current, best strategies for speech- language pathologists to help students with augmentative...
TRANSCRIPT
Current, Best Strategies for
Speech-Language
Pathologists to Help
Students with Augmentative
Alternative Communication Needs MariBeth Plankers, M.S., CCC-SLPRegional Area Technology CenterMinnesota State University MoorheadMoorhead, Minnesota
AgendaAM
8:30 Introduction
8:45 AAC General Info
8:55 Levels of Technology
9:30 Assessment
10:00 Break
10:15 Goals and Objectives
10:30 Vocabulary Selection
11:15 Collaboration
11:15 Planning Process
PM
11:45 Lunch
1:00 Literacy and AAC
1:30 Accommodations/Modifications/VI, OT, PT
2:10 Alternate Access
2:30 Autism Spectrum/Visual Strategies
3:05 Wrap up/Questions
Handbook Tour Addressing Questions and Introduction of Program Manager
TABLE OF CONTENTS
A Gift!
Qualities of the Gift
Immediate
Accessible
Dynamic
In Control
Emotions
Reflective
It defines who we are as a person. The gift is…
The Ability to Communicate
“I wonder…..” The rest of the story to be told…..
AAC General Information
What does AAC mean to you as an SLP?
Page 1
AAC RESOURCES Sticker reminder! Page 2
CommunicationsUnaided
Gestures
Body Language
Facial Expressions
Sign Language
Aided
Low-Tech
Mid-Tech
High-Tech
Electronic Communication Systems
Levels of Technology
Page 5
Page 5
Initial ConsiderationsThe Model
Model to AAC Guidelines
Student related AAC Options
Environmental Barriers
AAC Task Requirements
Goals
Multiple Modes
Team Decision
Page 6
AAC Options Student related
Accessibility
Cognition
Purpose
Function
Compatibility for setting/situation
Eliminate the Inappropriate
OptionsTech Level
Size
Vocabulary
Mounting
Dated
Student changes
AAC Task Requirements
Communication Functions
Academic
Social/Emotional
Gaining Attention
On-going Communication
Multi-media
Goal DrivenWhat is the overall goal?
Benchmarks to determine
Setting/Situation
People: Friends, family, school, community, vocational
Personal
Multiple Mode Considerations
Gestures
Signing
Eye Gaze
Facial
Pictures/Graphics/Text
Speech Generating Devices
Team Decision Process
Student
Parent/Guardian
Agency
School Staff: General/Special Ed.
Community
Vocational
Levels of AAC Technology
Page 6
No-Tech Considerations
Page 6
Gestures, Facial, Signing
Scavenger Hunt
Low/Mid-Tech Considerations
Page 7
Page 7-8
High-Tech Considerations
Page 8
Page 8
Aided Language Stimulation
Page 11
Page 11
Aided Communication Strategies: 101Handbook
The AAC Expert Learner, we must
show: How to use their system
How to communicate
How to use other modes of communication in conjunction
Key Aided Language Strategies
Allow for a model of communication to occur
Find strong areas of interest
Give feedback through various models: verbal, visual, tactile
Create numerous opportunities
Utilize stucture and routine throughout day
Consider wait time
Create multiple means of engagement.
Create multiple means for representation.
Create multiple means for action and expression.
Assessment Process
Page 13
Page 13
AAC Assessment
On-going process
Team supported
Leads to intervention planning
Include in the AAC Assessment
Student information
Environmental barriers and strengths
Modes/methods of communication
Current and considered interactions
Tasks to achieve
Tools for consideration
Page 14
Interview the IEP team
Participation Model
SETT (Student, Environment
Task and Tools)
Every Move Counts Clicks and Chats
Benefits of Participation ModelThere is a need for continuation
of intervention planning and implementation due to change in
on going communication.
Page 15
Assessment Segments Note the current communication abilities and needs, in addition to the expectations in the environment.
