Welcome to Functional Assessment: Week 7 Please discuss what you did this weekend with a partner….but only using the communication board provided

Updates Preference Assessment Due today Task Analysis on Functional Skills due next week May 9th Task Analysis on Communication Skills due May 16th Task Analysis on Academic Skills due May 23rd. Article Review #2 due May 9th Ecological Assessment Report due on June 6th.

“If I could not express myself, I would become like the tree in the forest—the one for which it does not matter if it makes a sound when it comes crashing down, because there is no one around to hear it. Unfortunately, there are still many silent fallen trees all around us if we stop and look.” Bob Williams, AAC user with complex communication needs (Williams, 2000, p. 250)

Entry Activity #1 Get together with a partner and discuss the preference assessment you conducted. You can use your communication board or your typical communication system

Entry Activity #2 Communication Bill of Rights

Communication Bill of Rights Each person has a right to: Request desired objects, actions, events, & people Refuse undesired objects, etc. Express personal preferences & feelings. Be offered choices & alternatives. Reject offered choices & alternatives. Request & receive another person’s attention/interaction Ask for & receive info about changes in routine & environment. Receive intervention to improve communication skills

Communication Bill of Rights Each person has a right to: Receive a response to any communication, whether or not the responder can fill the request. Have access to augmentative and alternative communication and other assistive technology services & devices at all times. Be in environments that promote one’s communication as a full partner with other people, including peers. Be spoken to with respect & courtesy. Be spoken to directly and not spoken for or talked about in 3rd person while present. Have clear, meaningful, and culturally & linguistically appropriate communication.

Entry Activity #2 Cont’d How you can ensure these occur for students within your current and future teaching situations?

Entry Activity #3 This activity is designed to be used throughout today’s discussion. Based on the chapter you read and what we are talking about today, explain how the assessment procedures we’ve been talking about all term apply to assessing communication.

K-W-L about Communication skills for students with sig. disabilities

Outcomes Define communication & identify who needs communication intervention Identify ecological and observational approaches to determining communication skills and needs.

Communication is… “the complex process of information transfer that individuals use to influence the behavior of others.” (Orelove & Sobsey, 1996)

Resources Downing, J.E. (2005)Teaching Communication Skills to Students with Severe Disabilities Snell, M.E., & Brown, F. (2011). Instruction of Students with Severe Disabilities

Pre-Requisites for Communication? Competence in a symbolic and language system (e.g., spoken English, manual ASL)? Formalized rules of word representation, production, & use? Breathing is the only real pre-requisite (Mirenda, 1993)

Communication is essential to quality of life Necessary to define oneself Share ideas, feelings Demonstrate knowledge & skills Socialize Perform job & daily tasks

Communication: Basic Right When communication fails: Wars are fought (communication fails between countries) Divorce (communication fails between partners) Fired from jobs (communication fails between co-workers, supervisors)

Communication in Daily Life Allows control over physical & social environment Allows for acquiring new skills (strong correlation between literacy & communication skill development for students with severe disabilities; Beukelman & Mirenda, 2005) Allows for socially acceptable way to express feelings of frustration Allows for development of friendships

Least Dangerous Assumption (Cardinal, 2002; Donnellan, 1984) Better to err on the side of assuming competence even if it is not there, rather than err on the side of assuming incompetence when competence is the case. All individuals need to communicate

Who Needs Communication Intervention? Students who demonstrate minimal communication skills that they are not adequately expressing themselves. Cognitive Referencing---Many professionals still believe that for children with severe intellectual challenges communication services are irrelevant (Downing, 2005)— Question should not be whether students will benefit from communication intervention, but how best to provide support

Basic Conditions for Communication (Beukelman & Mirenda, 2005) At least 2 people who understand each other Form (i.e. a way to send the message) Content (i.e., something to talk about) Function: Reason/Purpose to communicate Educational team members must ensure these are addressed

Social Issues in Communication Students in special education classrooms tend to have interactions with adults but limited interaction with other students (Foreman et al., 2004) What affects does this have on: learning communication, and making friends? Foreman et al., found that students with disabilities in general education were involved in significantly higher levels of communication interactions than their matched pair in special education classrooms (2004).

Two key parts of language… Receptive Language: Understanding what people mean when they speak to you. Expressive Language Being able to speak/communicate so that others understand you.

