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AAC Augmentative Alternative Communication Cindy Nankee CESA #3 WATI Consultant

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Presentation on theme: "AAC Augmentative Alternative Communication Cindy Nankee CESA #3 WATI Consultant"— Presentation transcript:

1 AAC Augmentative Alternative Communication Cindy Nankee CESA #3 WATI Consultant

2 Agenda 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

3 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

4 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

5 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

6 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

7 AAC can be a vehicle for developing: expressive language receptive language literacy control over the environment communication initiation

8 Which leads to… increased academic success increased participation in social situations increased self-esteem increased job opportunities And more…

9 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…

10 Assessment ASNAT AT Checklist/AT Wheel STAGES ATLAS Evaluware TASP Test of Aided-Communication Symbol Performance Communication Matrix – –Online Free/hard copy $8.00

11 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



14 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

15 Communication Boards Should Include... Vocabulary that reflects all 4 categories –Wants & Needs –Exchanging Information –Social Interactions –Social Etiquette Using the available symbols, could you communicate about an activity in all categories?

16 Communication Boards ml

17 Communication book

18 Placement of Communication Boards Mount on Wheel Chair On Desk/table On locker On Wall/ by bathroom/ sink Play areas Work area Kitchen area

19 Eye Gaze Frame

20 Simple Voice Output Device AbleNet BIGmack Switch (800)

21 Voice Output Device with Levels

22 Voice Output with Icon Sequencing Pathfinder, Prentke-Romich Company

23 Voice Output with Dynamic Display. DV 4 and MT 4 E-Talk Palmtop Mercury

24 Tango by Blink Twice

25 Speaking Dynamically Pro AAC Software with speech output Windows and Mac Create personalized dynamic, multilevel, talking boards $649.00

26 Type and Talk speech Synthesis

27 Tablet PC Speech Assistant

28 Terms/definitions VOCA – Voice Output Communication Device SGD – Speech Generating Device

29 Companies handling dynamic display devices DV4, MT4, MightyMo, Pathfinder, Vantage, Vanguard, Mercury, MiniMerc,

30 More on Communication Symbols

31 1.Like 2.Again 3.Show me 4.Whole 5.Past 6.Fast 7.Correct 8.Short 9.Tomorrow 10.Word 11.Communication 12.Thats crazy!


33 Object Communication System

34 Tangible Symbols Tangible symbols are objects or pictures that stand for or represent something about which we need to communicate.

35 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

36 When Billy gets home from school…

37 Line Symbols

38 Picture Communication Symbols

39 Text with Pictures

40 Communication Board with words/letters/numbers

41 In Therapy In the Classroom In the Home In the Community Behavior Regulation

42 Why Use Visual Tools and Strategies… 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 Hodgdon, 2002

43 AAC in Therapy ™ Schedules and Calendars ™ Tools to Give Information ™ Tools to Make Choices and Requests ™ Tools for Protesting and Rejecting ™ Tools for Behavior Regulation

44 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.



47 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)

48 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

49 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

50 Tools for protesting or rejecting "All Done Card


52 "Wait" Card

53 Teaching NO

54 "First-Then" Card

55 AAC in the Classroom Same as in Therapy Vocabulary Literacy Boards Literacy Activities to expand language –Customize books –You dont have to talk before you read –Reading comprehension increases if you are able to talk about it

56 Vocabulary

57 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


59 Snack Time Boscobel ECH Lily Rider, Louise Hebel

60 Snack Time Boscobel ECH Lily Rider, Louise Hebel

61 School to home note Boscobel ECH Lily Rider, Louise Hebel

62 Software to expand language skills Laurette Stages choice Pixwriter

63 AAC in the Home 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


65 Playdough recipe with Pixwriter

66 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

67 ?? Remember ?? The focus is not on the technology (low or high) rather, it is on communication, the academic activity and language. ?? Remember ??