Identify a communication systems that will support the student in new communication settings/situations.
Continue to support the system with changes as needed based on abilities and changes with the student.
Participation Model Process
Participation Patterns
Communication Opportunities
Participation Comparison
Barriers: Opportunity and Access
Participation Model Benchmarks
1. Identify a target activity (Twirl painting)
2. List the steps of the activity
3. Observe typical peers’ ability and performance and then rate the potential AAC individual’s level of independence.
4. Indicate if a difference is noted between the typical peer and the observed AAC individual’s performance.
5. Document which barriers inhibit participation.
Participation DocumentationLevels of Participation
Note the range from independent to no participation.
Types of BarriersOpportunity
Policy
Practice
Attitude
Skill
Access
Message Selection
Vocabulary
Symbols
Other notations
Intervention Planning
1. Opportunities are given to the student (time)
2. Demonstrate clarification of student’s ability
3. Accessibility is ready and always available
Intervention continued
4. AAC systems are readily accessible for quick and easy communication
5. Intervention may also include changes in the environment
SETT
Student
Environment
Task
Tools
Pgae 16
Benefits of Using the SETT
It is sequential
Driven by student needs
Supported by the environment and tasks
Tools are considered last
Example of Student questions
What does the student need to do, but is currently unable to do?
What are the student’s strengths, abilities, accomplishments, motivators and unique needs?
What strategies and accommodations have been successful?
Examples of Environmental
questionsWhat environments are typical for the student to complete IEP tasks along with materials available?
What is the physical and instructional arrangements?
What current supports and resources are available to the student and Team?
Examples of Task questions
What are the natural occurring activities that take place in the environment that are critical to the student?
What are other ways of completing the task?
Tools
What might be included and considered for the student’s AAC system of tools?
SETT Framework Reminders
Begin with the student in mind.
Determine the role and expectations of the environment and how the student works within a variety of settings/situations.
SETT Process Continued
Determine the tasks within the environment that the student is expected to accomplish.
Begin the process of determining tools that will best address the student’s AAC needs based on the environment and tasks demands.
Every Move Counts Clicks and Chats
Sensory based approach to communication and assistive technology for individuals with significant sensory motor differences, developmental difference and autism.
Page 17Jane Korsten, Terry Foss, Lisa Berry 2007, 2011 EMC Communication,
Every Move Counts
Everyone communicates in some way.
The goal is to identify a symbol system appropriate to the individual’s cognitive abilities.
Communication must be recognized and consistently reinforced with those with severe differences. http://www.everymovecounts.net/theprogram.html
Technology is a tool that should be used to
achieve goals and objectives. Once a tool has been decided, we
then must begin to determine what we
want the tool to accomplish.
Goals and ObjectivesWhat is your goal for today?
Page 19
Page 19
What is it that you want the student to
accomplish? Determine the AAC student’s
final outcome.
Three Components of a Goal:
1. Students know what they are suppose to do
2. How to do it
3. Why it is important
Goal example:The student will increase their ability to communicate effectively and independently using multiple modalities (facial expressions, gestures, verbal speech) with various communication partners in a variety of settings.
Lesson Plan objective examplesAllow for indication of preference or choice
Provide opportunities for requests and comments (through multiple modes of communication)
Provide opportunities for engagement with literacy (reading of a story)
Vocabulary SelectionWhat can we say??
Page 23
Nouns
Verbs
Descriptors Labels
Modifiers
Actions
Page 23
AAC VocabularyCore
Few in number
High use
Many settings
Variety
80% of sample words
FringeLarge number
Limited use
Select settings
Mainly names/nouns
20% of sample words
Page 24
Conversation Role Play Find a communication partner. Ask them
what they are doing tonight.Count the core and fringe vocabulary they
use in their response.
