July  30,  2012  

ISAAC  2012   1  

Crea%ng  Communica%on  Communi%es    

Linda  Burkhart,  Julie  Freed,  Emily  Thatcher,  Amy  Staples,  Eve@e  

Edmister,  Shirley  Robinson,  Gayle  Porter  

Who  are  we?  •  Emily  Thatcher:  Iowa  Department  of  EducaAon  •  Julie  Freed:  Grantwood  Area  EducaAon  Agency,  Iowa    

•  Amy  Staples  &  EveHe  Edmister:  University  of  Northern  Iowa  

•  Shirley  Robinson:  Santa  Clara  County  Office  of  EducaAon  (California)  

•  Linda  Burkhart  –  Maryland  

•  Gayle  Porter  –  Melbourne,  Australia  

Shared  connecAon    PragmaAc  OrganizaAon  Dynamic  Displays  (PODD)  

5  day  workshop  

5  day  PODD  workshop  

•  Principles  and  features  of  PODD  applied  to  a  range  of  access  methods  and  visual/auditory  presentaAons  

•  Aided  language  intervenAon    –  Immersion  –  aided  language  sAmulaAon  

–  Dynamic  assessment  -­‐  intervenAon  –  Developing  operaAonal  skills,  etc.    

5  day  PODD  workshop  

•  Shared  concepts  fundamental  to  PODD  design  and  implementaAon    – communicaAon  autonomy  – communicaAon  accessibility  – meeAng  varied  communicaAon  requirements  •  MulA-­‐modal  communicaAon  

–  the  development  of  communicaAon  competence  – HABITS  for  communicaAon  AT  ANY  TIME  

Communication • Autonomy • Accessibility • Requirements • Competence • Habits – for communication

at ANY TIME

Ownership  of  AAC  system  is  not  enough!  

•  Need  opportuniAes  to  learn  to  use  the  AAC  system  – Develop  competencies  over  Ame  

•  Partners  (communiAes)  who  interact  in  a  way  that  support  individuals  learning  and  use  of  AAC    

July  30,  2012  

ISAAC  2012   2  

5  day  PODD  workshop  

The  importance  of  supporAve  social  network    

•  CommunicaAon  partner  teaching-­‐  learning  

•  CreaAng  communicaAon  communiAes  

Communication community

•  Everyone communicates – Need to understand others and be understood

•  AAC is one way people communicate – Multi-modal communication

•  Everyone’s contribution is valued equally regardless of how it is expressed – Opportunity and response to AAC same as

speech

Community capacity building Knowledge, judgment & skills

Attitudes, beliefs

Policy and practices

•  Individual’s partners, social networks

•  Whole school / service

•  Whole community

Communica%on  Access  CommunicaAon  Resource  Centre,  Scope,  Victoria  (2011)    

“Communica*on  Access  is  about  communica*ng  with  people  who  do  not  use  speech  or  have  speech  that  is  difficult  to  

understand.  It  makes  everyone  in  the  community  aware  that  they  can  play  a  role  in  removing  communica*on  barriers.”      

               www.scopevic.org.au/index.php/site/whatweoffer/communicaAonresourcecentre/communicaAonaccess  

Communica%on  Access  CommunicaAon  Resource  Centre,  Scope  Victoria  (2011)    

•  Able  to  go  into  shops  and  services  and  know  that  people  will  –  treat  you  with  dignity  and  respect  talk  directly  to  you  –  give  you  Ame  to  get  your  message  across  –  listen  to  your  message  –  be  willing  to  use  other  methods  of  communicaAng  

       “the  most  important  thing  is  for  all  of  us  to  be  aware  that  communica*on  is  a  two-­‐way  process.  Both  people  

need  to  take  some  responsibility  for  making  the  communica*on  effec*ve  and  successful.”  

