3 IL State Standards Social Emotional Learning Listening and Speaking Goal 2 - Use social-awareness and interpersonal skills to establish and maintain positive relationships.Goal 3 - Demonstrate decision-making skills and responsible behaviors in personal, school, and community contexts.Listening and SpeakingGoal 4: Listen and speak effectively in a variety of situations.Plus more (reading, writing, etc.)!3
5 What do we know? AAC - Augmentative & Alternative Communication Who GoalsMartinsen & vonTetzchner, 1996Paula defined three groups based on Martinsen & vonTetzchner, 1986Alternate Language Group- little or no speech, difficulty in understanding languageAutism, severe cognitive impairment, auditory agnosiaGoal- to assist the understanding of langue, develop interaction skills and increase opportunities for expressive language.Expressive Language Group- severe speech motor dysfunctionCerebral Palsy, Severe Dysarthria, as age, gap increases between what can say and what understandGoal- To provide means to express interests, needs, and comments and to provide opportunity to actively participate in the curriculum and to develop literacy skills.Supportive Language Group- moderate motor speech dysfunction, problems with speech and languageSpeech is poor, but typically do become intelligible speakers, Downs Syndrome, Apraxia, Severe oral-motor impairments, severe articulation disordersGoal- provide a bridge for the development of speech and language and a means to enhance participation and communicative competence.However, all children's need for augmentative communication is not the same. Martinsen & von Tetzchner (1996) identified three groups of children who require augmentative/ alternative communication. They called these the: alternative language group, expressive language group, and supportive language group. Each of these groups is very different and requires AAC for different reasons.The Alternate Language Group is made up of children who use little or no speech to communicate and have a difficult time understanding spoken language. Children with Autism and severe cognitive impairment fall into this group, as do children with auditory agnosia (Problems recognizing sounds as meaningful linguistic elements.). Children in this group often use gesture as their primary means of understanding language. The primary goals of AAC with this group are to provide input to assist the student in the understanding of language, to develop interaction skills for that student and to increase the opportunities for expressive communication.The Expressive Language Group includes students who have severe motor involvement, thus severe speech motor dysfunction. As they mature these children experience a widening gap between what they understand and what they are able to express using speech. Children with athetoid cerebral palsy and severe dysarthria of speech are examples . The main goal for AAC intervention with this group is to provide a means to express their interests, needs, and comments, provide opportunities to actively participate in the curriculum and focus on the development of literacy skills.The Supportive Language Group includes students with moderate motor speech dysfunction. These children often have problems with both speech and language. Speech is poorly articulated during the birth through preschool years, although many of these children will become intelligible speakers. This group may include children with: Down syndrome, apraxia of speech, severe oral-motor impairments, severe articulation disorders and developmental delay. The primary goal of AAC intervention for this group is to provide a bridge for the development of speech and language and a means to enhance participation and increase communicative competence.
6 Alternative Language Group Wholittle to no speech & difficulty in understanding language (Autism, severe cognitive impairments, etc.)Goalassist in understanding language, develop interaction skills, increase opportunities for expressive languageStand if you have kids in this group! Count numbers!Video of Danny
7 Expressive Language Group Whosevere speech motor dysfunction (CP, Dysarthria), widening gap between expressive and receptive languageGoalprovide means to express needs, interests, comment, actively participate, develop literacy skills, etc.Stand if you have kids in this group! Count numbers!Video of Kylie B
8 Supportive Language Group Whomoderate motor speech dysfunction, problems with speech and language, speech is poor, but may develop more intelligibility (Downs, Apraxia, etc.)Goalprovide a bridge for development of speech and language and a means to enhance participation and communicative competencyStand if you have kids in this group! Count numbers!Video of Kelly and JackAided Language Stimulation can also be used when a student needs receptive vocabulary increased. Students in the Alternative Language Group especially benefit from an environment where communication partners use alternative language forms on a regular basis. So it is important to use Aided Language Stimulation, to provide picture schedules and to accompany spoken language with graphic symbols when communicating with a child in this group.When a student uses an augmentative communication board or device (or even their own voice) to respond to communication, but rarely or never initiates communication, increase communication opportunities through Environmental Communication Teaching.-Environmental Communication Teaching (ECT) uses incidental teaching episodes that are short, positive and geared towards functional communication, not language training. There are three major components to ECT training: (1) Use of structural analysis and modifications, (2) use of cues, prompts, and descriptive feedback, and (3) use of AAC techniques and approaches (McCloskey & Fonner, 1999). Structural analysis and modifications specifically focus on knowledge of the different contexts for interaction, how the contexts are socially regulated, and how communicative functions are utilized within those contexts. Within the ECT training, cues, prompts, and feedback strategies are used to facilitate the initiation of communication interaction. These strategies are also utilized to encourage the use of age- and activity-appropriate communication. The prompt hierarchy listed below is employed when target students do not exhibit the level or amount of communication expected.
