creating successful communication opportunities! division of accountability office of exceptional...

Creating Successful Communication Opportunities!

Division of AccountabilityOffice of Exceptional ChildrenAssistive Technology Services

Special Thanks to: Carol Page, PhD, CCC-SLP,

ATP SCATP

www.ed.sc.gov

Valeska Gioia Ed.S, ATACPAssistive Technology Specialist

Why Use AAC?• Provides a purpose and intent for

learning - Through play and active participation

• Self-concept, self-esteem, self-competence – improves ability to learn

• Means of expressive & improving receptive language

• Provides a means for self-talk and cognitive processing

Linda Burkhartwww.lburkhart.com

Why Use AAC?

• Communication – may lead to speech, may use AAC as a means indefinitely

• Reduces frustration and behavior problems

• Makes language less transient - VISUAL• Makes language more concrete• Social interacting with peers• Provides support for accessing other

emergent skills (i.e. literacy)Linda Burkhart

www.lburkhart.com

Successful Communication

1. Focus on Communication - Not the technology2. Assessment is an On-Going, Dynamic Team

Process3. Multiple Systems & Multiple Modalities4. Active Learning5. Learn Language through Natural Immersion in

Language 6. Input before Output 7. The ‘Juggling Act’ for Children who Have

Significant Multiple Challenges8. Motivation is Key Linda Burkhart

www.lburkhart.com

Multimodality AAC• More than one form of

communication is needed to meet needs and social expectations.

• Typically many of us use two or more forms of AAC or visual supports as we talk.

• Children learn multiple symbol systems.

Carol Page, PhD., CCC-SLP, ATP

SCATP

Difference between Communication & Visual

SchedulesVisual Schedule• Visual support used

toUnderstand routineUnderstand

expectationsFollow directionsDecrease anxiety

Communication• Symbols used toAllow individual to

communication messages that are important to him/her

Teach higher level communication skills by using motivating messages


SCATP

Picture or Visual Schedule

for Free Play

• The routine should be the act of checking the schedule.

• The routine should not be memorizing the actual items on the schedule.


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Active Participation

• Children with significant challenges, may become passive learners when they have difficulty communicating, interacting and/or understanding what is going on around them.

• Passive Role = Less Learning• Providing opportunities for control– Choice Making– Child-directed activities– Following Child’s Lead

Linda Burkhartwww.lburkhart.co

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Opportunities for Active Participation

Linda Burkhartwww.lburkhart.com

Opportunities for Active Participation

Communication Activities/Games – Carpet Play Square

Errorless Choice-Making• Opportunities for making choices - enable

the child to feel "In Control"• Provide choices that matter–Who (to sit next to, take turn)–What (song lines)–When (order of events)–Where (to put things, places)– How (to sing fast/slow; loud/soft)– Order of events (books, songs)– Song lines Linda Burkhart

www.lburkhart.com

Errorless Choice-Making

All children can participate in the song…

“This is the way we wash our___________.”


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Errorless Choice-Making


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Choice-Making using Labels as Symbols

Choice Board on Mat Board Using Product Labels

Motivation

• Motivation for Learning• Nobody does anything without a

reason that makes sense to them at the time - including young children

• Motivation for learning comes from within a person - Inborn Drives: 1. To Understand2. For Independence and Sense of Self3. To Connect Socially with Others


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Beyond Choice Making

• Communication is not ‘choice making’

• ‘COMMUNICATION’ means that we don’t already know what the person wants to say

• Some children are most interested in the social process, not the message


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Providing Communication Opportunities

• Initiate or call attention• Greet• Accept• Reject• Protest• Request objects• Share and show objects• Request information• Name• Acknowledge• Answer• Comment on

action/object• Express feelings

• Assert independence• Ask questions• Share information• Relate events• Call attention to how

things are related - similar and different

• Talk about past and future

• Negotiate and bargain• State opinions• Tease• Make up stories

Current Strategy – ‘Testing’

• Children are often asked direct questions with a right or wrong answer or given limited choices that don’t go anywhere

• “What is the weather?”


