Do You Do This? Read Aloud Strategies You Can Use with Your AAC Users

The “word gap” is real. You’ve heard this before if you read this blog regularly.  In fact, here is a link to my post on the 30 million word gap.

The fact is that children who are not read to come to school with far less vocabulary knowledge than kids who are. And children with fewer words in their vocabularies understand far less of what they read than their peers.

Our AAC users are particularly vulnerable.  Far too often parents and teachers alike underestimate their nonverbal child’s interest in or attention to books.  And yet books are the perfect way to boost an AAC user’s vocabulary.

BUT - and I’ll bet you know what I’m going to say - they need a robust AAC system with lots of room for a growing vocabulary.

So, you’ve settled your AAC user down with a pile of good books, all based on his interests.  You’ve had him choose one to start with, and off you go.

Vocabulary needs explicit instruction.  Illustrations and context are wonderful for comprehension, but children often need explicit structured instruction for word meanings.

So, when you come across a new word, stop and offer a child-friendly definition, using the context and pictures from the story.  Talk about the word and its meaning. See if you can relate it to something familiar. Provide other examples. And try to use the word in other contexts, as well.

And don’t forget to find the word in the AAC system.  Where is it? What kind of word is it? Where does it belong and what does it relate to? Talk about its features as you determine whether it belongs with the describing words or the action words or….

We need to give our AAC users the opportunity to love books and to learn from them. We need to provide them every opportunity to learn what their peers are learning and say what their peers are saying.  Books are one way in.  Read. And….keep on talking.

You might also be interested in my post about teaching vocabulary in themes.

Is it Story Time Yet? Why We Read to Children

The wrapping paper is gone, the boxes have been recycled, and - hopefully - the kids are still enjoying their presents.  It’s a new year, and perhaps we can build some new skills.

One of the things my children could always count on receiving as presents was books.  My kids loved being read to and I loved doing it.  I read to my children even before they were born, and instilled a love of books in them very early.  Even my ADHD poster boy would sit still for reading time.

Reading aloud to our children is so important. Research says they should be read to at least 15 minutes per day.  Which doesn’t seem like a lot. My kids would rarely settle for anything under 30 minutes - and they could be happy for hours being read to.

Reading to children opens up so many worlds.  For one thing, reading comprehension is based on understanding vocabulary.  By listening to stories with varied vocabulary in an illustrated context provides children with much-needed understanding of different words than they hear throughout their day.

Reading comprehension also requires a degree of background knowledge.  It is difficult to understand a story about a topic or event that you have no frame of reference for. But children can’t experience everything first-hand.  Reading a variety of books to them provides some background knowledge on a variety of subjects.

Screen time is a hotly debated issue, and we know we want kids to have quality screen time. What better way to harness their interest in technology than with the many quality book apps on the market.  The Nosy Crow apps have always been among my favorite; their stories are interactive and have some great humorous elements that keep kids engaged.

For students who want a bit more independence, the low reading level and high interest of the TarHeelReader.org books are attractive to many of our students.

Dial in to your child’s interests and find a variety of books - both fiction and nonfiction - to keep them engaged. And make sure to keep their AAC systems accessible so they can talk about the books. Encourage comments and opinions, and make a game of retelling the stories.

Books are our window to the world and, for many of our children, the only way they will experience some things. Open the window, let in the light, and pave the way for literacy skills.

And keep on talking.

You might also like to read my posts on reading instruction for AAC users.

Is Telepractice the Solution?

Lately, I’m seeing more and more of my colleagues doing teletherapy.  For many speech-language pathologists, it is the ultimate solution for busy lives with kids. As one therapist states: “teletherapy is still a GREAT fit for me and my young family.  The ability to work from home and be present and available for my kids at the end of their school day is extremely important to me and being a teletherapist has allowed me to do just that.” (https://bvgslp.com/teletherapy-what-to-know-before-starting/).

Therapists enjoy setting their own schedules and determining how many hours they will work.  For the most part, teletherapists are contract employees - self-employed rather than salaried employees.  There are, however, a few exceptions to that.

A friend of mine, Sarah Wu from Speech is Beautiful even wrote a guide called “Is Teletherapy Right for Me?” (https://speechisbeautiful.com/2017/03/is-teletherapy-right-for-me/), talking about the pros and cons and things to consider.

