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Strengthening Our AAC Therapy for Minimally Verbal Students 

with ASDPower Up ConferenceCarole Zangari, Ph.D., CCC‐SLP

Nova Southeastern UniversityPrAACtical AAC

Essential Ingredients

Visual Supports

Key Strategies

Activities & Materials

Essential Ingredients

AAC vocabulary

Session structure

Goals

J. Comer

No significant learning occurs without a 

significant relationship.

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StructureWe can reduce student anxiety by using structuring our therapy sessions thoughtfully.

Structuring Therapy Sessions

Make the plan visible

Predictability is a valuable tool.

Consider starting & ending each session the 

same way.

Consider including all parts of the session, even those that are brief &/or casual.

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‐ Can serve as a cue for students  w/ intellectual disabilities

‐ Promotes engagement‐ Can add an element of 

predictability

Using Music

Making the expectations clear promotes comprehension & engagement.

Seeing all the elements of the session gets everyone 

on the same page.

Vary the activities based on level of effort & perceived value (motivation)

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Low motivation, high effort

High motivation, high effort

Low motivation, high effort

High motivation, low effort

Medium motivation, low effort

Effort

Motor

CognitiveLinguistic

MultipleDemands

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Communicating via AAC is hard 

work, particularly at the beginning.

Student’s choice

Shared Autonomy

Clinician’s choice Generalization Generalization

Provide support for carryover to functional contexts.

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What words are accessible to the student?

Vocabulary

Context‐specific Words High‐frequency Words

Bufo, logic board, phosphorus

HIGH MOTIVATION

HIGH FREQUENCY

VERY COMMON

FLEXIBLE

LEAST COMMON

extinct, beneficial, arrive

Thursday, somewhere, enough

me, go, up

Binkie, car, water

Activity‐based Communication Displays

19Images: CoughDrop, MDCPS, T. Basan 20

Does the student have access to those words after the session?

(If not, what’s the point?)

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Robust AAC Systems

Core Vocabulary

Fringe Vocabulary

AlphabetMorpholo-

gicalmarkers

Prestored Messages

(You can do this.)

Image Credit: T. Jones‐WohleberClassroom CORE Book (http://bit.ly/1R04KNV)WordPower Flipbook (http://bit.ly/2xemYbS)

Image Credit: Saltillo

Lots of (free) starter sets to try out!

Consider navigational demands

Simple or Complex?

“And what about technology?”

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GoalsHow can we adjust our goal writing to maximize learning outcomes?• Infuse intervention strategies• Set criteria thoughtfully

Goals can include:• Strategies like aided language input

• E.g., Given consistent AAC modeling, ___ will…; When provided with aided language input, ___ will…

• Frequent opportunities• E.g., … use [skill] across 5 activities/day; … demonstrate 

[skill] at least 3 times per activity• Support for generalization

• E.g., … use [skill] in at least 3 environments

At least X times per

session/day%

AccuracyX out of Y

opportunities

See me, see my AAC

AAC EVERYWHERE

AIDED LANGUAGE INPUT

SUPPORTIVE STYLE

EXPLICIT INSTRUCTION

STEP 4

STEP 3

2 STEP

1 STEP

BE

STR

ATE

GIC

To teach AAC, speak AAC

Invite, don’t insist

Direct instruction

Be the fun!Be the fun!

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30-second Rule

29 30

Aided Language

Input

Aided Language

Input

Immersion

Like English Language Learners, students who are not yet competent with their AAC system benefit from being around people who use that same means of communication.

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You look good.

I like it.

What do you think?

What can I say?

Tell me what you think. What (is) up?

Let’s go. Who can help me?

Image Credit: A. Pearce

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Invite & Entice

What does a supportive style look like?

• Few directives for communication • Few questions & mands

• Descriptive talking (Van Tatenhove)

• ‘Think aloud’ approach• Narrate the student’s experience

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Are we testing or teaching?

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“Testing Style”* More. Show me ‘more.’* Stop. Which one says ‘stop’?* Is that ‘happy’ ? ( yes or no?)* Go. Point to go.* Tell me on your talker.

“Teaching Style”* More. Here’s some more.* Stop. Want me to stop?* Happy. You look so

happy!* Go. Let’s say ‘go’!

Build new skills with explicit instruction.

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Awareness of Goals

Component Parts

Demonstra‐tions

Explanations w/ Visual Supports

Effective Strategies

Informative Feedback

Explicit instruction is vital.

• Make the goals known• Break a ‘big’ skill into component parts• Use demonstrations• Provide explanations (with a visual component)

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Sequenced ActivitiesSkill: Moving from single symbol utterances to 2‐symbol utterancesActivity: Language Experience Surveys for generalization

What did you stop?

Stop kicking

Stop yelling

Stop crying

Explicit instruction also involves:

• Evidence‐based strategies such as:• Aided language input, recasts, extensions and explansions, mand‐model, descriptive talking, Read‐Ask‐Answer‐Prompt (RAAP), Comment‐Ask‐Answer‐Prompt (CAAP)

• Informative feedback• Heavy use of visual supports

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Effective Use of Visual Supports

Making themUsing them

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Agenda or Schedule

Visual Template

Anchor ChartToken Boards

Having a schedule is just a first step. Instruction is often necessary. 