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Single Message Voice Output

Big Mack by AbleNet Chipper by Adaptivation

Partner/One

by AMDi

Ideas for Single Message Devices

(i.e. BigMack)• During an activity to indicate “more” or “finished”• To initiate gain attention “you can’t catch me,” “tickle

me,” or “brush my hair.”• Use to sing a song, part or whole song• Use with a story with a repetitive line• Use during story time, “Turn the page”• Allow the child to “report” the weather during circle

time.• Mount next to door with recorded message “Bye.”• Mount next to door with recorded message “Hi, how

are you?” • Mount device next to inside of door with recorded

message “May I go outside?”

Ideas for Single Message Devices

(continued)• Record message on device related to switch-adapted activity (e.g. fan, light, bubble machine, dinosaur) and connect activity into the device.

• Send student to another location with a request/statement/question, “I would like to borrow___,” “Here’s the attendance, everyone is here today”

• Allow individual to notify others when they need a break with device with recorded message “I need a break.”

• Use for communication between home/school. Teachers can record a message for the child to relay once at home (“We had apples for snack.”) and parent may record a message about an event at home (“We read the book about lions”) for the child to relay to the teacher

• Use device with recorded message (“I want that.”) for individual to select when communication partner scans through choices (“book, computer, snack”).


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Sequential Message Voice Output

Little Step-by-Step by Able Net

Sequencer by Adaptivation

Partner One/Stepper by AMDI

Ideas for Sequential Message Devices

• Use it to spell a name. For example, “A-L-I-C-E – spells Alice – that’s my name Alice”. You can vary the length of this spelling activity depending on the switching ability of the user.

• Use it for counting. You can record the numbers from one to ten– The easiest activity is just to see how many switch presses the user

can do “Wow you got up to 8 today I wonder how many you will do tomorrow?”

– Using the device to count things in the room is a bit harder. “Let’s count how many people are here today”

– Giving directions to draw a silly picture “How many legs?” 1-2-3-4 – “Oh you want 4 legs hey?

• Use it to participate in book reading. For example, record the pages from a small book, e.g. “That’s not my lion”. The user can then “read” the page by pushing the switch when each page is turned.

• Use it to be funny. Record some jokes or riddles, e.g. “Knock knock – Police – Police to meet you – Want to hear another?”, etc. (4 switch presses).

Ideas for Sequential Message Devices

(continued)• Use it in cooking. Record the steps of a recipe to remind the rest of the class during cooking. “Break 2 eggs into a bowl – Add one cup of sugar – Beat until pale and frothy”, etc.

• Use it in class. Record all the students’ names. The device can now be used to do the roll call or to choose a partner for class activities.

• Use it to get to know people. Program in a chat script to make friends and get news from people. “My name is Sue what is yours?” – “I live in Springwood where do you live?” – “My star sign is Scorpio what is yours?” – “My favorite color is pink what is yours?” – etc.

• Use it to be social. Record some messages and compliments to be used anytime anywhere to make contact with people. “You look nice today” – “How are you doing?” – “What’s new?” – “Have you got time for a chat?”

• Use it for social scripts between 2 people to tell a story, engage in conversation, etc.

Current Strategy – ‘Here now, Gone Later’

Vocabulary flies in out of thin air and then poofs back into oblivion at the end of the activity.


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Vocabulary Always Available:Environmental Embedded

Supports


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Vocabulary Always Available:

Individual AAC


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Natural Immersion inLanguage -Input before

Output• Children most effectively learn to use

augmentative communication through the SAME methods that they learn to use verbal communication - through modeling in natural and functional contexts!!!