 

           www.scopevic.org.au/index.php/site/whatweoffer/communicaAonresourcecentre/communicaAonaccess  

Features  of    Communica%on  Accessible  schools  

•  Problem  solving  how  every  child  can  understand  others  and  express  themselves  

•  AAC  systems  readily  available  for  AUTONOMOUS  communicaAon  at  ANY  TIME  –  ExpectaAon  that  students  may  have  messages  to  communicate/share  

•  Extra  Ame  to  communicate  using  aided  AAC  –  AcAve  problem-­‐solving  to  enable  this  to  occur  with  available  resources  

•  InteracAon  paHerns  support  children’s  autonomous  communicaAon  –  Able  to  iniAate  their  own  messages,  not  just  answering  adult  quesAons  –  Child’s  iniAaAons  and  messages  using  AAC  responded  to  as  if  message  was  

spoken  –  Focus  on  child’s  varied  communicaAon  requirements,  not  just  adult  

“curriculum”  agenda  

July  30,  2012  

ISAAC  2012   3  

Features  of    Communica%on  Accessible  schools  

•  Staff  use  AAC  –  to  support  children  to  understand  (as  required)  –  to  provide  opportuniAes  for  children  to  experience  their  method  of  communicaAon  used  in  genuine  interacAons  (immersion)  

•  Everyone’s  contribuAon  is  valued  equally  regardless  of  how  it  is  expressed    

•  AAC  training  and  use  extends  beyond  the  school    –  engages  families  and  communiAes    

•  AdministraAon  supports  staff  and  resources  for  AAC  –   supporAng  communicaAon  in  the  mission  statement  

The  dream’s  easy  –  making  it  happen  is  more  of  a  puzzle!  

Establishing  Circles  of  CommunicaAon  Partners:  

The  State  Support  Piece  to  the  Puzzle  Partners    

Iowa  Literacy  &    CommunicaAon  Projects  

13

15

12

11

CedarFalls

Waterloo

Waverly-Shell Rock

SiouxCity

Lake Mills

Decorah

Marshalltown

Norwalk

SolonWest Branch

Muscatine

StormLake

Ankeny

DesMoines

CedarRapids

FortMadison

Iowa Department of Education Initiatives for Students with Significant Disabilities

87

910

1

Communication and Literacy Communication Literacy June 20, 2012Map #3876

Bureau of Studentand Family SupportServices

Project  LocaAons  

Establishing  a  CommunicaAon  Community:  Four  Pieces  to  the  Puzzle  

                                     Grant  Wood  Area  EducaAon  Agency  

 Our  Puzzle  Pieces  

1.  Professional  Development  2.  Resources  to  Support  These  Efforts  3.  Networks  of  Support  4.  RecogniAon  of  Roles                &  ResponsibiliAes  

Grant  Wood  AEA  

Community  

1.  Professional  Development  

•  Varied  Formats/Audiences  – Advanced  7-­‐Day  Training  for  SLP  Core  Team  –  Introductory  level  2-­‐Day  PODD  training  workshops  – One  day  “PracAce  with  the  PODD”  workshops  for  addiAonal  communicaAon  partners    •  Offered  mulAple  Ames  throughout  the  school  year  

– On-­‐going  and  extended  deeper  learning  opportuniAes  for  SLPs  

Professional  Development  

July  30,  2012  

ISAAC  2012   4  

1.  Professional  Development  

•  Content:  Focus  on  Building  CommunicaAon  Community  – AAC  System  OrganizaAon/OperaAon  •  Hands-­‐On  PracAce  Time  

– Belief  System  – Stressed  Importance  of  Aided  Input  – Provide  Wait  Ame  •  Create  CommunicaAon  OpportuniAes  •  Encourage  IniAaAon  

Professional  Development    

Share  Evidence  of  Success  

•  CollecAng  Video  Clips  of  Successful  AAC  IntegraAon–  with  our  own  local  students  – Varied  EducaAonal/Home  Seings  – Students  of  various  ages  and  disabiliAes  – Anecdotal  reports  – Verbal  TesAmonies  

