies, QuirkRoberts Publishing, www.usevisualstrategies.com P.O.
Box 71 Troy, MI 48099-0071
Karlan, George. Environmental Communication Teaching Training. Field-Initiated
Research Grant Award No. H023C9005 from the Office of Special
Education, U.S. Department of Education. Lafayette, Indiana: Purdue
University.
Quill, Kathleen, Do-Watch-Listen-Say, Paul H. Brookes Publishing, 2000
Raising a Reader, Raising a Writer: How Parents Can Help. Washington DC:
National Association for the Education of Young Children (NAEYC) #530
Teaching Our Youngest: A Guide for Preschool Teachers, Child Care & Family
Providers, U.S. Department of Education