Sample Schedule: Therapy SessionPocket at the bottom is used to store symbols once the activity has finished.Presented at the beginning of the session & the student is guided to refer to it during transition b/w activities. In this example, each picture symbol, a corresponding drawer contains materials utilized for the activity.E.g., Books, magazines, clear case with dollar bills and quarters, snack foods, cups, napkins, plates

Teaching the student to use it

1. Remove the top symbol•Match it to the same symbol on the corresponding drawer and place it on the drawer

•Remove the items in the drawer, & do the activity.

•When finished, put the materials away.•Take the symbol from the drawer and put it in the finished area of the schedule.

2. Repeat with the next symbol.

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Supporting Comprehension

Images: T. Moreno, A. Pearce

Learning Aids

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Harness the power of color & patterns

Pixon Project Kit

Build them together (co‐construction)Refer to them at the start (preview)Use them during the teachingRefer back to them later on (review)

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Engaging Activities & Materials

Image Credit: C. Goossens’

Using Content That is Meaningful to the 

Learner

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Capitalizing on interests

55Image credits: Rheinland‐Pfalz; P. Marco 

Why?• Builds engagement• Supports authentic connections• Generalization to real life

What contributes to student engagement?

PersonalInterests

Balance of Effort vs. Payoff

Variety & Autonomy

High Expectations56

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Anton

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Goals1. Increase sentence length to 4+ words2. Use prestored questions

Challenge• Plateaued on most language goals

Strategy• Create a highly motivating ‘end product’ in therapy

Morfo (free)

“I don’t want to do PE . What do you think?”

Anton’s Goals1. MLU 4+2. Use prestored questions

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“I’m just getting started.”“I’m ready to move on.”

Accessing Free/Low‐cost AAC Materials

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Selected AAC Vendors

AssistiveWare’s Core Word Classroom http://bit.ly/2DlaSVl

Selected AAC Vendors•PRC’s AAC Language Lab (subscription): https://aaclanguagelab.com/•Free resources: http://bit.ly/2JDmKlR

Selected AAC VendorsSaltilloChat Editor (Windows only): http://bit.ly/2JB9KgB  Videos & downloads: http://bit.ly/2xemYbS

Selected AAC VendorsSpeak for Yourselfhttp://bit.ly/2JC4g5h

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Selected AAC VendorsTobii‐Dynavox

• My Tobii Dynavox Resources for Professionals: http://bit.ly/2DhEbs1

• PageSet Central: http://bit.ly/2DkTIHA• Pathways: http://bit.ly/2JHuDqF

Pathways

Project Corehttp://bit.ly/2t5mByT

Image Credit: A. Joro

But my kids need technology! 

What about AAC apps?

But my kids need technology! 

What about AAC apps?

Glad you asked!http://bit.ly/SLP

AACapps

Glad you asked!http://bit.ly/SLP

AACapps

Tar Heel Reader ( https://tarheelreader.org/)

• Books created by teachers, SLPs, parents, etc. 

• Download as PPT or PDF• Read online

• Choice of 3 voices• Switch‐accessible

• Create a free account to store favorites & create collections

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Grade Level CollectionsCore Vocabulary Collections

Curriculum‐related Collections

Collaborative Writing

Create books WITH students 

(& publish to Tar Heel Reader)

Essential IngredientsWhat can we do to make AAC sessions run smoothly?

Visual SupportsHow can we build understanding & participation?

Key StrategiesHow can we make the AAC learning more effective?

Activities & MaterialsHow can we build engagement & enjoyment?.

Thank You!QUESTIONS?

You can find me at:@PrAACticalAAC zangaric@nova.edu

Zangari, 2020    www.PrAACticalAAC.org  

Strengthening Our AAC Therapy for Minimally Verbal

Students with ASD Power Up --- December 3, 2020

Carole Zangari Additional Resources

Communicator Levels

Dr. P. Dowden, University of Washington: http://bit.ly/2tME3vQ Continuum of Communicative Independence: http://bit.ly/2tMTp3f

Descriptive Teaching

Gail Van Tatenhove: http://bit.ly/2tIbgHV Core Vocabulary and Descriptive Teaching: http://bit.ly/2tMBbyM

Building Your AAC SLP Toolkit: Obtaining Free Apps for AAC Evaluations: http://bit.ly/2xvA86d

Core Vocabulary Posts: http://praacticalaac.org/tag/core-vocabulary/

Core Vocabulary in AAC Systems o http://bit.ly/1MfrYAH o http://bit.ly/1ExCFro

Core Vocabulary Misconceptions: http://bit.ly/2n3CLt9 Teaching Core Vocabulary: http://bit.ly/1FpLeHG