Recently, a company providing teletherapy reached out to me, in an attempt to spread the word about affordable speech therapy provided on their telepractice platform. They’re called Expressable, and are committed to providing “high-quality speech therapy services at a fraction of the cost of traditional therapy.”

This is what they have to say: “Expressable’s one-of-a-kind technology platform connects families to dedicated SLPs specialized for their speech therapy needs. Live therapy sessions are administered online with modern video conferencing software that clients can access from the convenience of their home.

In addition to providing a cost-effective alternative, Expressable also offers many advantages only available in their online platform. These include the ability for clients to securely message their therapist 5 days/week, personalized and recorded home exercises for continued skill building and parental involvement, and flexible scheduling with easy cancellations. “

The owner of Expressable has this to say, “The American Speech-Language-Hearing Association (ASHA) approved teletherapy as an appropriate method of service delivery in 2005. The lack of overhead costs in teletherapy means that a family’s money can go further. Without the barrier of geography, a clinician with a specialty is able to provide for a client living across the state. Teletherapy checks so many boxes for both clinicians and the families they serve.”

I don’t know a lot about them, and I am personally not embarking on a telepractice journey; having retired to the quiet life of creating curriculum resources, but if you’re a speech pathologist considering a change of pace or a parent looking for a therapist in an underserved area, you should check them out.

“Research demonstrates that online speech therapy is just as effective as therapy delivered in a practice-based setting.”  And, in case you have this unanswered question - yes, it is available to AAC use.

So, check out the possibilities of teletherapy. The world is changing with technology.

And of course, keep on talking!

p.s. If you are considering or already doing teletherapy, take a look at my BOOM card decks for use on tablets, computers -even smartboards. 

Where is the Opportunity for Control with AAC? Communicating in Group Homes.

I recently had a mom whose adult child is living in a group home ask me to provide some guidelines for staff to help them with using AAC.

For more than 20 years I have provided consultation to an agency that runs a few dozen group homes for adolescents with autism and adults with a variety of developmental disabilities and dual diagnoses.

Many adults with intellectual or developmental disabilities do not develop sufficient speech to meet their communication needs.  And once outside the school system, they are often unlikely to receive any direct services for speech-language therapy.  

Many do not have any speech. Many of those who do have speech lack adequate speech in many contexts.  And for all of these clients, we need to consider how to provide them with improved communication.

Adults with developmental disabilities are vulnerable for an inability to get their needs met.  They have the least access to sufficient communication systems or skill-building.  And even those who have had some alternative system when they were in school have frequently lost access to a system as they transition to adult services.

What we have is a system with

• Unique clients: who may have had no prior language interventions. (This is particularly true for older clients who were in school when there were fewer options and services.)  These clients may have developed ways to communicate that are not universally understood but have been established over a long period of time.
• Unique environments: where life is highly routinized, needs are all met, opportunities to exert control may be very limited, and there are frequently few opportunities for communication interactions.
• Unique partners: Staff in adult programs may have minimal education and training, often do not understand communication needs, have difficulty with consistency in the face of having to provide services to several clients at once, and who need strategies to use that give them step-by-step directions.

Our goal is to increase communicative intent, to increase communication in a way that we understand intent, and to improve quality of life by reducing frustration and anxiety.

The biggest bottom line is that communication needs to be motivating.  This can be difficult in group homes where needs are met routinely and opportunities for a single individual to exert control over what happens are limited by staffing ratios and other clients’ wishes.

I urged staff to consider what their clients - including this young man - want or like, what the environment allows them to have unique to themselves, what alternative response they can use to tell staff and how staff can consistently require that they use that response to indicate what they want.

I remind the staff to think of communication as power.  It is about having control over the environment.  Our clients need to learn that they can have this power.  Staff needs to consider ways and times when this is possible within the structured environment of a group home situation.

Until next time.... Keep on talking!

Have You Read My Story?

Recently I was contacted by a local magazine who wanted to interview me as part of a series of local women to know. I was flattered, of course, and readily agreed.  Me, a woman to know? Lovely thought.

So, the article is live, and it tells my story in brief. How I ended up where I did, doing what I do.
So, I am posting a link to the article here, in case you'd like to read about my voyage to AAC.

'til next time, keep on talking!