68 The following section from CCE Creating Communication Environments –Activities that focus on communication –Environment thats conducive to communication by the child –Partner that knows how to prompt, model, elicit language, pause Communication Activity Environment Partner

69 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 doesnt like/want Use communication boards/devices & visual tools

70 Increase Communication by being a good communication Partner Accept and respond to ANY communication attempt Provide descriptive feedback instead of praise (You wanted paint. Heres more paint.) Be silent when appropriate Be aware of use of figurative language (take your seat vs. sit) Use a prompt hierarchy

71 Prompt Hierarchy Environmental Cue –PAUSE Open Question –PAUSE Prompt OR Request for Communication –PAUSE Full Model –PAUSE Incorporate descriptive feedback into each step

72 Prompt Hierarchy Step #1 Environmental Cue Set up the environment to signal to the student that an activity is about to begin. –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

73 Prompt Hierarchy--Pausing Pause after every step Focus your attention on the student (expect communication!) A N PAUSED After student responds, provide... Descriptive Feedback

74 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

75 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

76 Prompt Hierarchy Step # 4 Full Model Provide a full model for student –Use students AAC device –Use developmentally appropriate model AND then…...PAUSE After student responds, provide... Descriptive Feedback

77 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!

78 Prompt HierarchyWHY? 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

79 CCE video

80 Visual Strategies – Susan Stokes CESA /20 CESA 9 2/26/07 CCE (Creating Communication Environments) WATI Consultants Get A Grip On Communication Cesa #2- 1/26 and 4/24 DynaVox – PECS (Picture Exchange Communication System) Green Bay 1/4 & 5; Milwaukee 4/23 &24

81 Creating a Communication Environment (CCE) 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. Communication Activity Environment Partner

82 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 training

83 Get A Grip on Communication 2 part training – assessment & programming Severe and profound multiple disabilities Special educators, SLPs, OTs, Paraprofessionals, Parents $225 College credit registration

84 DynaVox Trainings 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

85 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.

86 Visual Resources for Enhancing Communication from the Indiana Resource Center for Autism *Attainment Company, Verona, WI *Autism Resource Network *Don Johnston Company, Volo, IL *Imaginart Communication Products, Bisbee, AZ *IntelliTools, Inc., Novato, CA *Mayer-Johnson Company, Solana Beach, CA *Pyramid Educational Consultants I nc., Newark, DE *Silver Lining Multimedia, Inc., Poughkeepsie, NY *Slater Software, Inc, Guffey, CO

87 Planning –Assessment & Design Boardmaker Speaking Dynamically Pro PixWriter Microsoft Word Table

88 80/20 Rule Augmentative Alternative Communication is 80% planning and 20% programming

89 Assessment Evaluware –Computerized assessment –Assesses size/spacing/visual preferences/auditory preferences TASP –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.

90 Designing Communication Boards Physical considerations: –Size of symbols –Spacing between symbols –Physical access to all locations of board –Landscape vs. Portrait orientation

91 Designing Communication Boards Visual considerations: –Color vs. black/white –Color background –Size & spacing

92 Designing Communication Boards Language/Cognitive Considerations: –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

93 Arrangements for Communication Displays Activity-BasedCategory-Based Grammatically Correct-Based Alphabet and Word Based

94 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 (person- action-attribute-object-location) Should include problem-solving messages

95 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

96 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

97 Groupings are based on the alphabet May include combination word-symbol messages Effective use depends on the students prior knowledge, future goals, and the message selection techniques being used Alphabet or Word- based Displays

98 Color Coding will allow user and facilitator to locate symbols more easily Tip of the month

99 Goosens Crain & Elder Color Coding System C ommunication Displays for Engineered Preschool Environments (1994) Verbs…………………..Pink Descriptors………..Blue Prepositions……….Green Nouns…………………..Yellow Miscellaneous……Orange –WH words, exclamations, negations, etc.

100 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

101 Summary of Ideas 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

102 Category Worksheet Kristin Whitfield DynaVox educational specialist

103 Boardmaker Software Picture communication symbols used to create communication boards, device overlays, worksheets, picture schedules Teacher Tool $299.00

104 Boardmaker Plus Software This is Boardmaker plus voice Create interactive Activities Minus SDP bells and whistles Student/classroom Tool $399.00

105 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 $649.00

106 Boardmaker Tutorial

107 Word Table with ClipArt

108 symbols include emotions, animals, verbs, nouns, computer technology, and many more. Imagine Symbols are available for download for non-commercial use.

109 Created in Word with Free Image Symbols

110 This is a great site for non- readers. 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.

111 Resources on symbol use Symbols for literacy Products Webwide – see websites with symbol support

112 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. 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

113 References Hodgdon, L., Visual Strategies For Improving Communication: Solving Behavior Problems in Autism: Improving Communication with Visual Strategies, QuirkRoberts Publishing, P.O. Box 71 Troy, MI Hodgdon, L., Solving Behavior Problems in Autism: Improving Communication with Visual Strategies, QuirkRoberts Publishing, P.O. Box 71 Troy, MI 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

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