Professional  Development  

2.  Resources  

•  Agency  and  Local  District  Support  – Supported  communicaAon  partner  aHendance  at  PODD  training  workshops  

– CommiHed  resources  to  acquire  PODD  sojware  – Created  a  collecAon  of  various  PODD  books  for  short-­‐term  check-­‐out  for  use  by  IEP  teams  

– Districts  covered  cost  of  creaAng  a  PODD  book  for  individual  students  

Resources   3.  Networks  of  Support  

•  Created  a  regional  PODD  SLP  Steering  Team  to  provide  area  support  

•  Hosted  two  Parent  Night  events:  PODD  Gala  – Means  of  introducing  family  members  to  the  PODD  – Networking  of  parents  –  Venue  for  sharing  parent  tesAmonies  – Q  &  A    

•  Tied  the  use  of  AAC  to  Literacy  InstrucAon  – Without  a  means  to  communicate  literacy  instrucAon  is  quite  difficult  

Networks  

4.  Recognize  Roles  &  ResponsibiliAes  of  All  

CommunicaAon  Partners  

•  AAC  IntegraAon  needs  to  be  supported  by  ALL  IEP  team  members  – AAC  instrucAon  is  not  the  sole  responsibility  of  the  SLP    •  provide  integraAon  support  through  consultaAon  and  collaboraAon  

•  SLPs  can  MODEL  for  other  partners    

– Need  to  acknowledge  and  reinforce  that  a  comprehensive  language  system  is  criAcal  for  meaningful  instrucAonal  opportuniAes    

Roles  &  ResponsibiliAes   Next  Pieces  to  Our  Puzzle…  

•  Expansion  of  communicaAon  communiAes  – More  parent  connecAon  nights  –  Sibling  partner  training  –  Classroom  Peer  training  

•  Focus  on  Early  Childhood  Classroom  CommunicaAon  Support  –  “Stay,  Play,  Talk”  model  (Kathy  Thiemann-­‐Bourque  Nancy  Brady,  Life  Span  InsAtute,  University  of  Kansas)  

Expanding  

July  30,  2012  

ISAAC  2012   5  

Establishing  Circles  of  CommunicaAon  Partners:  

Two  Pieces  to  the  Puzzle  

University  of  Northern  Iowa    

Our  Pieces  of  the  Puzzle  1.  Research  Studies  2.  Pre-­‐service  educaAon  for                  students            

Higher  EducaAon     1.  Research  Studies    

•  Research  projects  completed  by  graduate  students  

•  Comprehensive  CommunicaAon  and  Literacy  Research  Project  –  A  research  study  completed  by  faculty  at  the  University  of  Northern  Iowa  under  contract  with  the  Iowa  Department  of  EducaAon  using  funds  made  available  by  the  United  States  Department  of  EducaAon  under  IDEA.  •  The  contents  regarding  the  study  do  not  necessarily  represent  the  policy  of  the  United  States  Department  of  EducaAon  [or  the  Iowa  Department  of  EducaAon],  and  you  should  not  assume  endorsement  by  the  Federal  [or  Iowa]  government.  

Research    

Research:  Comprehensive  CommunicaAon  and  Literacy  Project  •  Ongoing  professional  development  with  – 10  teams  in  Year  One    •  3  to  4  members  per  team  

– Week  long  professional  development  course  – Contact  once  a  month  – Video  conferencing  twice  a  semester  as  a  group  – Assistance  with  problem  solving  as  needed  

   

Findings      •  Increased  awareness  of  

the  need  to  have  access  to  communicaAon  

 

37  

71  

86  

0  

10  

20  

30  

40  

50  

60  

70  

80  

90  

100  

Prior  to  getting  started  

Beginning  of  Fall  

Ending  of  Spring  

Num

ber  of    AAC    

Time  Of  Year  

Total  Number  Aided  and  Unaided  Augmentative  and  Alternative  Communication  (AAC)  Tools    

Total  Number  AAC    

N=36  

Increased  Use  Of  AAC  Tools  In  The  Classroom       Findings    

•  Establishment  of  collaboraAve  communiAes    – Trouble  shooAng  students’  needs  (access,  opportunity,  etc.)  

