Creating Communication Environments

Creating Communication Environments
An Overview Developed by Judi Cumley and Mary Wirkus Wisconsin Assistive Technology Initiative This PowerPoint is intended to be a one day overview of the 4 Day CCE training. It can be used as a review for teams who have already participated in the full training or as an introduction for teams who are interested in participating in the year long process. The full year training requires a team (SPED teacher, SLP & paraprofessional + others) to attend 4 full days spread through the year, videotape lessons throughout the year of the team working with the student and implementing strategies to bring to each day for video feedback, offers feedback from peers, provides “team time” throughout the year to implement strategies and offers an opportunity to demonstrate growth of both the student and team to administrators, parents and colleagues. This one day overview, while providing much of the same content cannot replace the full year training and may not have the same impact on students or teams. The overview does not include videos of students or teams due to confidentiality. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Learner Outcomes Understand the foundations of functional and interactive communication Identify target activities and strategies for eliciting active participation by student(s) Select communication opportunities that are natural and appropriate Arrange the environment to promote communication Identify the steps in a “least to most” prompt hierarchy These are the foundational aspects of CCE Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Agenda Background of “Creating Communication Environments” (CCE)
Purposes of Communication The Three Main Ingredients of Creating a Communication Environment Activity Environment Partner The Prompt Hierarchy How Can This Be Useful for YOU? This is a full day of content. Some activities are built in, but in general, the content takes the full day. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Background Information
CCE is based on ECT (Environmental Communication Teaching) - developed by Dr. George Karlan at Purdue University Developed for a classroom TEAM Emphasis on eliciting communication within natural environments Originally developed as a 5-day training program for school-age children who use or need AAC Replicated throughout the country for children and students of all ages & disabilities (CCE in Wisconsin since 1999) Background info on ECT/CCE. We give credit to ECT since that is the foundation of CCE. FYI, Karlan never published so there is nothing in writing from him re: the impact of ECT. However there are now studies that use the same foundational concepts as ECT that have demonstrated increase in student’s communication. ECT training in WI (foundation for CCE) was provided by Kelly Fonner and Susan McCloskey in Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Everyone Communicates…
Crying Eye contact Sounds Words Pointing Falling asleep Screaming Communication boards Picture exchange system Voice output systems Gestures/signing Hair-pulling Have participants brainstorm ways we all communicate. Write them on flipchart if desired. Compare this list with what’s on flip chart. Give some real life examples (silent treatment by teenager or spouse), hair pulling, etc. Silence Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Communication Purposes
Expressing Wants and Needs *Once desired action or object is achieved, communication ends Social Interactions including Social Etiquette *Social vocabulary is difficult to provide, but vital for social acceptance Greetings, Conclusions, “manners”, etc . Exchanging Information * Starts as “joint attention” then develops into more complex interchanges with content or topic specific vocabulary Janice Light 1988, 1997, 2005 Based on some of Janice Light’s original work. She analyzed communication of “typical communicators” of all ages & was able to categorize their messages into these 4 different categories (she originally split up Social Closeness & Social Etiquette). Typical communicators send messages within these categories of communication purposes.. Read Janice Light’s summary or her original work if you want more… Light, J. (1996) Communication is the essence of human life: Reflections on communicative competence. AAC Augmentative and Alternative Communication, June 1997 (13), 61-70 Her most recent work in 05 combined Social Closeness & Etiquette. I’ve reflected that here. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Changing Purposes of Communication
Infancy Elementary Secondary Sharing Information Sharing Information WANTS & NEEDS Sharing Information Social Interactions & etiquette WANTS & NEEDS Social Interactions & etiquette Social Interactions & etiquette WANTS & NEEDS This is a graphic based on Janice Light’s work that demonstrates that while we continue to use those same purposes of communication throughout our lives, they take on different importance at different stages of our lives. For instance “wants & needs” takes on greater importance when we’re young than sharing information, but by the time we’re in secondary school, those 2 switch. Interesting to note that Social Interactions & Etiquette remain very similar throughout our lives. I didn’t continue the graphic to show lifetime, but Janice Light goes through to the elderly & unfortunately it looks a lot like Infancy! Group Activity- “stand up if you have helped a student communicate wants & needs, continue standing if you have helped a student communicate social etiquette messages. Continue standing if you have helped a student share information, continue standing if you have helped a student communicate messages that build social interactions”. Typically everyone will stand on the first , but usually you end up with half or less of the group standing by the end. Brief discussion about the “why’s” & how we’re going to work on changing that focus on wants & needs. The importance of different communication purposes changes over our lifetime J. Cumley, 2001 Based on J. Light, 1988, 1997, 2005 Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