Data Outcome:Core words: 80-95%Fringe words: 5-20%
What is the priority in selecting
vocabulary? Type of AAC User
Interests/MotivatorsParticipationSuccess
Page 25
Priority Selection Continued
Specific TechniquesEnvironmentOpportunitiesTasks Demands
Breakdown of Communicators
Emergent Communicator
Context Dependent
Independent
Emergent Communicator
Symbolic Communication needs to be indentified.
Context-Dependent
CommunicatorSpecialized strategies required.
Independent Communicator
Increase desire to gain across all settings.
Additional Vocabulary
Options
Page 26
Pixon ProjectStart with core vocabulary
Carryover to an AAC system that uses these words
Continue with simple manual board
Transition to possible speech generating device with manual boards
Pixon examples and resources https://store.prentrom.com/product_info.php/cPath/30/products_id/163
Starter set
PODD Communication
BooksProvide multiple opportunities to communicate
Give a variety of messages
Offer many topics
Consider multiple environments
Page 27
Vocabulary Organization
Collaborative Team
Page 29
Page 29
The TeamWho’s on the team?
Page 30
Team Discussions Plan for those discussions.
AgendaTeamMember
Team member 1
Team member 2
Team member 3
Team member 4
Team member 5
Topics
CurriculaAssess/EvalClassroomBehavior
Agenda TeamMember
Team member 1
Team member 2
Team member 3
Team member 4
Team member 5
Topics Programdevice
Program boards
Curricula
Social Science
Assess/Eval
Perform-ance testing
Informalvocabulary
Large groupintro
Classroom
Large group intro
Behavior
Small group
Small group
Roles and Responsibilities
Your Role(As You See It)
General Education(As You See It)
Paraprofessional’s Role(As You See It)
Your Role(As Seen by Others)
Page 31
Develop a Plan
Determine Roles and Responsibilities
Plan Agenda
Think Cross Categorical
Communicate with one another
Monitor Procedures
Access ideas/strategies
Behavior management
Adaptive procedures
Universal design for learning
Collaboration OptionsThe ideas through technology are endless!
Skype Facetime
Wiki Blogs
Listserve websites
Team ReflectionTeaching personality and style
New sense of enthusiasm and healthier, work environment
Aware of current ideas in education
Extension of interpersonal skills
Planning ProcessWhat is the goal you want to accomplish?Share one goal you wish to
accomplish!
Page 33
Page 33
Key Instructional Strategies
1. Structure the environment
2. Present choices and opportunities
3. Implement AAC into the classroom
4. Documentation
Page 34
ChoicesOpportunities
Morning Start time
Reading small group
Math group
Gym
Lunch
Tasks
Greeting and Request
Turn taking
Request action
Turn taking/Action
Classroom and AACDetermined by needs of the student
Document, Document, Document
Documentation Consideration
Prompting
Questions to Review
What did the environment look like?
What task was the student to achieve?
Multiple ModalitiesTargeting AAC
Low Tech
No Tech
Mid-Tech
High Tech
Page 35
Movement Creates Engagement
Engagement Creates Thinking
And
Thinking Creates Results
Targeting AAC AAC User Template
Time of day
Activity Goal/objective
Mode of Comm.
Data Collection
8:30 amStart Room
Art painting
ParticipateChoicesRequestTeam with peer
Comm. BoardSGDStep by step
++++-+++CCCCCSS
SSSSSS I
Page 36
Feature Matching AAC User AAC System
Sensory-Motor Physical Sensory Combination of Physical/Sensory
Sensory-Motor Component Auditory Visual Tactile Motor Access
Cognitive Components Cognitive Skills Language Skills Academic Skills
Cognitive Components Cognition for Operation Language Organization Flexibility and Growth
Environment Components User’s Environment Need for AAC Motivation/Behaviors
Environment Components Operation/Programming Durability/Repair Portability/Compatibility
Page 37
Collaborative Planning 101
On-going process
Re-evaluation
Reflection
Rejuvenation
Template Access for Process Planning
Literacy and AAC UsersShare your favorite literacy selection!