– Requests  for  on  going  professional  development  

– Requests  for  assistance  expanding  team/community  membership  

July  30,  2012  

ISAAC  2012   6  

Student  Findings  

•  32  out  of  36  children  exhibited  a  change  in  one  or  more  of  the  following    communicaAon  skills    • higher  number  of  the  total  interacAons  and/or  specific  communicaAon  funcAons  •  increased  variety  of  communicaAon  funcAons  and/or  range  of  semanAc  features  (vocabulary  representaAon).    • change  in  the  clarity  or  complexity  of  the  mode  of  communicaAon  

2.  Pre-­‐Service    

•  Bringing  professional  development  and  what  was  learned  from  classrooms  in  the  state  into  the  University  classroom    

 •  Research    –  providing  opportuniAes  for  undergraduate  and  graduate  students  to  receive  hands  on  experiences    

•  PreparaAon  for  future  employment  and  communicaAon  communiAes  

Pre-­‐Service  

Communication Putting it All Together

Profile– Santa Clara County Ø 32 school districts Ø Large densely populated geographic area with 15

different cities (50 miles from the north to southern part)

Ø Diverse Population

Ø In SiliconValley- High Tech Solutions

SCCOE Special Education Programs

Program Students

Infant 237

Charter Schools 122

Alternative Education

115

Licensed Care Institutions

59

Home/Hospital 26

Special ed SDC programs

1,573

Total 2,132

Program Classes Students Autism 45 333

Basic 76 717

Deaf/Hard of Hearing

17 145

Emotional Disturbance

14 93

Medically Fragile 13 121

Orthopedic Impairment

15 135

Skilled Nursing 3 29

Totals 182 1,573

Ø COE provides variety of services to districts (SDC) SCCOE Special Education (con’t)

Ø Students must have severe cognitive, physical or emotional disabilities to be referred

Ø Administer 180 to 190 Special Day classes Ø Located over 85 different schools and

community centers

Ø 1 to 3 classroom sites scattered throughout the county

July  30,  2012  

ISAAC  2012   7  

FY 11-12 Special Education Budget by Fund

Fund 820 $74.58M

District Requested Programs $66.44M

(Federal & State Resources: E.g., Clusters, IDEA Preschool & Lottery)

Other Centralized Costs $8.14M

(Sp. Ed. Dept. Admin., Indirect Charges, Custodial

& Facilities)

Fund 882 $6.49M

Medi-Cal & MAA $4M

Title I (Part A) $851.20K

Title III $24.01K

Workability I $135.54K

Categorical (Tier III) $518.58K

Preschool Desired Result (Part B) $40.00K

Early Start (Part C) $787.56K

Infant Discretionary

$52.89K

Charters $1.08M

Fund 932 $42.21K

Donations held by Clusters $42.21K*

Fund 950 $10.28M

Early Start Program $3.24M

San Andreas Regional Center

$1.00M

Non-Public Schools $6.04M

Staff & Budget 1000 Employees in just the special ed program of

the county

• 10 Principals • 200 SDC teachers • 618 Paras/SPHC • 50 SLPs • 22 OT/PT • 18 Psychologists • 18 Nurses • 12 Vision and O/M Specialists • 12 APE Specialists • 6 Audiologists • 21 Interpreters • 5 Mental Health • 8 Vocational Ed Specialists

Total 2011-12 Budget: $91 Million Dollars

Setting priorities

Ø Student Population—

Ø 90% of our student population have complex communication needs requiring AAC systems

Ø severe auditory processing issues Ø non-verbal/limited verbal

Ø Significantly high level of behavior plans in autism and

basic programs.