• Drill and practice, rote learning is not very effective for learning language

• Learning in functional situations facilitates generalization


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Input Before Output• Aided Language Stimulation (Goosens', Crain

and Elder)• Children can not be expected to know how to

use something until they are given an opportunity to learn how to use it in natural contexts

• Multi-Modal Language Stimulation - information needs to go in before it comes back out

• Modeling!• Just-right challenge – modeling one step

beyond current level Linda Burkhart

www.lburkhart.com

Strategies/Examples• To support transitioning from picture exchange system to

a pointing system, model the use of pointing to communication boards

• Model and encourage self-talk using multi-modality supports

• Song books and Song Boards• Use conversational language instead of just questioning

the child ("You like that,“ "Your car is crashing", "That's big", "I'm going to throw the ball", etc.)

• Avoid asking too many questions, use more comments and social expressions ("that's silly", "uh oh!". "we need to clean it up.")

• When asking a question, provide a concrete way for student to respond ("Do you want chocolate or regular milk" - showing both containers or pictures for child to select from)


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Providing Input through Songs


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Juggling & “Inconsistency”

• Cognitive attention focuses on anything that is not automatic.

• Children with significant physical challenges, have not yet developed reliable control of movements at an automatic level, and therefore, even simple movements can be unreliable and require a great deal of cognitive energy to perform.

• Juggling means that the child may only have some of the ‘components in the air’ at any given time, and having all the ‘components in the air’ will be rare. This explains why performance is so inconsistent and can not always be predictably repeated!


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Success?

• We need to take successes and move on, as opposed to requiring repetition of the task over a given number of trials – Meaningless repetition produces boredom and habituation and thus produces inconsistent test results

• For example – the habituation of single message devices and single switch activities


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Natural Contexts• Relate what they already know to new information –

increasing motivation and retention.• Provides meaningful opportunities for practice with

natural variability to maintain interest.• Augmentative systems need to be seen by the child

as a natural means for communication. This is another reason that the systems must be used by others, while communicating to the child.

• A variety of communicative functions need to be modeled

• Children’s attempts to communicate also need to be responded to and expanded upon using the same systems that the child is using.

• Provide activity-specific vocabulary on voice-output devices.

• Teaching vs. Testing! Linda Burkhartwww.lburkhart.co

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Engineering the Environment

1. Identify and prioritize communication activities that occur throughout the day.

2. Develop message sets for each activity.3. Depict message sets on communication

boards appropriate for the target student.

4. Place communication boards in the environments where they will be used.

5. Implement a systematic approach to cueing and teaching the students to use the boards. Carol Goossens', Ph.D., CCC-SLP, Sharon

Sapp Crain, M.S., CCC-SLP and Pamela S. Elder, M.A., CCC-SLP


• Consistent systems across children and environments, when possible

• Place picture symbols at your finger tips - throughout the environment

• Aided language stimulation• Model repair strategies and use of

alternative forms of communication• Sabotage and engineer activities for

communicative opportunities

Carol Goossens', Ph.D., CCC-SLP, Sharon Sapp Crain, M.S., CCC-SLP and Pamela S.

Elder, M.A., CCC-SLP

Aided Language Stimulation Research

• 3 week long aided language stimulation program on vocabulary acquisition skills of children with little or no functional speech (LNFS); 4 children single subject, multiple-probe study across activities

• 3 activities: arts and crafts, food preparation, and story time activity. Each activity was repeated over the duration of 5 subsequent sessions. Eight target vocabulary items were taught within each activity.

RESULTS: • The intervention met the criterion of being used 70% of

the time & providing aided language stimulation with 80:20 ratio of statements to questions

• All 4 children acquired the target vocabulary items. • The 3-week intervention program in aided language

stimulation was sufficient to facilitate the comprehension of at least 24 vocabulary items in 4 children with LNFS.

Dada, S., & Alant, E. (2009). The Effect of Aided Language Stimulation on Vocabulary Acquisition in Children With Little or No Functional Speech. American Journal of Speech-Language Pathology, 18,

50–64.

Article/Research on Aided Language

Stimulation• Study to determine impact on aided language stimulation on children with moderate cognitive disabilities.