If we only have to think about encouraging our students to communicate for three different purposes, why is it so HARD….. what can make it easier? A brief introduction to AAC & how it can augment student’s communication Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

AAC Augmentative/Alternative Communication
*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 Speech Generating Devices (SGDs) Picture Exchange Communication System (PECS) Morse Code Eye Gaze Picture Schedules Does anyone have students who are currently using AAC? What kinds of systems?- share Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

AAC can be a vehicle for developing: expressive language receptive language literacy control over the environment communication initiation Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

AAC is not…. A last resort “Giving up” on speech
Only for those of a certain IQ or Age Only the job of the speech-language pathologist We spend some time debunking some AAC “myths” Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Myths and Misconceptions: Young Children with CCN (Complex Communication Needs)
Myth and Misconceptions AAC hinders or stops further speech development The Evidence AAC approaches (signs, picture symbols, VOCAs*) do NOT hinder speech development. In fact, speech often increases during AAC treatment approaches Next few slides are from an article in ACN (Augmentative Communication News). All of the “myth busters” are based on research. This one... Millar,D., Light, J. & Schlosser, R. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review: Journal of Speech. Language and Hearing Research. 49: *VOCA= Voice Output Communication Aid From: Augmentative Communication News, Volume 18, Number 2, June, 2006 Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Myth and Misconceptions There is a representational hierarchy of symbols from objects to written words The Evidence Children can learn to understand and use a variety of symbols at a very young age (e.g., sign language) through repeated exposure to the symbol and its referent in natural contexts Even babies have learned abstract signs (Baby Signs) & symbols when used repeatededly & IN THEIR NATURAL CONTEXTS!! Romski, M.A., Sevcik, R.A., Cheslock, M.B. & Hyatt, A. (2002). Enhancing communication competence in beginning communicators: Identifying a continuum of AAC language intervention strategies. In J. Reichle, D. Beukelman, & J. Light (Eds.) Implementing an Augmentative Communication System: Exemplary Strategies for Beginning Communicators. (pp. 1-23). Baltimore, MD: Paul H. Brookes. From: Augmentative Communication News, Volume 18, Number 2, June, 2006 Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Myth and Misconceptions Children must have certain skills to benefit from AAC (e.g., be at a certain age, have a particular cognitive or linguistic level, etc.) The Evidence There are NO prerequisites for communication. AAC focuses on all aspects of communication and communication begins at birth. AAC is an appropriate intervention approach for anyone with CCN. National Joint Committee (NJC) for the Communication Needs of Persons with Severe Disabilities (2002). Access to communication services and supports: Concerns regarding the application of restrictive eligibility criteria. Communication Disorders Quarterly, 23, From: Augmentative Communication News, Volume 18, Number 2, June, 2006 Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Myth and Misconceptions AAC is a last resort and means professionals are “giving up” on speech The Evidence The “Wait and See approach” is not an effective way for teams (e.g., speech-language pathologists, teachers, paraprofessionals, parents to develop communicative competence) American Speech-Hearing-Association. (2005). Roles and responsibilities of speech-language pathologists with respect to alternative communication: Position statement. ASHA Supplement 25. From: Augmentative Communication News, Volume 18, Number 2, June, 2006 Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Using AAC effectively Communication partners must model AAC use
Use of a penlight or finger on paper displays (aided language stimulation) Sit next to individual with device to facilitate modeling Use it as both a receptive and expressive tool Be natural-focus on communication, not the device/board AAC must be engineered into the environment Displays mounted around the room/school/home ACCESS to communication wherever student “is” Pool Playground Home Out shopping Bathtub School or instructional settings Stress both of these. Think of AAC as another language (it really is….) or a child’s first language. How long does a “typical child” just listen & observe before they actually use/speak their first words/phrases? Generally about 1-2 years! It generally won’t take that long for an AAC user to start using their board/device/system. But “we” often just give a child a communication board & show them a few times then expect them to use it , or teach them symbols out of context in a drill type setting & then say “we tried AAC & it didn’t work!”. Think of the child’s receptive language & how they REALLY need to see you use & model the vocabulary (also a very good way to see if you have the right vocab on the board!!) Access, access, access. If it’s an SGD (speech generating device)- Do NOT turn it off or take it away if the child is talking when they should be listening! Teach the student (just like everyone else) when they have to be quiet & listen and when they can talk! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

When designing AAC overlays, be sure to include...
Vocabulary that reflects all 4 categories Wants & Needs Exchanging Information Social Closeness Social Etiquette Use a communication board to talk to each other. Does it contain the 4 purposes of communication? Have a variety of communication boards that pairs can use to communicate. Some of them can be less effective (wants/needs only) than others. Share what is missing, frustrations, successes! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