Page 39
Page 39
Research reveals five skilled areas:
Phonemic Awareness
Phonics
Fluency
Vocabulary
Comprehension
Page 40
10% or less of AAC users read beyond 2nd grade
Karen Erickson (2003)
Traditional reading instruction
Decoding
Sounds make up words
Letter sound relationship spoken aloud
Individual reading aloud
Choral reading aloud
Sight words only
Assessment of Literacy and AAC Users
Page 40
Literacy Strategies for AAC UsersExchange 1 literacy strategy with the person next to you! Aacliteracy.pbworks.com
Page 41
Physical Strategies
Adapting books
Text to speech options
Create stories
Software options
Websites
Switch access
Communication Strategies
Vocabulary options
Associations (comparisons)
Graphic organizers
Sequencing of events/story
Visual supports
Opportunites to respond/comment/question
Comprehension Strategies
Text to speech
Speech to text
Pre-teach vocabulary
Pre-program and on the spot programming of SGD
Allow wait time for exploration and comprehension
Ask and answer questions
Writing Strategies
Audio: Music, rhyme, singing with signing
Visual: Lists, sequence, planning, problem solving
Tactile: Journaling, personal self, reflection
Movement: Story telling, video modeling, performance
Page 42
General Literacy Strategy: KWL
Already know
What to know
Have Learned
Page 43
General Strategy: Reading
ComprehensionMonitor comprehension
Meta=-Cognition
Graphic and semantic organizers
Answer questions
Generate question
Recognition of story struction
SummarizingPage 43
Inclusive Planning for Literacy
Include all children
Assist with strategies
Use technology
Use AAC no-tech supports
Involve everyone… as we learn from one another
Model, model, model: Partner Assisted Scanning
Page 44
Role of Technology with Literacy
Accommodations
Modifications
Supports and adapts
Carryover to other settings and situations
Must be part of the routine/expectations
AAC Literacy Apps
iBooks
Enhanced books
Grasshoppers apps
Book Creator (rainbow colored app)
Language Builder apps
Accommodating and Modifying Curriculum
Page 47
Page 47
Accommodations are what we put in place to allow a student with a disability to participate as fully as possible in the general education curriculum.
Accommodations may be provided for:
Assessment and assignments
Learning environment
Time demands and scheduling
Special communication systems
Instructional methods and materials (AIM)
Video Modeling
Pgae 49
Why is video modeling effective?
Capture nature of social skills
Offers real life experiences
Identifies with the students’ interests
Gives access to watch it over and over
Eliminates surrounding distractions and helps for focus on a specific action
Provides a beginning, middle and end routine Page 49
Research supports Video Modeling
Individualized interventions produced higher generalization than group interventions
Interventions should be designed to address the individual, rather than forcing to “fit” into a selected group
Meta-Analysis of Student-Based Social Skills Interventions for Children with ASD. Scott Bellini et al., Remedial & Special Education, May/June 2007.
Page 141
What is Video Modeling?
Video ModelingWatching a peer on videoWatching an adult on videoWatching others on Video
Page 50
What is Video Modeling?
Video Self-ModelingWatching yourself on video
Skills to be taught using video modeling
Social Skills: play skills, perspective taking, conversational skills
Functional Skills: Self care, community participation
Positive Behaviors
Language Learning
Prepare for a new event
Prepare for an event that creates anxiety and/or fear
Cortical Vision ImpairmentOccupational and Physical Therapy
Page 51
Page 53
Cortical Vision impairment is
a visual loss which causes
difficulty in processing and interpreting incoming visual
information.
Page 54
Cortical Vision Impairment (CVI)
CausesLack of oxygen to the brain
Brain malformation or head injury
CNS infections
Poison or drug exposure
Premature birth/trauma
Cerebral Palsy/Seizures/Epilepsy
Methods for InterventionUse movement to assist with
locating and maintaining visual tracking.