• 3 preschool children with moderate cognitive disabilities who were functionally nonspeaking; 12 target vocabulary

• Aided language stimulation during a scripted routine designed for a preferred activity. Before beginning the scripted routine, the experimenter placed a communication board in front of the child. The experimenter referred to each object/symbol four times during each session. The position of the symbols displayed was randomized before each session.

• Results indicated that all 3 children displayed increased symbol comprehension and production following the implementation of aided language stimulation.Dada, S., & Alant, E. (2004). The Impact of Aided Language Stimulation

on Symbol Comprehension and Production in Children With Moderate Cognitive Disabilities. American Journal of Speech-Language Pathology, 13, 155–167.


Carol Goossens', Ph.D., CCC-SLP, Sharon Sapp Crain, M.S., CCC-SLP and Pamela S.

Elder, M.A., CCC-SLP

Environmental AAC Supports

Communication placemat


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Communication CD CaseCommunication CD Case


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Communication Photo Album


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Add Communication Symbols to Play Toys



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Add Communication Symbols to School Items



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AAC Symbols • 95 teachers rated their students’

symbolic communication level:- abstract- concrete- pre-symbolic- awareness

• Statistically significant difference between teacher rating and student actual performance on 10 tasks

(Brower, D. Flowers, C. & Wakeman, S.Y., 2006)Check out:http://www.osepideasthatwork.org/toolkit/index.asp

Continuum of AAC Symbols

Continuum: • objects (easiest)• objects with

pictures and text• photos, pictures

and text (photographs are often easiest for children with ASD)

• text (most difficult)

Carol Page, PhD., CCC-SLP, ATPSCATP

Using Objects to Communicate

• May need to use the actual object at first.• Use a duplicate object (symbol) as soon

as possible.• Begin exchange system.• Mount object on board or voice output

device.• Change color, size or texture of object.• Introduce second, but very different

object symbol.

Elizabeth Rush, MA, CCC-SLP, CPMMary Joan McClure, MS, CCC-SLP

Why Objects Work

• Concrete (low cognitive demand)• Static or permanent (low memory

demand)• Iconic (close obvious relationship to

referent)• Easy to manipulate• Allow tactile discrimination• Support expressive and receptive

communication Elizabeth Rush, MA, CCC-SLP, CPM

Mary Joan McClure, MS, CCC-SLP

When Objects Don’t Work

• Object identification is not communication.

• Miniature objects are not understood well by some (individuals who have visual impairments or autism).

• Non-motivating objects used.• Difficult to find objects to represent

verbs, adjectives, modifiers, etc. (core vocabulary)


SCATP

Object Choice Board

Choice Board Using Clear Plastic Zip Drive Cases

Object Choice Board

Choice Board Using CD Holder

Low Cost Solutions

Vertical Choice Board

Object Cards

Communication Cards

Object CardsFrom Attainment Company

Using Pictures/Graphics to Communicate

• Pictures and graphics have varying levels of iconicity.

• Size, background color, and number do matter.

Picture ResourcesPictures with printed words• Product labels and wrappers• Pogo Boards• Boardmaker software• Pics for PECS 2005 software• Picture This software (Silver Lining

Multimedia, Inc.)• Flash Pro 2 software• Free Photos (www.freedigitalphotos.net)• Picture Master Language Software• Google Images

Adapted Learningwww.adaptedlearning.com

• Free resource that provides a place to find and share adapted curriculum (i.e. communication boards, visual supports) created with Boardmaker Software Family products.

• Screenshot of what each board looks like, ratings, & comments

• Users can download boards, or save them to ‘my files’ which stores your favorite boards under your account.