AAC: Establishes a means of communication
Provides opportunity for social interaction Promotes receptive communication Encourages expressive communication Decreases frustration Provides opportunity for initiation summary Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

What are some characteristics of their communication?
Think about YOUR students who are struggling to communicate effectively… What are some characteristics of their communication? Give the teams some time to talk about & write down some of their student(s) communication characteristics. They will compare their student’s characteristics with those listed on the next slides. Have the teams share so everyone hears how difficult each other’s students are. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Common Characteristics of Students Using AAC
Rarely initiate interactions Usual form of communication is NOT using a communication device Gestural responses (head nods) to yes/no questions main form of communicating May use “challenging” behaviors to communicate Based on Kathleen Quill’s book “DO-WATCH-LISTEN-SAY:Social and Communication Intervention for Children with Autism”, Brookes Publishing, 2000. Our “typical” students who are using AAC have these types of challenges every day. They are typically passive communicators who answer questions but rarely initiate They typically communicate using gestures, vocalizations, head nods, but they don’t communicate using their system unless prompted. The reason head nods is the main form of communicating is because WE primarily ask yes/no questions! Joe Reichle & Pat Mirenda have lots of research about challenging behaviors being a form of communication. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Common Characteristics of Students Using AAC
Most vocalizations are unintelligible Rarely interact with peers Communication system may not be available when needed Necessary vocabulary is not programmed or correct symbol is not available How many times is the communication system still in the “bag”, or someplace besides where the student is? Vocab. It is hard to keep current…I look at student’s devices in 3rd grade who still have their EC pages on their device! Someone (!) needs to take responsibility to clean it out, keep vocab current, etc……not talking about curriculum, even just the personal info (change how old they are after a birthday!) & stories. What do we do as partners to help or hinder student’s communication? Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Supporting AAC users…. Create a Communication Environment
Expect all students to communicate Recognize and respond to the student’s communication initiations Arrange the environment to increase the likelihood for communication Identify communication opportunities within natural routines and activities Based on part of the original ECT information. This is the only place we talk about expectancy of communication & then recognizing and responding to the child’s efforts. Yet it is commonly understood that simply expecting students to communicate (as opposed to the opposite) makes a huge difference in their actual communication! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Addressing Communication Challenges AND Creating a Communication Environment…
Requires changes in the… Activities Environment Partner Communication The 3 legged stool is our “symbol”. It started when someone asked a co-presenter many years ago which one was really the most critical….activity, environment, partner. She responded by saying they are like a 3 legged stool. Anytime you think one is more important than the others or “short” one leg by not giving it as much attention, you tip over! In CCE, all are critical for optimal communication by the student Activities Partner Environment Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Dr. George Karlan “Incidental teaching episodes are brief,
positive, and oriented toward communication rather than language teaching.” The one and only quote from the originator of ECT….but the point is that we aren’t doing “language lessons”, but are talking about effectively using quick, natural communication opportunities throughout the day. Dr. George Karlan Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Selecting a Target Activity to Elicit Communication
Should be brief in nature, but occur 3-4 times per week Requires communication (initiations) by the student Activity should be process - not product oriented Activity represents a class of activities Art activities, cooking, reading books, snack Variation in content from episode to episode, but same “core” vocabulary Choices are offered during the activity COMMUNICATION is the goal of the Target Activity! “Target Activity” is an original ECT term. We have continued to use it because it helps the teams identify just one activity they are going to change. We try to have them focus on something short in duration, but that occurs frequently--for practice for both the student and themselves. They need to think in terms of what is the student going to say, not how are they going to “teach” the student. Communication opportunities for the student are not responses to teacher questions….we are talking about student’s initiations. Activity should be process oriented. If there is a “right and wrong” way to do something, student communication opportunities are limited and the “product” ends up being the objective rather than communication. When the target activity is one of a “class” of activities, it is much easier for the student and the adults. The framework is the same, the core vocabulary is the same, the setting is the same. You only change the “fringe” or specific vocabulary. When we have familiarity with all of that, then it is easier for everyone concerned to focus on our goal of communication. Natural choices for the student during the activity are critically important. They present natural reasons to initiate. They offer new opportunities for vocabulary, expansions of utterances, give you a reason to wait for the child to communicate. It’s all about Communication!!! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Selecting Target Activities
Start by identifying a “target” activity Student must have a reason to perform the activity Activity must provide opportunities for success Must be motivating Must be functional and interactive Must be age-appropriate Must reflect family wishes/team consensus Describe your Target Activity on the Target Activity Form TEAM TIME: Have them list their “typical” day on a sheet of paper or activities that the TEAM does regularly with the student. (We have had teams who identified someone other than those in the training who would facilitate the Target Activity…we address that head on now) I also talk about “group/calendar time” since it always appears on someone’s “short list”. Group time is often a very language rich time with opportunities for student interaction….BUT, I generally ask the question, when you do group time, who is directing it- you or the students? The answer is almost always the teacher. It’s a great time, don’t get rid of it….just don’t use it as a “Target Activity”. Most teams need lots of help identifying an appropriate Target Activity. With experience, you will be able to identify those that are doomed to fail. Depending on your teaching style, you can help them figure that out early on, or you can let them discover it themselves. We stress that it is more than OKAY to change your Target Activity over the year. We’ve had teams that have changed it every time we see their tape including their final one. That is progress! They identify that something isn’t working & try something different. The points are self-explanatory…students have to be motivated to participate in the activity, success is usually inherent in the motivation & age appropriate part…..there needs to be a reason from the student’s point of view….which also reinforces functionality. The team has to agree that this is an activity that they will all support. Introduce the Target Activity Form (also in the next slide). Their Target Activity description should read like the directions for a substitute or paraprofessional to set up the activity. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