Use high contrast such as black and white stripes.
Use boundaries and borders improve attention and eye gaze behaviors.
Continued Methods for Intervention
Simplify the visual environment. Present one item at a time and gradually increase object presentation.
Allow adequate time for responding and processing.
More Interventions
Provide adequate lighting.
Use selective colors, such as red and yellow.
Use technology to adjust size, color, contrast and brightness.
Use simultaneous touch and vision to establish tactile perception.
CVI RemindersTeam approach for intervention is very important.
The ability to use vision fluctuates across time and situations.
The unusual attending and eye gaze behaviors is used as an attempt to self-compensate for visual difficulties.
Appropriate and timely intervention is of utmost importance.
Occupational/Physical Therapy
Page 55
Focus of OT and PT with AAC
Seating and positioning/mobility
Computer access
Augmentative communication
Activities of Daily Living
Environmental Controls
Typical Roles in an AAC Evaluation
Functional range of motion
Strength/Sensory
Cognitive/Functional skill level
Roles Continued
Coordination/Reach
Hand strength and finger isolation or other isolated access control
Posture and change in position and environment
Alternative Access
Page 55
Page 57
Direct Selection Methods
Range of motion
Position of changes
Move object around and assess right/left, top/bottom, midline/cross midline
Head/Mouth Access
Head Mouse
Low tech options: mouthstick
QuadJoy: mouse/sip and puff access
Sip/Puff
Eye Gaze and Head Control Access
Eye Gaze Tracker infrared input (Tobii ati)
Add the Head Mouse Tracker
Use with dedicated computers and AAC devices
Head Pointer
Head Tracker
Eye Tracker
Switch AccessDetermine ability for single switch access
Identify activation site
Access one or more switches
Determine switch type
Activate and release switch on command
Hierarchy of Access Sites (multiple sites
if able)Hands,
Head/voice
Arms/elbows
Legs/knees
Feet
Indirect Selection Method
Page 59
Scanning
Automatic: runs automatically number of times programmed to
Step: press to select and advance movement of cursor
Directed or Inverse: hold down switch until movement stops
SeeBboardmaker examples
Autism Spectrum DisorderShare a social moment!
Page 59
Page 61
ASD Qualifying Areas
Communication
Social Interaction
Sensory Integration
Augmentative Alternative Communications: Autism Spectrum
Disorder
Page 62
AAC Supports for ASD
Visuals
Choices/Options/Personal Perferences
Routine and Predictability
Social Opportunities
Multiple Modes for Access
Motivation
Speech Generating Supports
How do we determine the plan of action?
A thorough assessment of includes:
Observations
Non-biased opportunities
Formal and informal assessment tools
Team interviews on social cognition and social behaviors
Key Components
Create opportunities for engagement for
participation
Determine skills to acquire
Sensory Motor Movement
Movement creates engagement and engagement creates opportunities to communicate.
AAC Camp Minnesota State University
Moorhead Speech Language and Hearing Clinic
Sensory Foundation for Camp
Tactile: perception of touch
Vestibular: perception and movement
Auditory: hearing input
Proprioceptive: body awareness
Visual: visual acuity and visual perception
Page 63-64
Tactile Activities
Visual Supports and Strategies
Share your favorite visual!
Page 63
Page 67
Visual Supports
Increase in understanding
Clarification
Routine
Positive outcomes
Planning
Make or break of success
Page 68
Designing Visuals
What does it mean?
Carryover?
Size, font, style, limit language
Graphics, photos, line drawings, objects
MovementPage 69
Visual Supports for Communicationshttp://www.autism-mi.org/about_autism/interventions_support/visual.html/title/creating-visual-literacy-supports-for-special-needs-students
Page 70
Informal Assessment Checklists
Page 73
AAC Technology Checklist Considerations
Page 73
Page 75
The rest of the story….
Thank you! Please complete your evaluation!