Presentation on theme: "AAC Augmentative Alternative Communication"— Presentation transcript:
1AAC Augmentative Alternative Communication Cindy NankeeCESA #3WATI Consultant
2Agenda Share assessment experiences Showcase low, mid & high tech AAC Communication SymbolsIdeas for Using AACSet Up SuccessEducational OpportunitiesPlanning Communication Boards – the 80/20 ruleBoardmaker
3Session ObjectiveParticipants 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 systemParticipants will increase knowledge of AAC resources.Participants will create materials using Boardmaker software
4Name some ways we communicate Communication boardsPicture exchange systemVoice output systemsGestures/signingHair-pullingBody positionCryingEye contactSoundsWordsPointingFalling asleepScreamingSilenceBut for children who tend to communicate in “socially inappropriate” ways, we must find alternate (or augmentative!) ways to help them be effective communicators.
5Augmentative/Alternative Communication AAC *refers to the ways (other than speech) that are used to send a message from one person to another (ASHA, 2005)ExamplesCommunication boards/books/picture symbolsVoice output communication devices (VOCAs) now referred to as (SGD) Speech Generating DevicePicture Exchange Communication System (PECS)Morse CodeEye Gaze
6AAC is not…. “Giving up” on speech Only for those of a certain IQ Only the job of the speech-language pathologistJust “HIGH TECH” devicesA “one-time only” endeavor
7AAC can be a vehicle for developing: expressive language receptive language literacy control over the environment communication initiationQuote over next few slides comes from Linda Burkhart’s book referenced on the slideLinda’s background is as a teacherExpress wants and needs, make choicesReceptive understand agenda, transitions,Literacy boards with booksEnvironmentInitiation greetings
8Which leads to… increased academic success increased participation in social situationsincreased self-esteemincreased job opportunitiesAnd more…
9Individuals Who Might Benefit from Visual Tools… Pre-ReadersCommunication Delays/DisordersEnglish Language LearnersAttention Deficit DisorderComprehension ProblemsLearning DisabilitiesDevelopmental DelaysTraumatic Brain InjuryDown SyndromeAutism Spectrum DisorderAnd many more…
10Assessment ASNAT AT Checklist/AT Wheel STAGES ATLAS Evaluware TASP Test of Aided-Communication Symbol PerformanceCommunication MatrixOnline Free/hard copy $8.00
11Online 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 parentsThe parent version is designed to be "user friendly"Results on a one page Profile
14Showcasing Low to High Tech AAC The WATI Continuum Communication board or bookEye gaze frameSimple voice output deviceVoice output device with levelsVoice output device with icon sequencingVoice output device with dynamic displayDevices with speech synthesis that use typing
15Communication Boards Should Include... Vocabulary that reflects all 4 categoriesWants & NeedsExchanging InformationSocial InteractionsSocial EtiquetteUsing the available symbols, could you communicate about an activity in all categories?Social closeness-social banter, comments, creates conversation, develops relations “What did you do last night”
16Communication BoardsNext on the WATI Communication continuum
31Like Again Show me Whole Past Fast Correct Short Tomorrow Word CommunicationThat’s crazy!Quiz, talk about boardmaker symbols
32Communication Symbol Guideline REAL OBJECTSTANGIBLE SYMBOLSTOBIs (true object-based icons)COLOR PHOTOSBLACK & WHITE PHOTOSLINE DRAWINGSPICTURE COMMUNICATION SYMBOLSTEXT W/ PICTURESTEXT & LETTERSTangible symbols are whole objects, parts of object, texture that represents object, photos.Make sure the child can understand and use objects/photos, without a doubt BEFORE moving on to picture symbols. Failure of symbols due to mistake of not understanding objects. The point here is that many young children need to use actual objects PRIOR to being able to understand Boardmaker symbols. This session is focusing on what they can do with Boardmaker.Sign language is a separate strategy. Requires fine motor more than pointing to picture and requires partner fluent in sign.
33Object Communication System www.adaptivation.com This product contains common objects along w/ picture symbols to assist in the transition between the two methods.
34Tangible SymbolsTangible symbols are objects or pictures that stand for or represent something about which we need to communicate.
35A T. O. B. I. can be a line drawing, photograph etc 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
36When Billy gets home from school… Who will be home when he gets home from school/daycareOr who will be coming to pick him up.
41Ideas for Using AAC In Therapy In the Classroom In the Home In the CommunityBehavior Regulation
42Why Use Visual Tools and Strategies… Hodgdon, 2002Give students information about their activitiesPrepare students for what will or will not happenReduce the anxiety that comes from the unexpected, especially during transition timesHelp students understand the concept of “finished”Provide the structure for appropriate behavior and participationSupport communication and conversation
43AAC in Therapy Schedules and Calendars Tools to Give Information Tools to Make Choices and RequestsTools for Protesting and RejectingTools for Behavior Regulation
44Picture SchedulesWhat 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.