The Target Activity Form- Sample
Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc. How is vocabulary represented: Activity Vocabulary: Wants/Needs: Social Interactions & Etiquette: Sharing Information: Introduction of Target Activity form. We will be using this form throughout the training. We developed it after lots of “false starts”. It seems to help teams refine their activities, focus on communication and consider the prompt hierarchy (when they get to that point). These next few slides take them through the process of filling out the first sections. An example of Snack as an activity described using the form. Right now they should only fill out the Target Activity Description (where the red font is) for their Target Activity. Give them Team Time to fill out the Description on their Target Activity Form for their identified activity (have extras on hand) Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

pick a different activity!
Does your Target Activity have at least THREE opportunities for the student to initiate? What does the student have to say to BEGIN the activity? What does the student to have to say to CONTINUE the activity? What does the student have to say to END the activity? If you can’t think of 3 statements the student needs to say to be engaged in the activity…. pick a different activity! There should be a minimum of 3 student communication opportunities- It helps teams to identify clear beginning, middle and ending communication opportunities for the student. What does the Student SAY to start the Target Activity. What does the Student SAY to continue it. What does the Student SAY to end the activity. That gives us a minimum of 3 communication opportunities for the student during the Target Activity. I usually ask the participants to think of something they do every day (eat lunch) and what it would be like to only speak 3 times during that activity! So while it may be hard for us to find 3 communication opportunities for our students, we would be greatly handicapped if we could only talk 3 times! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Communication Turns-example
Snack Beginning: Student asks for snack items.(e.g., milk, cracker, napkin, straw, placemat) “I want….” “Can I have ….” “milk”, etc. Middle: Student asks for “more”, “help”, makes social, informational or etiquette comments to peers and adults “I want more ….”, “more ….”, “good …..” “I like …” “You want…” End: Student indicates when finished (asks to be excused, says “all done”, asks for clean-up materials, asks to go to transitional activity) “all done”, “clean up”, “no more”, “bye-bye” An example of what at least 3 communication opportunities would be necessary for the student to communicate during a snack Target Activity Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

The Target Activity Form- Sample
Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc. How is vocabulary represented: Activity Vocabulary: Wants/Needs: Social Interactions & Etiquette: Sharing Information: Student asks for snack items (e.g., Milk, cracker, napkin, straw, placemat) “I want …” “Can I have….” “milk” Student asks for “help” Student asks for “more…” Makes comments to peers and adults “I want more…” “I like ….” “good …” “You want …..?” Example of Activity Form Communication Turns column filled out for snack Give them Team Time to fill out the Communication Turns column on their Target Activity Form for their identified activity. Student says “all done” when finished “clean-up” “go play” “bye-bye” Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Communication Considerations
How will the vocabulary be represented (e.g., objects, tangible symbols, photos, symbols, etc.) List the vocabulary that must be available. Try to have vocabulary that represents Wants/Needs Social Interactions & Social Etiquette Sharing Information What symbol set is appropriate for the student?---there is more than PCS…show some examples. Can they provide even very simple vocabulary that meets the 4 basic purposes of communication? Be prepared to give them specific examples depending on their target activity. Help them to understand that even if the student is only at a wants/needs level, you need to provide that expansion vocabulary (social interaction, etiquette & sharing information) so you can model it for the student. The student can’t expand their messages when they don’t have to vocabulary to do so &/or have never seen it modeled. At the very least they should have a template of their “goal” with blank spaces where they will insert those message beyond wants/needs. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