• Create public or private groups that can to share boards within a group.

http://www.adaptedlearning.com/

AAC Program created with PowerPoint

“Dynamic Beginnings” – Free Downloadhttp://www.childrenshospital.org/clinicalservices/Site2016/mainpageS2016P16.html

• Created by Sharon Shaham, MS, CCC-

SLP, Children’s Hospital Boston• 8 buttons per page• Can not modify• Real child voice

http://www.childrenshospital.org/clinicalservices/Site2016/mainpageS2016P16.html

http://www.childrenshospital.org/clinicalservices/Site2016/mainpageS2016P16.html

South Carolina Assistive Technology

ProgramSCATPSCATP – (South Carolina Assistive

Technology Program) Columbia, SC; provides state-wide resources for the community; demonstration lab for public; free trial loan of AT devices (only pay return shipping)

SC AT EXPO Free and open to the public!

www.sc.edu/scatp

http://www.sc.edu/scatp

SC Department of Education

Assistive Technology Specialists (ATS)

Mission• The mission of Assistive Technology

Services (ATS) is to provide assistive technology support, training, consultation, equipment, and technical assistance to educators who teach students at risk of academic failure and students with disabilities.

ATS SERVICESProfessional Development• presentations, workshops, and trainings

on assistive technology for districts and regions, both in person and online;

• training on conducting assistive technology evaluations and assessments for local staff.

Funding Assistance • Identification of funding sources • Research into grant opportunities • Formation of funding networks among

AT professionals

Additional ATS ServicesTechnical Assistance• Formation and support of AT teams within schools

and districts• Collaborative sessions with instructional

technology specialists• Recommendations on interventions for assisting

students at risk of academic failure and students with disabilities

• Training in AT assessment, evaluation, and implementation for AT teams

E-News – “AT Connect”• News on free software, scheduled trainings, and

upcoming conferences• Sign Up!

http://listserv.sde.state.sc.us/archives/atconnect.html



SCCATN WIKI! SC Collaborative Assistive

Technology Networkhttp://sccatn.wikispaces.com/

Upcoming Trainings, ConferencesFree ResourcesVendor Links

FAQ Best Practice in AT

http://sccatn.wikispaces.com/

Assistive Technology SpecialistsCoastal RegionStacy Springer, MS, OTR/L, ATPCharleston, [email protected]

Midlands RegionValeska Gioia, Ed.S.Columbia, [email protected]

Upstate RegionMark Daniels, MS, Ed.Greer, [email protected] http://ed.sc.gov/agency/Accounta

bility/Regional-Services/ATRS.html

mailto:[email protected]

mailto:[email protected]

http://ed.sc.gov/agency/Accountability/Regional-Services/ATRS.html



AT Resources• ABLEDATA http://www.abledata.com ABLEDATA is sponsored by the

National Institute on Disability and Rehabilitation Research, U.S. Department of Education. The searchable ABLEDATA database contains over 21,000 products.

• Alliance for Technology Access (ATA) http://www.ataccess.org The ATA provides AT information and support services to children and adults with disabilities.

• ATSTAR Program http://www.atstar.org The Assistive Technology - Strategies, Tools, Accommodations and Resources (ATSTAR) Program is designed to increase AT expertise through technology-enhanced learning environments.

• Assistive Technology Industry Association (ATIA) http://www.atia.org The Assistive Technology Industry Association is an organization of manufacturers, sellers or providers of technology-based assistive devices and/or services. The organization sponsors the ATIA annual conference and the Assistive Technology Outcomes Journal.

• Assistive Technology Training Online (ATTO) http://www.at-training.com The Assistive Technology Training Online Project provides internet-based training in both general and specific areas of adapted computer use.

http://www.abledata.com/

http://www.ataccess.org/

http://www.atstar.org/

http://www.atia.org/

http://www.at-training.com/

AT Resources• California State University at Northridge, Center on Disabilities (CSUN)

http://www.csun.edu/cod/ Located at California State University, Northridge, the Center on Disabilities develops and publishes materials of interest to the field of disability and sponsors conferences, seminars, and workshops.

• Center for Applied Special Technology (CAST) http://www.cast.org CAST is an organization that works to expand learning opportunities for all individuals, especially those with disabilities, through the research and development of innovative, technology-based educational resources and strategies.

• Closing the Gap http://www.closingthegap.com This web site spotlights resources in computer technology, special education and rehabilitation. The Resource Directory is a database of over 2000 hardware and software products which is web searchable. Links to vendors are included.