47Tools to Give Information “Behavior problems emerge because what the student is expecting and what is really happening are not the same.”Linda Hodgdon, 2002Calming down boardRule Cards (“When I get to the gym, I sit on the red line.”)International NOLightning BoltActivity Termination SymbolsSocial stories w/ or without picture supportsCard to hold (WAIT)Show calming down board, lightning bolts, activity termination symbols, social stories (made w/ Writing W/ Symbols), wait card, international NO, etc. from inside your Autism WATi KIT
48Making 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
49What to choose, what to choose… Which snack to eatWhich toy to play withWhich seat to sit inWhich person to walk withWhich cereal to buyWhich washcloth to useWhich job to doWhich CD to listen toWhich book to read
50Tools for protesting or rejecting "All Done“ Card
55AAC in the Classroom Same as in Therapy Vocabulary Literacy Boards Literacy Activities to expand languageCustomize booksYou don’t have to talk before you readReading comprehension increases if you are able to talk about it
57Literacy BoardsWhat is it? A single page containing pictures/words specifically relating to a particular storyWhy? Used to identify key characters of the story, along with messages like “turn the page,” “more” or other story-specific commentsWhen? Use before, during, and/or after a story to help lead discussion and help the child fully understand the vocabulary and concepts within the storyHow? Model use by pointing to characters, comments as you talk/read about them
59Snack TimeSimple snack timeBoscobel ECHLily Rider, Louise Hebel
60Snack Time Boscobel ECH Lily Rider, Louise Hebel More complex snack Does it meet 4 categories?Wants and needs/Exchanging Information/Social closeness/social etiquetteBoscobel ECHLily Rider, Louise Hebel
61School to home noteBoscobel ECHLily Rider, Louise Hebel
62Software to expand language skills LauretteStages choicePixwriter
63AAC in the Home Same as Therapy and classroom Create boards for playing gamesFollow a recipeAAC systems with infrared can be used to control anything that can be operated with a remoteChannel surf the TVPurchase a infrared mini controller and automate small appliances (lights, fans, computer, robotic vacuum)Control infrared toys & switch adapted toys
66AAC in the Community Same as Therapy/Classroom/Home Make choices at the restaurant/library/Make comments about: sporting events/movies/concerts/ plays/festivals/fashionsCreate shopping lists
67communication/the academic activity/language ?? Remember ??The focus is not on the technology (low or high) rather, it is on communication, the academic activity and language.Rememberthe focus is not onthe technology rather,it is oncommunication/the academic activity/language??Remember
68The following section from CCE Creating Communication Environments Set Up SuccessThe following section from CCE Creating Communication EnvironmentsCommunicationActivityEnvironmentPartnerActivities that focus on communicationEnvironment that’s conducive to communication by the childPartner that knows how to prompt, model, elicit language, pause
69Arrange the Environment to Increase the Likelihood of Communication Common Strategies….Use motivating materials and activitiesMaterials should be in view but not accessibleStudent should need assistance with some materialsProvide small or inadequate amounts of materialsSabotageProvide something the student doesn’t like/wantUse communication boards/devices & visual tools
70Increase Communication by being a good communication Partner Accept and respond to ANY communication attemptProvide descriptive feedback instead of praise(“You wanted paint. Here’s more paint.”)Be silent when appropriateBe aware of use of figurative language (“take your seat” vs. “sit”)Use a prompt hierarchy
71Prompt Hierarchy Environmental Cue Open Question PAUSEOpen QuestionPrompt OR Request for CommunicationFull ModelIncorporate descriptive feedback into each step
72Prompt Hierarchy Step #1 Environmental Cue Set up the environment to signal to the student that an activity is about to begin.Ringing bellLining up at the doorArt materials prepared but out of reachDesired items visible but inaccessibleCutting the pizza, e.g.After student responds, provide Descriptive Feedback
73Prompt Hierarchy--Pausing Pause after every step Focus your attention on the student (expect communication!)ANPAUSE DAfter student responds, provide Descriptive Feedback
74Prompt 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…...PAUSEAfter student responds, provide Descriptive Feedback
75Prompt Hierarchy Step #3 Prompt or Request Communication Provide a prompt to studentsChoices, carrier phrase, initial sound, visual cue ORRequest Communication“Tell me what you need.”“Tell me what goes next.”AND then……PAUSEAfter student responds, provide Descriptive Feedback
76Prompt Hierarchy Step # 4 Full Model Provide a full model for studentUse student’s AAC deviceUse developmentally appropriate modelAND then…...PAUSEAfter student responds, provide Descriptive Feedback
78Prompt Hierarchy—WHY?Gives student the necessary time to process information and to formulate a message to communicateProvides a structure for adults that encourages communicationCan be customized for individual studentsOrganized least to most
80Educational Opportunities Visual Strategies – Susan Stokes CESA /20 CESA 9 2/26/07CCE (Creating Communication Environments) WATI ConsultantsGet A Grip On Communication Cesa #2- 1/26 and 4/24DynaVox –PECS (Picture Exchange Communication System) Green Bay 1/4 & 5; Milwaukee 4/23 &24
81Creating a Communication Environment (CCE) ActivityEnvironmentPartnerCCE is for staff struggling with the implementation of AAC systems including language boards and low tech to high tech devices, across the school environment.