Speak for Yourself ‘Where Do I Start?’ Worksheet: http://bit.ly/1anxKgG

Language Development

Language Milestones: http://bit.ly/2tMv7GD Brown’s Stages: http://bit.ly/BrownsLangStages Morphological Development Charts: http://bit.ly/2tMpLuV

Activity Ideas

Recipes for Success Series: http://praacticalaac.org/?s=recipe+for+success Book-related: http://praacticalaac.org/?s=Praactically+reading

DIY Core Vocabulary Resources

Tabi Jones-Wohleber’s Classroom CORE Book: http://bit.ly/1R04KNV AAC materials that feature core vocabulary: http://bit.ly/10nYK6p Year of Core Vocabulary & A(nother) Year of Core Words:

http://praacticalaac.org/?s=year+of+core School Year of Core Vocabulary: https://bit.ly/3mofLjb

Zangari, 2020    www.PrAACticalAAC.org  

Selected References Checkley, R., Reidy, L., Chantler, S. Hodge, N., & Holmes, K. (2012). “Black white zebra orange orange”: How

children with autism make use of computer-based voice output communication aids in their language and communication at school. Journal of Assistive Technologies, 6, 4, 245 – 258.

DeThorne, L.S., Johnson, C.J., Walder, L., & Mahurin-Smith, J. (2009). When “Simon Says” doesn’t work: Alternatives to imitation for facilitating early speech development. American Journal of Speech-Language Pathology, 18, 133-145.

Ganz, J.B., Earles-Vollrath, T.L., Heath, A.K., Parker, R.I., Rispoli, M.J., & Duran, J.B. (2012). A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42,1, 60-74.

Liboiron, N., & Soto, G. (2006). Shared Storybook reading with a student who uses AAC: An intervention session. Child Language Teaching and Therapy, 22, 69-95.

Light, J. (1997). “Let’s go star fishing”: Reflections on the contexts of language learning for children who use aided AAC, Augmentative and alternative communication, 13, 158-171.

Murray., J., & Goldbart, J. (2009). Cognitive and language acquisition un typical and aided language learning: A review of recent evidence from an aided communication perspective. Child Language Teaching and Therapy, 25, 31-58.

Olive, M.L., de la Cruz, B., Davis., T.N., Chan, J.M., Lang, R.B., O’Reilly, M.F., & Dickson, S.M. (2007). The effects of enhanced milieu teaching and a voice output communication aid on the requesting of three children with autism. Journal of Autism and Developmental Disorders, 37, 1505-1513.

Proctor, L., & Zangari, C. (2009). Language assessment in students with AAC needs, pp. 47-69. In G. Soto & C. Zangari (Eds.) Practically Speaking: Language, Literacy, and Academic Development for Students with AAC Needs. Baltimore: Paul H. Brookes Publishing Co.

Romski, M.A., & Sevcik, R.A. (1996). Breaking the speech barrier: language development through augmented means. York: Brookes Publishing Company.

Romski, M.A., Sevcik, R.A., Cheslock, J., & Barton, A. (2006). The system for augmenting language. In R.J. McCauley & M.E. Fey (Eds.), Treatment of language disorders in children (pp. 123-173). Baltimore, MD: Paul H. Brookes Publishing.

Romski, M.A., Sevcik, R.A., Adamson, L.B., Cheslock, M., Smith, A., Barker, R.M., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language and Hearing Research, 53, 350-364.

Schlosser, R.W., (2003). The efficacy of augmentative and alternative communication: Towards evidence-based practice. New York: Academic Press.

Shane, H.C., Laubscher, E.H., Schlosser, R.W., Flynn, S., Sorce, J.F., & Abramson, J. (2012). Applying technology to visually support language and communication in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 6, 1228-1235.

Solomon-Rice, P. (2011). Enhancing the language skills of toddlers with severe communication difficulties who benefit from AAC: A comparison of two language intervention approaches. Unpublished Doctoral Dissertation, University of California, Berkeley.

Soto, G. (2013). Conversation-based AAC intervention. Annual ASHA Convention. Soto, G., Solomon-Rice, P., & Caputo, M. (2009). Enhancing the personal narrative skills of elementary school-

aged students who use AAC: The effectiveness of personal narrative intervention. Journal of Communication Disorders, 42, 43-57.

Waller, A., & O’Mara, D.A. (2003). Aided communication and the development of personal story telling. In S. von Tetzchner and N. Grove (Eds), Augmentative and Alternative Communication: Developmental Issues (256-271). London: Whurr Publishers.

Zangari, C. (2012, September). Helping the general education team support students who use AAC. Perspectives in AAC, 21, 3, 82-90.

Zangari, C., & Van Tatenhove, G. (2009). Addressing language demands of the curriculum for more advanced linguistic communicators, pp. 173-193. In G. Soto & C. Zangari (Eds.) Practically Speaking: Language, Literacy, and Academic Development for Students with AAC Needs. Baltimore: Paul H. Brookes Publishing Co.

Power Up ASD AAC Presentation 112620 HandoutPower Up Supplemental Resources