1. Augmentative Communication Step By Step By Tracy Vail,MS,CCC/SLP Speech/Language Pathologist Letstalksls.com tlvail@mindspring.com

2. Why? Teaches the child the power of communication even before they can vocalize. Teaches the child the power of communication even before they can vocalize. Makes “words” valuable Makes “words” valuable Gives the child some control over their environment. Gives the child some control over their environment. Serves as a replacement for other maladaptive behaviors Serves as a replacement for other maladaptive behaviors

3. Step 1. Learn the child How does the child respond to different sights? How does the child respond to different sights? How does the child respond to different sounds? How does the child respond to different sounds? How does the child respond to different textures? How does the child respond to different textures? How does the child respond to touch? How does the child respond to touch? How does the child respond to taste? How does the child respond to taste?

4. Step 2. Become a provider of “all good things” Provide all the favorite things with no demands Provide all the favorite things with no demands Never allow the child to play with favorite things alone. Never allow the child to play with favorite things alone. Look for “engagement” Look for “engagement” The child is running TO you, not away from you The child is running TO you, not away from you

5. Engagement

6. Step 3. Determine the best response form Voice Output Devices Voice Output Devices Picture Communication Board Picture Communication Board Picture/Object Exchange Picture/Object Exchange Sign Language Sign Language

7. Considerations for Voice Output Devices Vary greatly on complexity and cost Vary greatly on complexity and cost Allow child to hear speech when button is pushed Allow child to hear speech when button is pushed Can be understood by anyone Can be understood by anyone There is a tendency for children with Autism to use the tool inappropriately. There is a tendency for children with Autism to use the tool inappropriately.

8. Picture/Theme Boards Can be used to stimulate language development Can be used to stimulate language development Allows child to “see” what’s being said Allows child to “see” what’s being said Children can be taught to point to communicate Children can be taught to point to communicate Easy to use for specific activities Easy to use for specific activities Child must gain attention of “listener” before communicating. Child must gain attention of “listener” before communicating.

9. Theme Board

10. Considerations for Picture/Object Exchange Teaches child to initiate communication Teaches child to initiate communication Photos/objects/icons can be used Photos/objects/icons can be used Requires 2 people for initial teaching Requires 2 people for initial teaching Must keep pictures/objects/icons available Must keep pictures/objects/icons available Movement of handing picture is always the same Movement of handing picture is always the same Tough to teach functions other than requesting Tough to teach functions other than requesting

11. Picture Exchange

12. Considerations for Sign Language Not everyone understands Not everyone understands Child may have difficulty with fine motor movements Child may have difficulty with fine motor movements Signs can be iconic Signs can be iconic Child always has hands available Child always has hands available Abstract concepts easy to teach Abstract concepts easy to teach Each movement is different, just like speech Each movement is different, just like speech

13. Sign

14. Considerations in choosing Choose what works for the individual child Choose what works for the individual child Run experiments to see which the child will learn the quickest Run experiments to see which the child will learn the quickest Can use a variety of response forms simultaneously but not for the same object/action Can use a variety of response forms simultaneously but not for the same object/action

15. Step 4. Choose Targets Avoid general words –( i.e. eat, more)- Be as specific as possible Avoid general words –( i.e. eat, more)- Be as specific as possible Teach the child’s very favorite items/actions even if they seem strange to you Teach the child’s very favorite items/actions even if they seem strange to you Avoid words that are “polite” but carry no meaning (i.e. please/thank you) Avoid words that are “polite” but carry no meaning (i.e. please/thank you) Avoid words you would like the child to request but for which he/she has no interest (i.e. potty) Avoid words you would like the child to request but for which he/she has no interest (i.e. potty) Avoid “yes/no” early in teaching Avoid “yes/no” early in teaching

16. Using Signs to Request

17. Watch for Confusion as Vocals Develop

18. Don’t Drop Augmentative Communication Too Quickly