"To communicate is like breathing air in and out. It is impossible not to do. It is the heartbeat of our own existence! It is the cornerstone upon which everything is built.”

--Paul Marshall

CURRICULUM MODIFICATIONS USING

AAC

Jeanne Tuthill, MA, CCC-SLPSimmons CollegeNovember 2014

FRIDAY NIGHT TOPICS

Introductions/Course Syllabus/Assignments

What is AAC? Teaming/Laws Myths/Truths of AAC

FAVORITE WEBSITES

aac.unl.edu/yaack

www.aacintervention.com

Praacticalaac.org

www.lburkhart.com

http://teachinglearnerswithmultipleneeds.blogspot.com/

Spectronicsinoz.com

www.janefarrall.com

http://www.pinterest.com/lasenders/

Favorite Websites

What is AAC?

AUGMENTATIVE AND ALTERNATIVE COMMUNICATION

“AAC refers to an area of research, clinical, and educational practice. AAC involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of individuals with severe disorders of speech-language production and/or comprehension, including spoken and written modes of communication.” (ASHA, 2005)

AAC is a System with four primary components

1. Symbols2. Aides3. Techniques4. Strategies

What is AAC?

1. SYMBOLS (VOCABULARY)

CUP

COMMON PICTURE SYMBOL SETS

List from Kate Ahern:http://teachinglearnerswithmultipleneeds.blogspot.com/2009/06/picture-and-photograph-symbols-sets.htmlSpectronics Symbol Set Comparisonhttp://www.spectronics.com.au/article/symbol-set-comparison

MAYER-JOHNSON

BoardmakerPicture Communication Symbols (PCS)

BoardmakerThin Line Series

DYNAVOX

Dynasyms

SYMBOLSTIX

MINSPEAK/UNITY

Semantic compaction

PIXONS

More info about the Pixons Projecthttp://www.aacinstitute.org/Resources/ProductsandServices/Pixons/

Gail Vantatenhove free resources: http://www.vantatenhove.com/products.shtml

2. AIDES (EQUIPMENT)Low tech to High Tech

3. TECHNIQUES (ACCESS)

EYE POINTING AND EYE GAZE

4. STRATEGIES

Aided Language StimulationModelingExpansion and elaborationRecasting

Prompting_________________________

Using multiple modalitiesRepairing breakdowns

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FACILITATED COMMUNICATION

ISAAC (International Society for Augmentative and Alternative Communication)

http://www.candleaac.com/files/ISAAC_Position_Statement_March%2018.pdf

ASHA

http://www.asha.org/policy/PS1995-00089/

AAC TOOLS

UNAIDED VS. AIDED

UNAIDED COMMUNICATION

• Pointing• Gestures• Eye pointing• Facial Expression• Body Language• Behavior

•Manipulation(of people)

•Vocalizing•Sign Language•Tactile Signing•Speech

You only need what you can take with you into the shower.

-Lyle Lloyd, Perdue University

UNAIDED AACADVANTAGES & DISADVANTAGES Non-verbal

Communication is natural

Most people understand simple gestures – even from other cultures

It’s quick Easy to Use Doesn’t require any

special equipment/always available

‾ Signing requires enough fine motor control

‾ Signing (aside from simple gestures) not understood by most others in the community

‾ How do you communicate about more than “here and now”?

‾ Eye pointing, facial expression, body language can be subtle or easily misinterpreted

AIDED COMMUNICATION

USING “STUFF” to communicate!

Objects(Full scale, Miniature, Partial)Pictures/Symbol-based systems

High tech or Low Tech Word/letter-based systems Braille

AIDED ADVANTAGES & DISADVANTAGES Visual language Constant, not fleeting Flexibility and

richness of language that can be created

Lot of choices for ‘symbol’ selection

Variety of accessibility features for those with physical issues

‾ Something that has to be carried around and made accessible

‾ Requires some focus to be on the device/ system rather than on the communication partner

‾ Must be updated on a regular basis (new words added)

From: Linda Burkhart, Total Augmentative Communication in the Early Childhood Classroom

Multi-modal Communication!