The Target Activity Form - Sample
Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc. How is vocabulary represented? Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands Activity Vocabulary: milk, straw, napkin, cracker, placemat… Wants/Needs:I, want, more, help, specific snack items Social Interaction & Etiquette:sit here, want some?, please, thank you Sharing Information:good, yucky, uh oh, all done Student asks for snack items (e.g., Milk, cracker, napkin, straw, placemat) “I want …” “Can I have….” “milk” Student asks for “help” Student asks for “more…” Makes comments to peers and adults “I want more…” “I like ….” “good …” “You want …..?” Example of Communication Considerations column filled out for Snack Target Activity Give them Team Time to fill out the Communication Consideration section on their Target Activity Form. Student says “all done” when finished “clean-up” “go play” “bye-bye” Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Video….. This is a good time to show a video of a student engaged in a good target activity. It should show multiple opportunities for student initiated communication (without teacher prompts). Ideally the teacher will be modeling and expanding the student’s communication using their communication system. You should see student &/or adult using all of the purposes of communication plus meet the identified criteria for a “target activity”. Lead a discussion labeling the key components that the group identified (or missed). Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Addressing Communication Challenges AND Creating a Communication Environment…
Requires changes in the… Activities Environment Partner Communication Now we’ll focus on the environment. Some of the teams may have already made changes in their environment by creating a CCE Target Activity. This discussion will bring a few more options to mind. Generate a discussion about what some of the changes they have already planned for their environment. Activities Partner Environment Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Arrange the Environment to Increase the Likelihood of Communication
Common Strategies…. 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 The environment can create obstacles or opportunities for communication. Motivating materials: if it’s exciting/fun/you like it…..you’re going to want to do it, ask for it, get more….. You can see, but you can’t get it.....but it’s fun, exciting (see above). We always want what we can’t get! It’s nearly impossible to teach students to ask for help when everything is done/provided for them. Give them real & motivating reasons to ask for help. It doesn’t have to be everything & all the time, but it’s a great way to encourage students to talk to their peers. If it’s fun/exciting/yummy (see above), then you want more. Don’t give all of it to them at once. Sabotage is a great way for kids to problem solve and create opportunities to tell you what you did wrong(!)…..give them the wrong “tool” (pencil instead of paintbrush, paint instead of glue, fork instead of spoon) or “forget” key ingredients (plate, paper) Know your students well (we’re trying to increase communication, not melt-downs), but you can’t learn appropriate ways to reject unless you are given something you don’t want (white instead of chocolate milk, yellow paper, water, the “wrong” placemat) Provide visual and communicative supports throughout their environments (classroom, hallway, bathroom, on their or your body, etc.). Think about providing multiple copies of a “snack placemat”, “playdough board” with the playdough, encourage all students (even the verbal ones) if they want to use a communication system. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Your Environment Are there any environmental changes you could make to increase communication? Activity-based environmental changes Material location, amount, type Communication-based environmental changes Picture symbols, communication boards, device placement Environmental modifications can be activity based, but also think about the communication supports throughout the environment. Have portable low tech communication systems (i.e., clipboards, communication books/binders, visual schedules) in various locations throughout the environment even if the student has a high-tech device. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Note Environmental Arrangements
Video- Note Environmental Arrangements Show a video that demonstrates good environmental modifications. Try to use those that aren’t “typical” modifications. Some examples might be a V.I. student using a calendar box, a student who has multiple options to communicate for the activity (work mat with symbols for activity, clipboard with color symbols on it and an SGD for social comments), classroom with engineered labels throughout, etc. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc. How is vocabulary represented? Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands Activity Vocabulary: milk, straw, napkin, cracker, placemat… , Wants/Needs: I want, more, help, specific snack items Social Interaction & Etiquette: sit here, want some?, please, thank you Sharing Information: good, yucky, uh oh, all done Student asks for snack items (e.g., Milk, cracker, napkin, straw, placemat) “I want …” “Can I have….” “milk” Student asks for “help” Student asks for “more…” Makes comments to peers and adults “I want more…” “I like ….” “good …” “You want …..?” Sample Target Activity Form with Environmental Modifications section completed. Allow team time for teams to discuss & note their environmental modifications. All students have snack placemat with specific snack vocabulary velcroed on top & core vocab. permanently on sides. Single small pieces of snack Straw on table, but out of reach Milk carton not open Wrong flavor of milk (sabotage) Student says “all done” when finished “clean-up” “go play” “bye-bye” Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Requires changes in the…
Addressing Communication Challenges AND Creating a Communication Environment… Requires changes in the… Activities Environment Partner (And that means YOU!) Communication Review of the “stool” again. Already focused on Activities & Environment…..now the focus shifts to the communication partner. Partner Activities Environment Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