Ø High percentage 1:1 aides for behavior/behavior intervention services

Ø Parents request high level of pull out individual

Speech Therapy services to improve communication

Starting the Journey

Need for Change Culture/Paradigm shift around Communication

Ø Culture Shift— New focus on communication Ø Communication needs to be modeled in a way that students

can understand and reproduce.

Ø Communication happens all day every day

Ø All students can and do communicate Ø Communication is fundamental to all activities Ø Communication is not an adult directed task

Ø Students must have a functional communication system

Ø All types of communication must be honored and recognized so that it is functional for what the student wants to say

Making the shift— Putting the pieces together

Ø Comprehensive system for both receptive input and expressive output Ø Allows students to be immersed in language learning throughout the day

Communication System to Stem across Programs and Abilities

Ø Allows students to communicate what they want to say when they want to say it (over time)

Ø Focuses on “how to” of AAC communication

Ø Pragmatically based so that functions of language are valued

Ø Meets needs of all levels of communication

Ø Grows with student need with consistent navigation as a student moves from class to class

Training Critical Piece of the Puzzle

Ø Variety of training scenarios Ø Five day training for all SLPs Ø Two training for Administrators Ø Two day training for Teachers,

Support Staff and Parents together (ongoing)

Ø One day training for ParaEducators

Ø One day SLPs “next steps” trainings Ø 3 to 4 times a year

Ø In class training –

Ø targeting classrooms

July  30,  2012  

ISAAC  2012   8  

Ø Cost for initial implementation Ø $400,000 to $500,000 each year for first 2 years

Ø Secure sustainable funds Ø School Based Medi-cal/MAA funds Ø Categorical Funds Ø Grants

Ø Cost vs. Results vs. Cost Savings Ø Students more functional

Ø Parents happy with services Ø Reduced requests to pay for outside services Ø Reduced need for ABA and behavior specialists Ø Reduction in need for 1:1 aides Ø Reduction in workman’s comp costs

Budget Resources/Outreach Ø Partnership with inhouse PrintShop

Ø Books printed professionally in bulk for cost saving Ø Safe hours of SLP time

Ø Collaborate with local university Ø University student intern volunteers

Ø PODD CDs on serve for easy access Ø Sharing customizations/pages

Ø Use workman’s comp staff/community volunteers to assemble books

Ø Reach out to train NPS, Private SLPs, ABA specialists, district personnel

Resources

Ø Administrative Support/Part of the Communication Community

Ø Online videos of Student use/ classroom modeling

Ø Ongoing SLP support Ø Changes in service delivery Ø Value added service for teachers

Ø Commercial production of PODD books/Availability is high

Ø Monthly PODD Communication news published in SCCOE Newsletter by Assistant Superintendent

Ø Trainings for writing meaningful, attainable and measurable IEP communication goals.

Support/Reinforcement Support

Ø Create a parent/staff support teams

Ø Secure long term budget priority

Ø Develop a system to mentor teachers in the classroom

Next steps Securing the Pieces for the Future

Ø Empower staff to “speak” about communication with confidence in IEPs/all the time.

Ø Create training videos for practice and collaboration between parents/staff/community

Ø  Pilot a change in service delivery model for SLP services

Ø What parents/ staff are saying: Ø  I got a video of a student using his own PODD and me using mine to communicate. This student is amazing—months ago he was

running out of the classroom constantly and couldn’t follow adult-directed tasks, and did not use icons reliably. Now he is spontaneously using >4 icons off the quick words and has “explored” the PODDS link himself (I haven’t used the “go to” strand often, yet he figured it out!). (SLP working with student)

Ø  “Wow! I was so impressed with the PODD for a high school girl with a traceotomy. We had a 45 minute conversation that could have gone on for

hours” (Summer replacement SLP seeing student for first time)