Communication Forms (Behaviors) Multi-modal nature of communication No one form of communication will meet all needs or all social situations Teaching a combination of different modes is necessary Examples: Vocalization, body movements, pointing, facial expressions, nodding, gestures, use of object symbols, picture symbols, manual signs

Communicative Functions/ Intent Request Initiate/greeting Terminate Attention Naming Accept/Reject Protesting situations Affirming situations Expressing choices or preferences

Contents of Communication When there is nothing to say, there is no communication (i.e. the awkward pause when run out of things to say) Individuals with severe disabilities need to have access to a variety of objects, pictures, and photos

Communication Skills Speech Language Conversation Skills Articulation,Resonance, Voice, Fluency Language Phonology, Syntax, Semantics, Pragmatics Conversation Skills Turn taking, content, initiation, closure Articulation - production of consonants, vowels with lips, teeth and tongue Resonance - balance of airflow between nose and mouth Voice - vibration of vocal chords in larnyx Fluency - rate and rhythm; rising and falling; change in pitch Phonology - rules for structure, distribution, sequencing of speech sounds Syntax - rules for word order, sentence organization and word relationships Semantics - word meaning Pragmatics - language use in context; how adapted to different social situations

Problems in the Classroom? Receptive language deficits Cannot recall sequences of ideas presented orally Difficulty understanding humor, sarcasm, figurative language May not understand questions Trouble following directions Cannot retain information presented orally Difficulty understanding compound and complex sentences

Expressive Deficits Spoken language may include incorrect grammar or syntax Limited use of vocabulary Frequent hesitations/can’t find right words Difficulty discussing abstract, temporal or spatial concepts Jumps from topic to topic Afraid to ask questions, does not know what questions to ask, does not no how to ask questions.

Assessing Communication Skills Standardized Tests will not provide the information you need Assessment driven by questions that need to be answered to help benefit from communication intervention—Team Effort Interviews with Significant Others & Ecological-Functional Assessment Process

Considering assessment options? Current communication Environmental conditions Motor capabilities Cognitive/linguistic capacities Language capacities Literacy capacities Sensory/perceptual capacities

Assessing Receptive Communication Skills Receptive skills for a specific activity need to be identified What does the student do to demonstrate that the message has been received and understood? Document what forms of communication seem to be best understood

Assessing Expressive Communication Skills Any attempt by the student to start, maintain, or end a communicative exchange should be noted. How the students communicates (the form)—Skill level? Why the student is communicating (function/intent)—different forms of communication for different purposes? What the student talks about (content)—information on breadth of skills and accessibility?

Significant Other Interview(s) See Communication Style Assessment—handout Interview questions for professionals---handout

Questions for professionals What modes is the student using to communicate throughout the day? Does the student have a means to initiate an interaction? How? Does the student have opportunities to initiate an interaction? When? With whom?

More professional questions Do others in the environment understand and respond appropriately to the student? Does the student have a means to engage different functions of communication, or does he or she primarily make requests or protests? (List the functions/purposes of communication & how the student conveys them)

More Questions to ask Does the student have different things to talk about? What are they? Does the student have the means to respond to others and maintain conversation? How? Does he/she have a way and know how to end a conversation? How?

Last Question… Does the student have a way to correct a communication breakdown? How?

Assessing current communication Communication Matrix by Charity Rowland http://www.communicationmatrix.org/en/ (designs to learn website) Organized by communication function List of behaviors Not used, emerging or mastered

Ecological-functional Assessment Process Uses observational techniques to analyze skill demands of the natural environment and determine how the student performs within the environment Leads directly to intervention plan (Snell, 2002)

Communication Ecological Inventory Worksheet (Figure 8-10, p Communication Ecological Inventory Worksheet (Figure 8-10, p.249, Best, Heller, Bigge, 2005) 1. Ask: Where does the student spend time? (environment, sub-environment, activities) 2. Select Activity: (e.g., ordering food) 3. Observe: (for vocabulary used in activity) List Expressive Vocabulary used in the activity List Receptive Vocabulary used in the activity 4. Review listed words and determine which words & skills need to be taught to the student.

Example of Communication Ecological Inventory Where does the student spend time? Environment: Community: McDonald’s Subenvironment: McDonald’s counter area Activities: Ordering food, waiting in line, socializing in line Select activity: Ordering Food

Example Cont’d Observe vocabulary used in activity Expressive: “I want, hamburger, fish sandwich, small, medium, large, coke, milkshake, yes/no, that’s all, thank you, my order is wrong, I need, extra ketchup, for here, please repeat that, how much?” Receptive: “May I help you?, Is that all?, Here or to go?, Your order will be ready soon?, I don’t understand, Your total is_____” Review listed words: which are above, below, and at the student’s level. Which are within or outside student’s experience, which are necessary for the task

Ecological Inventory of Functional Skills Steps in Activity Natural Cues Comm. Skills Needed Student Performance Discrepancy Analysis Interv. Plan Receptive or Expressive + or - Why student isn’t doing the step suggestions

10 minute partner activity Think of the student you are working with for your task analysis. Use the examples presented and outline how you will determine his/her communication needs

Augmentative & Alternative Communication is… “any means that helps a person communicate when conventional speaking, writing, and/or understanding others are not possible.” (McCormic, Loeb, & Schieffelbusch, 2003) “any item, piece of equipment, or product system, whether acquired commercially off the self, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities.” (IDEA, 1990 ~ Federal Register)

Two types of AAC techniques Unaided- Do not require any external equipment (i.e. manual signs, facial expressions, gestures) Aided- Incorporate external devices (i.e., computers, microswitches, or speech-generating devices (SGDs) Most people use both to communicate in different situations with different people