BUT REMEMBER! AAC IS NOT…

It’s not just “the stuff”It is not just high tech devices.AAC devices are not a “magic wand” or a “quick fix”It does not mean the abandonment of efforts to establish or improve natural speech.One size definitely does not fit all!

WHAT ELSE IS AAC?AAC is an interdisciplinary field of professionals who provide the variety of perspectives necessary when working with students who have Complex Communication Needs (CCN)

SLP AT SpecialistSPED (or Gen. Ed.) Teacher OTParents/Caregivers PTParaprofessionals Vision SpecialistBCBA

WHO DO WE SERVE?

http://depts.washington.edu/augcomm/03_cimodel/commind1_intro.htm

Emerging Communicators

An "Emerging" communicator does not have a RELIABLE method of EXPRESSIVE communication through SYMBOLIC language.

PRIMARY GOAL : EMERGENT COMMUNICATOR

Identify the first method of expressive symbolic communication

PRIMARY GOALS FOR: CONTEXT DEPENDENT

expand vocabulary with variety of partners in a variety of contexts

Independent Communicator

PRIMARY GOAL FOR: INDEPENDENT COMMUNICATOR

The individual’s own goals and desires for improved communication.

WHEN DO WE IMPLEMENT AAC?

o Communication needs not meto Risk of developmental/language

delayso Deviant speech production

mechanismo Impact on future speech abilities

AAC intervention commences at the individual's existing language level versus waiting for him or her to attain a certain skill; more of a "try and see" rather than a "wait and see” strategy

Goossens, 1989McGregor, Young, Gerak, Thomas, &

Vogelsberg 1992 Romski & Seveik, 1988

SUMMARY OF A REVIEW OF THE LITERATURE(SILVERMAN, 1995)

Decreased Increased

frustration temper tantrums hyperactivity “bizarre” behaviors

self-confidence independence social interaction attention span involvement in class

activities physical relaxation awareness of others participation in self-

care

MYTHS/TRUTHS OF AAC

MYTHS/TRUTHS #1AAC is only for people who do not communicate verbally.

True or False?

False. AAC can be used by a wide variety of communicators.

In fact, we all augment our communication through gestures, facial expressions, and we increasingly use symbols to understand and interact with our environment.

MYTHS/TRUTHS #2The primary purpose of communication is to express wants/needs.

True or False?

False. For most people, in most situations, expressing wants and needs is secondary to social expression.

"I know many parents and educators who are so happy to have their child be able to just express their needs. I think people who do this are doing a great disservice to their child; because there is so much more to life and communication than just expressing needs.“Jon Feucht, 2003 Edwin and Esther Prentke AAC Distinguished Lecturer

Communication Functions

PURPOSES OF COMMUNICATION INTERACTIONS

Information transferSocial closenessSocial etiquetteCommunication of wants/needs

Janice Light (1988)

Communicate with oneself/internal dialogue

Beukelman & Mirenda (2005)

Changing Purposes of Communication

WANTS

&

NEEDS

Social Interactions

& etiquette

Sharing Information Sharing

InformationSharing Information

Social

Interactions

& etiquette

The importance of different communication purposes changes over our lifetimeJ. Cumley, 2001

Based on J. Light, 1988, 1997, 2005

Social

Interactions

& etiq

uette

WANTS

&

NEEDS

WANTS & NEEDS

MYTHS/TRUTHS #3The use of AAC will interfere with a child’s vocal/speech development.

True or False?

False. Published literature and clinical experience supports the assertion that AAC does not interfere with a child’s natural ability to develop vocal/verbal communication. …

Using augmentative communication is not an indication of giving up on vocal communication.

(Resources on Wiki: Myths of AAC)

MYTHS/TRUTHS #4Is it necessary for a child to understand specific concepts or have a certain level of cognition before introducing AAC?

True or False?

False.

Use of symbolic words and concepts does not have to wait until children understand those concepts.