Stuck on AAC Implementation? My Five Step Plan for Intervention

Communicative competence was defined by Janice Light (1989) as:

"– the state of being functionally adequate in daily communication and of having sufficient knowledge, judgment, and skills to communicate effectively in daily life."

I advocate for a 4 step process to building AAC use: Choose, Plan, Prepare, and Implement.

Step 1: Choosing vocabulary - We want to make sure our AAC user has a robust vocabulary so that he can say whatever he wants.  We don’t fill the system with preprogrammed phrases that may not represent what he wants to say; but we may use some often-used phrases for speed of interactions in social situations.

Step 2: Once you have the vocabulary set in your AAC system, you wan to plan your intervention strategy.  Think about what words you want to target first. Are you going to focus on core words used in a single activity or those identified core words whenever they occur in the environment naturally?

Step 3: Next, Prepare. Prepare with a modeling plan. Become comfortable with the child’s AAC system sufficiently to be able to model the words you have set as targets.  This is important. You might even want to practice ahead of time.  But don’t worry if you make mistakes or have to stop and think about where a word is.  These are perfect times to use verbal referencing and talk about what you are doing.

Step 4: Implement.   Provide Aided Language Stimulation (ALgS)/Modeling.  The AAC system needs to be available at all times. The partner will model each of the words, showing the child how the word is used in that context and where to find it in the AAC system.  Be careful not to give directions, test, make the child perform.  Don’t ask the child to “Show me _” or “What is _?” or “Where is _?”  Remember that communication for real purposes and messages is the goal, not trying to find out how much the child knows.  Use expectant pauses, natural cues.

Step 5: Collect data.  Assess and revise the plan as needed.

It is easy to implement AAC in the classroom by

1 Offering choices as often as possible

2 Using consistent vocabulary and sequences within frequently repeated classroom routines

3 Sabotaging the environment during a routine task so that students need to communicate

4 Utilize simple scripts within routines so that staff are consistently modeling the same vocabulary and sentence types

5 Make sure to model vocabulary used during routines that goes beyond requesting; to include commenting, providing information, asking questions, and other communication functions

 AAC implementation does not need to take a significant amount of planning time or equipment.  Just think about the language you use routinely.

Looking for more information about AAC implementation?  Take a look at my book: Make the Connection!  Available on Amazon. (affiliate link)

Are You Drowning in Alphabet Soup?

We all use acronyms way more than we’d probably like.  There are acronyms everywhere; television stations, directions, and, of course, in our professional language.  

And sometimes we forget that not everyone knows the acronyms we use; especially in our clinical capacities.  Even using SLP can confuse some people.  Many call us Speech Therapists and have no idea of the full professional title.

So, I am going to clear up some of the confusion around acronyms used in AAC.  Let’s start with that one:

AAC - Alternative - Augmentative Communication; those modes of communication that replace or supplement natural speech.

PAS - Partner Assisted Scanning; a process by which the communication partner scans through the selections either auditorily (saying the words), visually (by pointing to the symbols) or both.  The partner scans through the choices available on the (no/low-tech)  AAC system, always in the same order, looking for an agreed-upon response from the individual to accept an option.  Partners present the choices in the same sequential order every time.  This strategy is usually used with an individual with significant motor or visual problems who has difficulty accessing an AAC system independently.

ALgS - Aided Language Stimulation is also called Aided Input (AI) and refers to the process of modeling use of the AAC system to the user while speaking.

AT - Assistive Technology; an umbrella term used to talk about assistive and adaptive devices or systems for individuals with disabilities. It includes any piece of equipment or software program or app that can be used to increase the functional abilities of students with disabilities.  This umbrella includes AAC.

CCN - Complex Communication Needs; used to refer to those AAC learners who have significant disabilities and needs beyond simply replacing their speech. These AAC users have a combination of physical, sensory, and other challenges that make communication difficulty

CVI - Cortical Vision Impairment; refers to a brain based vision disorder

SGD - Speech Generating Device; or VOCA (voice output communication assistant)

Voice output can be either digital (recorded speech) or synthesized (computer-generated) speech.  

Those are my top 7 picks for confusing acronyms I hear in IEP meetings that leave some people shaking their heads.  Do you have any others?

If you're looking for more information about AAC, morew terminology explained, and a step-by-step guide to implementation, try my book Make the Connection!  (affiliate link)