What are some common characteristics of communication partners?
Brainstorm behaviors we do that support AND hinder student communication Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

As a Communication Partner…
What Can DISCOURAGE a student from communicating… --test, bombard, or demand responses (e.g., “what is this called” “what do we use a knife for?” “what do we call this?”) --use rhetorical questions (e.g., “you don’t want milk, do you?”) --use YES/NO questions --anticipate their needs so they don’t have to ask Kids are aware of when we ask the same questions over & over and they know we already know the answer (what’s your name….). Some partners also attempt to give the kids a “hint” but really bombard their processing system ….what color is this? It’s the same color as Jenny’s shirt. It starts with b… Students with language processing or word retrieval problems (many of our students) don’t have the language background or understanding to make all of those connections especially that quickly. Every time you ask another question, give a hint, they may start all over again. When we ask a rhetorical question, we aren’t expecting an answer! Remind them that one of the foundational components of CCE is to expect communication! There is a time & place for yes/no questions, but we tend to overuse those with our students. Remind them of the value/power of asking open ended questions where a student has to make a choice, offer information, etc. This can be the biggest issue with families, peers and some paraprofessionals. It can lead very quickly to the student developing “learned helplessness” in which they become passive participants in activities, communication, learning and life! We need students to be actively involved in activities. Some strategies include “playing dumb”, “forgetting” some components necessary to complete the activity, being “busy” with someone/something else, go to the other side of the room…. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

What else Can DISCOURAGE a
As a Communication Partner… What else Can DISCOURAGE a student from communicating… --don’t give them regular access to their communication system(s) --when they make a choice, ask them again --use only teacher-directed activities so the student doesn’t HAVE to communicate --”GOOD TALKING!” as a reinforcer --use figurative language (“take your seat” vs. “sit”) --”rush” the student’s communication How many times is the system in the backpack, in another room, etc. This brings the opportunity to discuss multiple systems. There are lots of times when even the most expensive system isn’t appropriate for the environment (lunch room, outside, carting it around during choice time). Students should have access to & see modeled a variety of systems low to high tech (when appropriate). So, they might have a lunch placemat or a simple communication strip at lunch time, a keychain with simple messages outside, center specific communication boards in the preschool (playdough board is with the playdough, rice play, blocks, etc.), sticky notes with curricular specific vocabulary on them (water cycle, evaporation, rain…) Nothing makes you rethink your choice than someone questioning it (are you sure you want to wear those pants?). We don’t mean it the same way, but when we question a child’s choice, it can have the same effect. A better response is to restate the student’s choice in a statement form…(“you asked for milk…..here’s your milk” (even though they never drink milk!) Direct instruction is necessary for many instructional activities. But communication based activities require student interactive, open-ended activities. Have a balance throughout the day. Only in Spec Ed do you hear that comment. It says nothing about the message the student just said. How many of us would say “I like the way you asked for ____” to our family members. A natural response to the message is much more reinforcing. Our students often don’t have the linguistic and background knowledge to make sense of idiomatic speech….it can “stop them in their tracks” and make them act like “the cat has their tongue” if we don’t “hold our horses” when using figures of speech. Some of our kids need lots of time when initiating. They may have retrieval or word finding problems, processing problems (understanding what you just said), motor planning, etc. Take your time, be patient, but expect them to communicate (look expectantly). Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Strategies to Promote Communication Adapted from Original ECT, Hodgdon, 1999
Engage (get at their level, eye contact) Establish attention Proximity to child Be in their line of vision Watch for student to orient to you (attention shift) Use visuals (present visual first) Use meaningful gestures Exaggerate movements to attract attention Hold gestures (point long enough to mutual referent) Less may be better! Match student’s verbal output? Expand by one General strategies from original ECT combined with work from Linda Hodgdon. The basics are really to engage the student. Use meaningful gestures, wait for them to attend to you, use language at their level and respond to their attempts naturally. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Strategies to Promote Communication Adapted from Original ECT, Hodgdon, 1999
Wait for responses Count to 5, 10 after a command/question Stay engaged Increase opportunities for initiation Be consistent with labels (why?) Modify the environment to create active participation, communication Make sure the student has access to communication at ALL TIMES! A different way of re-stating previous points. Many of these are pre-cursors for the prompt hierarchy, just presented slightly differently with different vocabulary. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