9 Assessment & Evaluation How do we help?Assessment & EvaluationUniversity of Oregon Teaching EffectivenessProgram defines assessment as:Assessment is the process of gathering and discussing information from multiple and diverse sources in order to develop a deep understanding of what students know, understand, and can do with their knowledge as a result of their educational experiences; the process culminates when assessment results are used to improve subsequent learning.Found on
10 Assessment and Evaluation Evaluation can be defined as:to draw conclusions from, judge,compare and contrast, interpret,decide.In AAC, assessment and evaluation are used interchangeably, but perhaps they should be used together!
11 Augmentative Communication Assessment Goal of AAC- Assist individuals with communication disorders to become communicatively competent to meet current needs and to prepare them for future needs.Beukelman & Mirenda, 1998
12 Augmentative Communication Assessment Purpose of AAC Assessment:Determine which methods and tools will improve the exchange of information between the individual and others- communication!Knowledge of individualAssessment of the skills and needs of the individual in multiple areas affecting access to and understanding of communication (vision, motor, hearing, language, etc.)Knowledge of AAC (not just devices, but also techniques and strategies)Integrated with Evidence Based PracticeIncludes researchClinician’s expertiseConsumer’s values and preferencesBeukelman & Mirenda, 1998Heling & Rush, 2009
13 Results of the AAC Assessment To provide a plan for communication supports that includes:Details of recommended non speech and/or speech generating systemsRecommendations for any changes to the environment to support communication (including training partners)Recommendations for intervention to address or improve operational, linguistic, strategic and social competence
15 Types of AAC Assessments Candidacy modelsWho needs AAC?Replaced by Communication Needs modelsBased candidacy on needs, not on impairmentsParticipation modelAssess and base AAC on functional participation requirements of peersFeature-Based Assessment for Speech-Generating Devices (SGD)Beukelman & Miranda, 1998
16 Plan to Assess and Evaluate Identify and define areas of concernGather information related to concernsGather relevant information for various skill areas related to the use of Speech Generating Device (SGD)Analyze informationCreate a Feature ListGenerate and prioritize potential solutionsCompare intervention optionsDevelop trial action planConduct trials and collect data on effectivenessFormulate recommendationsDocumentPolitano, 2009
17 State the Need or Goal Make sure that everyone is on the same page! What do you hope to achieve by the end of this assessment and evaluation process?
18 Gather the Information Survey family and team members or service providers regarding:Current problemsCurrent communication behaviors or skillsActivity preferencesAny history of usage of communication supportsIf there is conflict over whether the student needs AAC refer to an intelligibility test! Create your own or use The Quick Screener powerpointNeed Case History Form
19 Gather the Information What can I use?Any case history form obtained or developed or customized for this purposeWATI formsEaster Seals DuPage formsInfinitec Student Summary forms (handout)
20 Gather the Information Sensory/PerceptualGoal is to determine size, type, placement of symbols & identify language input & output optionsVision (Any standard assessment information and/or informal notations by team members)Visual AcuityVisual FieldOculomotor FunctioningLight SensitivityColor PerceptionAsk for ideas of how to assess this skill (what other tools can be used, such as Powerpoint, BoardMaker Plus, Device software)
21 Gather the Information What can I use?Formal or Informal testing materials may be:TASP (Test of Aided-Communication Symbol Performance by Joan Bruno)Created boards/electronic displays with differing symbol sizes and placements (eye gaze and direct selection)Pogo Boards (https://www.pogoboards.com/Login.aspx)Speech Generating Device Page sets/tasksDynaVox, Prentke Romich Company, Tobii, etc.