• Council for Exceptional Children (CEC) http://www.cec.sped.org CEC is an international professional organization dedicated to improving educational outcomes for individuals with exceptionalities, students with disabilities, and/or the gifted. Services provided include professional

http://www.csun.edu/cod/

http://www.cast.org/

http://www.closingthegap.com/

http://www.cec.sped.org/

AT Resources• Georgia Project on Assistive Technology (GPAT) http://www.gpat.org

GPAT is a project of the Georgia Department of Education: Division for Exceptional Students, providing a range of technical support services in the area of assistive technology to local school system personnel and their students. Contains helpful resources, forms, and a video-linked consideration guide. GPAT Videos - http://coefaculty.valdosta.edu/spe/ATRB/Video_Tips.htm

• Maryland Assistive Technology Network http://www.matnonline.com/ Established by Johns Hopkins University Center for Technology in Education (CTE), the Maryland Assistive Technology Network (MATN) provides assistive technology specialists information on the most up-to-date AT policies, practices, and devices. CTE offers professional development opportunities to MATN members through its semi-annual institutes with nationally acclaimed leaders in assistive technology, regional meetings, and the MATN Online Web site.

• National Assistive Technology Research Institute (NATRI) http://natri.uky.edu (NATRI) conducts assistive technology (AT) research, translates theory and research into AT practice, and provides resources for improving the delivery of AT services.

http://www.gpat.org/

http://coefaculty.valdosta.edu/spe/ATRB/Video_Tips.htm

http://www.matnonline.com/

http://natri.uky.edu/

AT Resources• National Center for Technology Innovation (NCTI)

http://www.nationaltechcenter.org/ NCTI seeks to broaden and enrich the field of technology for the education of students with disabilities by providing resources and promoting partnerships for the development of tools and applications by developers, manufacturers, producers, publishers and researchers.

• Office of Special Education Programs (OSEP), U.S. Department of Education http://www.ed.gov/about/offices/list/osers/osep/index.html?src=mr OSEP is dedicated to improving educational results for children with disabilities. The site provides information on Federal policy, national grant projects, national studies, and statistics related to disabilities and other related resources.

• Oregon Technology Access Program (OTAP) http://www.otap-oregon.org/ OTAP provides training, information, technical assistance and resources regarding the uses of technology for children with disabilities.

• Quality Indicators for Assistive Technology (QIAT) http://www.qiat.org The QIAT Consortium is a national grassroots group dedicated to identifying, disseminating, and implementing a set of widely applicable quality indicators for assistive technology services in school settings. The QIAT listserv provides a national forum for discussion of AT issues.

http://www.nationaltechcenter.org/

http://www.ed.gov/about/offices/list/osers/osep/index.html?src=mr

http://www.otap-oregon.org/

http://www.qiat.org/

AT Resources• Rehabilitation Engineering and Assistive Technology Society of North

America (RESNA) http://www.resna.org/ RESNA is an interdisciplinary association that provides a credentialing program for assistive technology service providers. The RESNA Technical Assistance Project provides technical assistance to the 56 state/territory programs as authorized under the AT Act of 1998.

• Technology and Media (TAM) Division of CEC http://www.tamcec.org TAM is a division of the Council for Exceptional Children (CEC) that works to promote the effective use of technology and media for individuals with exceptional educational needs. The site includes information on conferences and professional publications including the JSET Journal.

• Texas Assistive Technology Network (TATN) http://www.texasat.net TATN is a collaborative network between the twenty (20) education service centers in Texas with Region 4 Education Service Center in Houston providing statewide leadership. The site provides links, resources, and training materials.

• Wisconsin Assistive Technology Initiative (WATI) http://www.wati.org WATI is a statewide project funded by the Wisconsin Department of Public Instruction to help all school districts develop or improve their assistive technology services. It includes information on best practices, training materials, resources, sample forms, and provides links to other sites related to AT.

http://www.resna.org/

http://www.tamcec.org/

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