The most language learning will occur when your response is related to the student’s focus of interest or to what he has communicated. Student’s learn language when it’s at their level and has immediate relevance to their focus. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

YOU are part of the environment …
When you use a prompt hierarchy you can: Provide consistency across partners because of framework Give students processing time Be individualized Provide only as much prompting as is needed Key points and an introduction to the prompt hierarchy, but also a reminder that everything we do (or don’t do) impacts the student’s environment & therefore the student. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy Environmental Cue Open Question
PAUSE Open Question Prompt OR Request for Communication Full Model Incorporate descriptive feedback into each step The steps of the CCE/ECT Prompt Hierarchy…. A “least to most” way to prompt or cue students to initiate. Pause between every step to wait expectantly for the student to initiate. Affirm that other prompt hierarchies exist (PECS is the primary one that teams use)….what’s most important is that everyone is consistent using a prompt hierarchy. The reason we like this one is because it is a Least to Most hierarchy. We use descriptive feedback whenever the student initiates/responds, so define that first. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Descriptive Feedback Use after the student has produced a communicative response (at any point within the hierarchy) Descriptive feedback is specific to the student’s communication “Oh, you asked for more juice, here’s your juice.” “You want paint. Here’s some blue paint.” “You asked to be all done. We need to do just one more, then we’re all done.” “You looked at the cheese, here’s some cheese for your sandwich”. Descriptive Feedback is your natural response to the student’s message. It is specific to what they said, not how they said it. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Descriptive Feedback Serves Three Functions Acknowledges Confirms
Immediately acknowledges that the partner “heard” the student’s communication attempt Confirms Confirms that the message sent by the student is the same as the message understood by the partner. Models Can be used to model an expanded version of the communication message. If a student isn’t verbal or using an SGD (speech generating device), then their message may be missed (pointing, eye gaze). Giving them descriptive feedback lets them know that you received their message (oh you want more pizza) Our students don’t always have clear messages, when you give them descriptive feedback, it confirms that the message you received is the same as the one they sent. (pizza….more pizza) Descriptive feedback is a great natural way to expand student’s language, model using other vocabulary on their system, expose them to other purposes of communication besides wants & needs. (“mmmm, good pizza”) Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy Step #1 Environmental Cue
Set up the environment to signal to the student that an activity is about to begin. Lining up at the door Getting everything ready for an activity & then waiting…….. Art materials prepared but out of reach Desired items visible but inaccessible Cutting the pizza up and waiting If student responds, provide Descriptive Feedback Not every activity lends itself to an environmental cue, but it is surprising how setting everything up & then waiting is a very effective environmental cue. The real key to using an environmental cue is being quiet! Look expectantly at the students….shift your gaze from the materials for the activity to the students & WAIT! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy--Pausing. Pause after every step to give the
Prompt Hierarchy--Pausing Pause after every step to give the student time to respond to the cue. Focus your attention on the student (expect communication!) A N PAUSE D If the student responds, provide Descriptive Feedback The PAUSE is the other part of the hierarchy that we push because it occurs after every step. If they pause, it helps them not to repeat (bombard) the student with repetitions. Every student is different in terms of how long you pause….part of the key is waiting expectantly (body language, facial expression, etc.) Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

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 ONE time “What do you want?” “Whose turn is it?” “Where does that go?” AND then…...PAUSE If student responds now, provide Descriptive Feedback Focus on the fact that it is a “wh” question…..one that cannot be answered with a yes or no (some paras have problems understanding what we mean by “open question”) The other focus is that you ask the question ONE time and then wait! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy Step #3 Prompt or Request Communication
If the student does not respond to the open question & pause…… Provide a prompt to students (ONE time) Choices, carrier phrase, initial sound, visual cue OR Request Communication (ONE time) “Tell me what you need.” “Tell me what goes next.” AND then……PAUSE If student responds now, provide Descriptive Feedback This is the first time we actually prompt the student in the hierarchy. It can be a choice (“do you want milk or water?”) a carrier phrase (“I want……”) Initial sound (mmmmm) or visual cue (point to milk carton, sign milk- if the student understands sign & it isn’t their primary form of communication) You can also rephrase that open question into a Mand or Command…Tell me what you want Remind them at each step you pause to give them time to process and respond. If they do, then provide the descriptive feedback. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy Step # 4 Full Model
If the student does not respond to the partial prompt and pause….. Provide a full model for student Use student’s AAC device Use developmentally appropriate model AND then…...PAUSE If student responds now, provide Descriptive Feedback At the last step you provide the full model by saying it and using the student’s system, using a model the student can imitate. We still pause expectantly because emerging communicators may imitate at this stage. But even if they don’t……you provide the full model- give the student what you think they want & provide descriptive feedback. You looked at the pizza….here’s some pizza. The great thing about this hierarchy is that the next time you use it (the next bite of pizza)….you start all over again with minimal prompts. Over time, if it is motivating to the student, they will initiate communication with fewer prompts. They also have a better chance of generalizing in other activities. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