Ø  “So I'm sitting at the snack table having snack with my PODD and my speech group minding my own business when one of the aides in the room goes up to Mike (one of the other students in the room) with her PODD book over her shoulder (she just finished the PODD training three days earlier ) and she pointed to "more to say" and said to him "I have something to tell you." She flipped to page 2a and pointed to "I want (to do an activity)" and said "We're going to do an activity." She flipped to page 11a and pointed to "something to eat or drink" and said, "It's time to eat. Go to the table.“ Mike got up and joined me and my students at the table. Now I've known Mike for about 5 years and have been his SLP quite a bit of that period and at the beginning of this year had to recommend to his mom that we discontinue direct service since his communication skills were unchanged since I first worked with him. Same few words, “All done” and “more” were his signs, and he could choose from about 10 icons to get some things he might want. So Mike sits down next to me and I say, "Hi Mike, what are you doing here?" expecting just a smile. Well Mike reaches up to my PODD book and touches "more to say." I laughed out loud because Mike has never had anything to say let alone more to say but it was cute so I flipped to page 2a where Mike touched "I want (to do an activity). I flipped to page 11a where Mike touched "something to eat or drink." We all almost dropped on the floor. (Later from page 18 he told me both his juice and his cake were yummy.) Now I have to schedule another IEP to put him back on speech after the holidays.” (SLP talking about a student he had dropped from services due to lack of progress)

Ø  For first time ever, my husband and son like each other. When Jack told him the dog was scary with his PODD, he started to cry. My husband loves dog and Jack always be so mean to it and get in trouble. We never known that he was afraid. But now they talk and my husband gets the PODD so he can talk to. My husband say, I didn’t know he smart!!!!” (from a mother)

Ø  “Hi Fran Just want to say thank you for all the work you have done with Maximus. We are using the PODD book more at home. I'm finding out that I need to catch-up with Maximus on being more fluent with it. As you know we are moving to Concord a big home in a wonderful neighborhood. Maximus told me with his PODD that he wants a chicken or a duck as a pet, I was kind of hoping for goldfish OH WELL !. But on to business, I’m going to E-mail laura that I want a IEP meeting before he transfer to the new school. In the new IEP it is the utmost importance to not only stress but to require that he continues on with the PODDS training, because with it he has proven he can communicate with the world. At home he tells us he wants to watch tv or the dvd or go the farm, were there's ducks and chickens or Harold the helicopter is up stairs or he thinks brocali is yucky and stinks—who knew !!” (parent writing to her son’s SLP)

Successes Supporting the Journey “Wow thank you for the training and for helping us understand. It is not just about the communication but about the relationship. The very first day after the training we took our PODD book home and showed it to Melissa. I guess she had been using it in class for a while because she gave us a big smile and pointed to “More to Say” That was the beginning of our journey. Three months later, we now “talk” and laugh with our daughter who has never said a word in her 14 years of life but she sure has lots to say. As a dad, when I heard she was retarded, I had no expectations of her. I guess she had none of me either. Some days I am not sure whether to laugh or cry. I guess I am still overwhelmed knowing what a delightful daughter I have not known for 14 years.” (Father talking about his daughter)

Successes It is a Process!

• It will take time! • Changing beliefs • Developing skills • Automaticity and integration in practice

July  30,  2012  

ISAAC  2012   9  

OK to just get started!

• Implementing with a single individual and her partners or a single classroom can begin right away

• More comprehensive implementation for

developing a communication community may require more extensive planning and support

Success Breeds Success

• Slowly spreads as people talk about successes

• Build towards a critical mass – tipping point

Go back to the purpose of communication

• Changing service models

• What are the real communication requirements?

• Now and in the future

• Autonomy!

Measure Everything Against the Long term Destination:

For an individual to be able

to say

Whatever they want to say,

whenever they want to say it!

Remember it takes time to change cultures

A journey of a thousand miles begins with a

single step!

Lao-tzu