Waiting until a child demonstrates understanding of what is presented to him or her may promote passivity.

Tell me and I'll forget; show me and I may remember; involve me and I'll understand. --Chinese Proverb

Tell me and I'll forget; show me and I may remember; involve me and I'll understand. --Chinese Proverb

Developing language skills through AACmay be of critical importance if the individualis to make functional cognitive gains as well.

Infants & Young Children ,Vol. 18, No. 3, pp. 174–185

MYTHS/TRUTHS #5We should start with just a few words/concepts/symbols/signs/etc… until the student proves understanding and then add more words a little at a time.

True or False?

TYPICAL EXPRESSIVE LANGUAGE DEVELOPMENT

First word by approx. 12 months

By 18 months5-20 words

By 2 years150-300 words

By 3 yearsapprox. 1000 words

TYPICAL RECEPTIVE LANGUAGE DEVELOPMENTFirst word by approx.

12 monthsBy 18 months5-20 wordsBy 2 years 150-300 wordsBy 3 years

approx. 1000 words

Understands 50 words

Understands 200 words

Understands “just about everything”

SPEECH AND LANGUAGE MILESTONES

Adapted from the American Speech-Language - Hearing Association’sHow Does Your Child Hear and Talk? (http://www.asha.org/public/speech/development/chart.htm)

BIRTH TO 3 MONTHS

Receptive Language:

Startles at loud sounds

Quiets or smiles when spoken to

Seems to recognize familiar voices

and quiets if crying

Increases or decreases sucking in response to sound

Shared attention with another person

Expressive Language:

Makes pleasure sounds (cooing and gooing)

Cries differently for different needs

Smile when he/she sees you

http://www.asha.org/public/speech/development/chart.htm

4-6 MONTHS:

Receptive Language

Moves eyes in direction of sounds

Responds to changes in tone of your voice

Notices toys that make sounds

Pays attention to music

Emerging two-way engagement (peek-a-boo)

Responds to name

Expressive Language

Babbling sounds more speech-like with many different sounds including /p/,/b/,/m/

Chuckles and laughs

Vocalizes excitement and displeasure

Makes gurgling sounds when left alone and when playing with you

http://www.asha.org/public/speech/development/chart.htm

7 MONTHS TO 1 YEAR:

Receptive Language

Enjoys games like pat-a-cake

Turns and looks in direction of sounds

Listens when spoken to

Recognizes words for common items like "cup", "shoe", "book", or "juice“

Begins to respond to requests (e.g. "Come here" or "Want more?")

Expressive Language

Babbling both long and short groups of sounds ex: "tata upup bibibibi“

Uses speech/non-crying sounds to get/keep attention

Uses gestures to communicate (waving, holding arms to be picked up)

Imitates different speech sounds

Has one or two words (hi, dog, mama) around first birthday.

http://www.asha.org/public/speech/development/chart.htm

WHAT CAN I DO TO HELP? BIRTH TO 1 YEAR

Reinforce the baby's communication by making meaningful eye contact, and imitating vocalizations.

Repeat/Imitate laughter and facial expressions.

Teach the baby to imitate actions, such as peek-a-boo, pat-a-cake, or waving bye-bye.

Talk while you are doing things ex: dressing or feeding

Talk about where you are going, what you are doing, and who or what you'll see.

Talk about colors, practice counting, teach animal sounds

http://www.asha.org/public/speech/development/chart.htm

Video 2Video 1

People are the most important component in developing communication skills.

COMMUNICATION

a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior

LANGUAGE From Merriam-Webster Dictionary

a systematic means of communicating ideas or feelings by the use of conventionalized signs, sounds, gestures, or marks having understood meanings

a formal system of signs and symbols including rules for the formation and transformation of admissible expressions

We need to primarily be using systems that organize language not fragmented sets of communication boards or pictures.

https://www.youtube.com/watch?v=Vib2__BDCXc

BE A BUBBLE BLOWERNOT A BUBBLE POPPER