82Creating a Communication Environment (CCE) A four part sequential interventionA team is required (teacher, SLP, Para, OT, PT, Parent)CESA #2 Milton Wisconsin$600. per 3 person team, $50. per additional team memberJill Gierach, CESA #2 WATI consultantShelly Weingarten, CESA #1 WATI consultanttraining link
83Get A Grip on Communication 2 part training – assessment & programmingSevere and profound multiple disabilitiesSpecial educators, SLP’s, OT’s, Paraprofessionals, Parents$225College creditregistration forms
84DynaVox Trainings www.dynavoxsys.com DynaVox Local TrainingsIntroductory and Advanced TrainingsOnline Programming TutorialsVideo and slide presentationsDynaVox Virtual Classrooman online learning environment that features a live instructor
85Picture 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 peopleThe 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.
86Visual 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
87Creating Communication Boards PlanningAssessment & DesignBoardmakerSpeaking Dynamically ProPixWriterMicrosoft Word Table
8880/20 RuleAugmentative Alternative Communication is 80% planning and 20% programming
89Assessment Evaluware TASP Computerized assessment Assesses size/spacing/visual preferences/auditory preferencesTASPHard copy assessmentAn easy-to-use tool for assessing symbolic skills,Design communication boardsHelp select Aug Communication deviceSet appropriate AAC goalsServes as a tool to benchmark progress in aided communication performance.
90Designing Communication Boards Physical considerations:Size of symbolsSpacing between symbolsPhysical access to all locations of boardLandscape vs. Portrait orientation
91Designing Communication Boards Visual considerations:Color vs. black/whiteColor backgroundSize & spacing
92Designing 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 timeOrganizationBrandenburg, S., & Vanderheiden, g.C. (1988)The Vocally Impaired: Clinical Practice and Research pp
93Arrangements for Communication Displays Activity-BasedCategory-BasedGrammaticallyCorrect-BasedAlphabet and Word Based
94Activity-Based Displays For use with a specific activity (block play, cooking, office help)May necessitate repeating of symbols across multiple displaysShould include comments and social etiquette messagesGeneral left-to-right progression (person-action-attribute-object-location)Should include problem-solving messages
95Category-Based Displays Groupings are based on categories with vocabulary items arranged according to familiar categoriesMay include a main board (e.g., I want to tell you a joke) with branching subtopic messagesRequires knowledge of categorization and the hierarchy of languageDifficult to express relational concepts, or complex thoughts, and difficult to use appropriate syntax
96Grammatically-Correct Displays Groupings are based upon some knowledge of grammarProvide a way to generate more complex thoughts, to develop linguistic and literacy skillsIncludes semantic arrangements, grammatical arrangements, or a modified Fitzgerald KeyMakes it possible for communication partners to model language (augmented input/aided language stimulation
97Alphabet or Word- based Displays Groupings are based on the alphabetMay include combination word-symbol messagesEffective use depends on the student’s prior knowledge, future goals, and the message selection techniques being used
98Color Coding will allow user and facilitator to locate symbols more easily Verbs/descriptors/nouns/prepositionsTip of the month
99Prepositions……….Green Nouns…………………..Yellow Miscellaneous……Orange Goosens’ Crain & Elder Color Coding System Communication Displays for Engineered Preschool Environments (1994)Verbs…………………..PinkDescriptors………..BluePrepositions……….GreenNouns…………………..YellowMiscellaneous……Orange“WH” words, exclamations, negations, etc.
100Planning is Ongoing Continue to Adjust Variables Expand vocabularyIncrease size & array of symbolsIncrease settings: home/community/other people/times in a dayDiffer communication: requests/labeling/commenting/questionsMulti symbol utterancesAccessible/portableBridge up/down hierarchy
110This 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.
111www.widgit.com Resources on symbol use Symbols for literacy Products Webwide – see websites with symbol support
112ReferencesAmerican Speech-Language-Hearing Association website:Burkhart, L. 1993, Total Augmentative Communication in the Early Childhood Classroom, p.38Binger, 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, 2005DynaVox educational specialist Whitfield, K., Planning for and supporting Meaningful Participation and Learning for children and Adults Using AAC
113ReferencesHodgdon, L., Visual Strategies For Improving Communication: Solving Behavior Problems in Autism: Improving Communication with Visual Strategies, QuirkRoberts Publishing, P.O. Box 71 Troy, MIHodgdon, L., Solving Behavior Problems in Autism: Improving Communication with Visual Strategies, QuirkRoberts Publishing, P.O. Box 71 Troy, MIKarlan, 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, 2000Raising a Reader, Raising a Writer: How Parents Can Help. Washington DC: National Association for the Education of Young Children (NAEYC) #530Teaching Our Youngest: A Guide for Preschool Teachers, Child Care & Family Providers, U.S. Department of Education