22 Test of Aided-Communication Symbol Performance (TASP) Written by Joan Bruno, available from Mayer-Johnson,A tool for the assessment of Mayer- Johnson symbol-based communication skillsIncludes subtests on symbol size and number, grammatical encoding, categorization and syntactic performanceResults may help determine AAC intervention strategies and goalsProvides starting point for designing communication boards or selecting a page for an AAC deviceShow pages scanned in
23 Gather the Information Sensory/Perceptual (cont’d)Hearing (Standard Assessment)If aided, where is sound best heard from?Other sensory systems (tactile, olfactory, vestibular, gustatory) ** If these are the targets for more in-depth investigation, use of Every Move Counts, Clicks and Chats is recommended as the assessment tool. Information from that tool can then be brought to the Feature Match outline for further determination.Bring out Every Move Counts book.Discuss kids with significant challenges for whom connecting with the environment is a major goal and there disabilities a major road block. Discuss the need to develop communication keys: Be able to separate themselves from the environment, Understand that these is something they can do to exchange information with someone, understand that there are things about which to communicate, and understand that there are people with whom to communicate.Sternberg, L. 1980, Communication Programming Inventory. In Educating severely and profoundly handicapped studnets, Rockville, MD: AspenEvery Move Counts is a unique blend of communication strategies with sensory integration techniques to better meet the needs of individuals with disabilities.Studies by experts in SI have reported an increase in spontaneous language after vestibular stimulation. (Magrun, W.M., K. Ottenbacher, S. McCue, and R. Keefe. 1981, Effects of vestibular stimulation on speontaneous use of langauge in developmentally delayed children. The American Journal of Occupational Therapy 35(2):101-4.)Process for Every Move Counts:Identification Process (find activities to which the individual responds (hopefully in a positive manner)Definition Process (a specific response is selected and contingencies are introduced--the occurance of a pleasurable event becomes dependent on the individual giving a more clearly defined response) Co-occurance!Elicitation and Refinement Process (provide frequent opportunities for the individual to experience co-occurances between their response and the event).Generalization and Expansion ProcessAllows for individuals limitations rather than penalize for them, it does not require a specific response, but gives you a framework for interpreting the responses given.
24 Gather the Information Motor SkillsGoal is to identify optimal seating, positioning, and motor technique for using AAC systemWork with other members of the interdisciplinary team, as necessaryIdentify appropriate positioningIdentify selection method and technique (direct, scanning, encoding)Where on the body (hands, head/voice, feet, arms/elbow, legs/knees, eye gaze)Positioning has a direct impact on motor control, which is necessary for use of all ATDetermine direct selection via what? And thenRangeTarget SizeExperience with Control EnhancersIf Scanning: determine visual, auditory or both? What type of switch access, describe, timing, method of highlighting, memory load of messages or cuing.
25 Definitions Direct Selection- Scanning- Directly touching the item or target desiredScanning-Moving a highlight to a specific targetLinear, circular, row column, column row, group row column, etc.Single switch automatic scanning, two switch step scanning, inverse scanning, etc.
26 Switch DataTalk about How do you know it, How can you show it book from WATI site
27 Gather the Information Motor Skills cont’dWhat action will be usedHow with the movement be used (direct select, head pointing, eye gaze, joystick, Morse code, scanning)ConsiderationsType, range, accuracy, consistency, strength, speed, etc.Activation site: the minimum size of the targets, possible number of targets, spacing of targets, etc., will be determined by accuracySensitivity: the amount of pressure or force needed to activate the target.
29 Gather the Information Questions to ask yourselves:Can the method of access be used repeatedly without undue fatigue, discomfort or embarrassment?What does the student like/tolerate?Can this method be used across all environments or will there need to be other options for other situations/positions?
30 Gather the Information What can I use?Formal or Informal testing materials may be:TASP (Test of Aided-Communication Symbol Performance by Joan Bruno)Created boards/electronic displays with differing symbol sizes and placements (eye gaze and direct selection, scanning)Pogo Boards (https://www.pogoboards.com/Login.aspx)Speech Generating Device Page sets/tasksDynaVox, Prentke Romich Company, Tobii, etc.
31 Gather the Information CognitionGoal is to identify AAC techniques & strategies & select types of symbolsModification of existing assessment instruments may be necessary along with the expertise to interpret resultsGain information on how the student perceives world and how they may use communication within their understanding.
32 Gather the Information Cognition cont’dAssess ability to categorizeAssess ability to use memory skills/motor patternsWhat can I use?Communication Matrix (www.communicationmatrix.org), Every Move Counts-Clicks & Chats, Communication and Symbolic Behavior Scales by Wetherby and Prizant, TASP, other formal or informal tests and inventories.
33 Gather the Information Language skillsGoal is to identify language skills for communication and comprehension.Modification of existing assessment instruments may be necessary along with the expertise to interpret resultsVocabularyGrammarDiscourse/PragmaticsLiteracy(assess understanding if possible and survey needs)Assess reading, spelling, and writing skills if present.Can the student use letter cues, recognize words when offered, understand alphabetical arrangements, etc.