PAUSE In other words…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! Need I say more? WAIT for the student to respond. In other words…PAUSE! Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy 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 as least to most This may be the time to introduce some brightly colored Prompt Hierarchy charts. (I use florescent colored paper with the Prompt Hierarchy on one side & descriptions of each step on the back.) Describe how teams in the past have posted it throughout their room or specifically where their Target Activity is (by the snack table). Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Prompt Hierarchy Show a video of adult staff using the prompt hierarchy with a student. When used correctly, the prompt hierarchy goes really quickly, so I often show 2 clips of the same video. One is just the standard video of the adult prompting a student to initiate. The second is the same video with captions labeling each step. Lead a discussion….if time have participants role play the steps of the hierarchy by having one participant be the student & one the adult (use chocolate as the requested item!). Have each participant go through the steps (in both roles), stopping at various points. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc. How is vocabulary represented? Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands Activity Vocabulary: milk, straw, napkin, cracker, placemat… , Wants/Needs: I want, more, help, specific snack items Social Interaction & Etiquette: sit here, want some?, please, thank you Sharing Information: good, yucky, uh oh, all done Student asks for snack items (e.g., Milk, cracker, napkin, straw, placemat) “I want …” “Can I have….” “milk” Snack materials set out, but out of reach of students. Adult waits expectantly. What do you want? What do you need now? Who do you want to pass that to? Student asks for “help” Student asks for “more…” Makes comments to peers and adults “I want more…” “I like ….” “good …” “You want …..?” Do you want apple or crackers? I want …….. Mmmmmmm (for milk) Sample form with Prompt Hierarchy column completed. Team time for teams to do the same for their Target Activity All students have snack placemat with specific snack vocabulary velcroed on top & core vocab. permanently on sides. Single small pieces of snack Straw on table, but out of reach Milk carton not open Wrong flavor of milk (sabotage) I want milk. Apples please I want more crackers please Student says “all done” when finished “clean-up” “go play” “bye-bye” You asked for milk…here’s more milk. Crackers…..here’s 3 more crackers. Milk is good! Are crackers good too? Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

CCE is a paradigm shift…
From sole focus on the student’s AAC device to communication From focusing on the student’s communication limitations to creating a communication environment From a single player to team ownership for communication opportunities From product-oriented activities to consciously designed communication-based activities CCE requires some mind-set shifts. Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Where do I go from here?

Some Possibilities… Identify one specific student (do not select
your most “challenging” student!) Encourage other teams in the district to join you & form a “study group” where you…. Use videotaping to help you analyze your activities, partner behaviors & environment Critically analyze the activities for student communication opportunities (minimum of 3) Set up your environment to maximize communication (one activity a day) Post prompt hierarchy & start to use Provide feedback to team members & ask for same Others? Most teams will ignore the fact that we suggest they do not start to learn the process with their most challenging student. The trainer should help them think through this.

References American Speech-Language-Hearing Association website: 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. Blackstone, S. (2006). Young children. False beliefs, widely held. ACN:Augmentative Communication News, June 2006, 18 (2). Casey, K. & Kornfeld S. (2004). Developing language-rich light tech AAC systems for young children. Closing the Gap, October/November 2004, 23 (4). Hodgdon, L.A. (1999). Solving behavior problems in Autism: improving communication with visual strategies. Troy, Michigan: QuirkRoberts Publishing. References from the full CCE training & this presentation Adapted from Environmental Communication Teaching ECT from CISC, PA. Developed by J Cumley & M Wirkus-Pallaske

Karlan, George. Environmental Communication Teaching Training
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. Light, J. (1996) Communication is the essence of human life: Reflections on communicative competence. AAC Augmentative and Alternative Communication, June 1997 (13), Light, J.C. (2005, May). AAC interventions to maximize language development for young children. State College, PA: AAC-RERC. Retrieved June 10, 2008 from Skotko, B., Koppenhaver, D., & Erickson, K. (2004). Parent Reading Behaviors and Communication Outcomes in Girls with Rett Syndrome. Exceptional Children, 70 (2), Quill, K. (2000) Do-Watch-Listen-Say: Social and communication intervention for children with autism. Baltimore: Brookes Publishing. WATI (2009). Assessing student’s Needs for assistive technology.

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