Communication System Combination of all of the techniques used by an individual student

Unaided Communication Teachers need to be attuned to how student communicates Understand what various gestures, vocalization, and other techniques mean

Gesture Dictionary What John Does What it means How to Respond Runs to the door “I want a drink of water” Let him go for a drink of water from the water fountain or set a timer for when he can go Grabs another student’s arm “I like you” Explain the meaning to John’s classmate & help them work together

When is unaided communication appropriate? Used when students have no other way to get their messages across Must be Socially acceptable & Intelligible

Manual Signs: Pros & Cons Some people who can hear use manual signs (e.g. ASL) Advantage: requires no equipment Disadvantage: Many people do not understand signs, therefore limited communication partners What are other pros or cons?

When to teach signs Poor prognosis for speech Signing partners available Physically able Adequate cognitive skills A portable communication system is desirable

Aided Communication Low-Tech/Non-electronic: symbols, and communication displays Hi-Tech/Electronic: Speech-generating devices Advantages/ Disadvantages of both?

Symbols for Communication Real Object Symbols Photographs & Pictures Line Drawing Symbols Textured Symbols Letters & Words Define these types of symbols and for whom they may be appropriate for. How would you be sure if symbols are appropriate for the student?

Selecting Symbols—What to look for? Should make sense to the user & communication partners (assess with range of choices) Similarity between the symbols & what represents should be obvious Students sensory modalities should be considered Symbols introduced gradually building on current communication skills

Communication Displays--examples Velcro board with a few picture symbols that students point to Plexiglas eye gaze display that a student uses eye to “point” (Figure 8-19, p.261) Communication Book or Wallet

Considerations for Designing Displays Messages: which are needed, in what contexts Symbols: depending on the individual & messages How symbols are displayed: booklets, notebooks, wheelchair trays, scanners Organizing symbols: context specific, how many per page, etc.

Graphic arrays Designing communication boards or communication notebooks Choosing items Size of each item Positioning each item Accessibility of each item Perception of each item (both user and communication partner) Item placement/ordering- groups? Effort in scanning? Motor involvement in using array- vertical or horizontal?

Using Symbols to Promote Participation/Conversation Calendar/Schedule Systems Choice Displays Remnant (e.g. Movie ticket, scraps from activities) Displays Conversation Displays

Hi-Tech: Speech Generating Devices Devices “talk” when a student touches a symbol on the device What are advantages/ disadvantages?? Advantages: “Voice”, can be easily integrated in everyday environments Disadvantages: Cost, cumbersome, break down (when broken down—student has no voice), requires a lot of training for student , staff, and family

Types of Electronic Devices Single-level Devices: deliver a limited number of messages (about 20), simple to program & operate (e.g. BIGmack) Multi-level Devices: Up to thousands of messages, more difficult to program, multiple symbol displays to program messages on two or more levels. Comprehensive Devices: “dynamic display” technology For whom do you think each fits??---most likely dependent on physical & cognitive impairments

Supporting AAC learners is a collaborative effort Family/caregivers & friends Present & future employers Teachers (SPED & Gen Ed.) Speech/language specialists Physical & occupational therapists Student

Supporting AAC Learners (continued) Access to AAC Available Accessible Appropriate Atmosphere of acceptance Nonjudgmental - OK to make mistakes, model correct response, praise attempts, allow more time, minimize peer pressure, reinforce tolerance of individual differences.

Teaching Communication Skills General Education Classroom Ideal environment- numerous opportunities to communicate with responsive communicative partners However, students need specific & systematic instruction to acquire desired skills Educational Team must develop teaching strategies and implement them consistently

Things to Consider with AAC Mode of communication – Input: how the student receives the message; Output: means in which the student transmits the messages to others Mechanism for communication – Gestures, Vocalizations, Graphic Type of selection - Direct selection, Scanning, Encoding Physical display - Number of graphic symbols, Spacing and arrangement, Background, Orientation, Fixed or dynamic Vocabulary selection Output - Print copy, Speech, Scan display Direct Selection - one movement necessary; generally faster; requires sufficient range of motion; requires pointing skill - fine movements Scanning - conducted by listener or “speaker”; generally slower than direct selection; less fine motor required; Encoding - indicate through pattern or series of signals/codes; rapid access to small number of items; faster than scanning in large vocabulary;

What do we choose to teach? Consider: What to communicate about Activities/environments used in People communicate with

Initial Instructional Strategies Establishing Want/No Response Prompt Strategies (Time Delay, System of Least/Maximum Prompts) Milieu Teaching- modeling, manding, time delay, incidental teaching Environmental Arrangement & Interrupted-chain Strategy Conversation skill training

Supporting AAC Learners (continued) AAC Training Training for student, parents/family/friends, teachers, employers, peers Training in the use/maintenance of the system Training in facilitative/instructional techniques that promote communication