34 Gather the Information What can I use?Use word lists, use interview and observation inventories.Use formal tests (TACL, CELF, SPELT)Video an interaction opportunity, take a language sample! What topics initiated, continued, terminated? What types of words used, how frequently, etc.Use formal or informal assessments regarding literacy levels, sight words, etc.
35 Gather the Information Symbol SelectionGoal is to identify types of language representationModification of existing assessment instruments may be necessary along with the expertise to interpret resultsDetermine how an individual can communication with symbols & possible symbol typesObjects, Texture cues or symbols, Cut Out Photographs, Pictures, and Symbols, Photographs, Line Drawings (Color), Line Drawings (Black & White), Realistic (Color), Realistic (Black & White), Visual Scenes, Alphabet/SpellingTalk about use of photos with BM symbols on them and then fading, etc. Pogo boards with different symbols, etc.
36 Gather the Information What can I use?TASP; Speech Generating Device Protocols; Metaphor Protocol by Gail VanTatenhove (http://www.vantatenhove.com/showfree.php?id=182)Informally created comparisons
37 Gather the Information Use of Communication Partners & EnvironmentsNote support or prompting help given by communication partnersNote needs for different environmentsWhat can I use?Informal observation/documentation, video clips, interview, Social Networks by Sarah Blackstone.
39 Analyze the Information Determine a list of features needed based on performances, behaviors, needs gathered.Input Features and Selection MethodsAccess MethodDirect Selection-Range/size, touch sensitivity or responsiveness, position, zoomScanning-Number of choices, prompting (auditory/visual), zoom, highlighting, etc.
40 Analyze the Information Input Features and Selection Methods (cont’d)Display DesignSize of targets, number of targets, arrangement, contrast, etc.Think about direct selection-- motor memory is important! Maybe do motor memory test?
41 Analyze the Information Output NeedsSpeech outputType- digitized, synthesized, combinationDisplay outputWords/letters for partner/user referenceActivation markerEnvironmental controlsInterface to computers, printers, phone systems
42 Analyze the Information Message CharacteristicsWhole sentencesPhrasesWordsLettersPicturesAbility to combine any of the above?Rate Enhancement StrategiesVisual scenes, topical dictionaries, Unity, word prediction, abbreviation-expansion
43 Analyze the Information Physical CharacteristicsSizeWeightBattery LifeDurabilityMountingTransferabilityEase of setupVisibilityBackup systems
44 Determine Options How do I do that? Generate a list of systems that meet many or most of the needs listHow do I do that?AAC TechConnect (trial)Manufacturer WebsitesHandouts from other sourcesOwn ExperienceTalk about asking manufacturers representativesShow some examples of charts
46 Resources for Systems Comparison AACtechConnectMy Dynamic TherapyClosing the GapSETBCABLEDATAAssistive Technology Exhibits (ATIA, CTG,CSUN etc)Speech Generating Device manufacturersEnabling DevicesGus Communications Inc.Dynavox TechnologiesAMDIAblenet
47 Trials Where can I go? Obtain the top 3 systems for trial State Assistive Technology Program- Lending Program,www.iltech.orgInfinitec CoalitionSpeech Generating Device CompaniesProfessional LoanLocal RepresentativeDevice RentalSchool Districts and Special Ed CooperativesInfinitec WebsiteilTech website
48 Trials Set up systems for student Vocabulary, access method, voice, positioningTrain staff that will be involved with student for trialTry systems with student and note performance, behaviorsLength of trial may depend on student and equipment availabilityDetermine what is important to observe during the trialEase of accessUse of the system functionally (where and with whom and with what other supports)Document performance
49 Trials Compare performances and data and discuss with team members Determine next plan of actionFurther trialsProcural of system and supportsDevelop communication intervention planDetermine responsibilities for ongoing training, troubleshooting, and updating
50 Where do I go to write the report/submit for purchase? Report Templates and Funding InformationAAC-RERCAssistive Technology Law Center, Inc.Funding SourcesAAC Report CoachFunding Assistance from Speech Generating CompaniesOther processes within district or use of established forms from WATI or GPAT (www.gpat.org/)
51 Activity Break into small groups One person volunteers to present a student they work with (no real names please)Work through the Assessment process with the group and determine:What type of communicator?What team members need to be involved?Roles-responsibilitiesWhat do you know as it relates to the Assessment process?What information still needs to be collected, how?Next steps..Be prepared to share key points with group.
52 Contact InformationKathleen Post, MS-CCC/SLPManager, Assistive Technology Department,Easter Seals DuPage & Fox Valley Region830 S. Addison,Villa Park, IL 60181Infinite member website:Wiki site for AAC Linked Series: at