Sunday, August 27, 2017

All About a Starting Place

To follow-up on my last post, I want to talk a little bit more about beginning with young students who are very impaired.  There are a couple of things I wanted to add, especially if you’re backing up from a system that seems too complex.
So, where do I start?  With just 1 core word.  If I’m working with a student who cannot learn the Word of the Week in 1 week, or for whom 4 symbols per page is too much right now, I go back to my basic core and find the word that will give this student some communicating power.



Often that first word is NOT want, but is Go!  “Go” gives us a lot to work with, because it can be used in so many ways.
I can teach the child to use “Go” when (s)he wants to go somewhere.
I can teach “Go” when the student wants you to go away and leave him/her alone.
I can teach “Go” in order to give the student a direction to give others to ‘turn it on and make it go.’

Think about how powerful that one core word can be.

When I’m working in an evaluation I always have my portable dvd player and some wind up or other battery operated toys.  I’ve lost track of the number of hours I have spent teaching, “Go,” with dvd’s. (This also works if you have 2 iPads, using one for YouTube or music and the other for communicating. I also use my phone for music.)

When I am doing evaluations I like to see just how far I can “push the envelope.”  Can I establish “go,” and then move to “go more?”  And then can I get to “want go more?”  I have literally spent an hour just with videos and a basic device page and gotten that far, and more!  All it takes is consistent modeling, motivating activities, and a structured, direct instruction.

Now not all students can do that even with the best instruction in the world.  And I have also seen many students who take much longer to learn “Go.”  But I am here to tell you that I pretty much have not found a young student who cannot learn basic cause-effect with communicating.

What I do find are teams  who give up.  It is difficult to maintain the consistency and level of instruction when progress is very slow.  More often than not, I see staff who get discouraged by the lack of feedback from the student and, when discouraged, eventually give up the level of modeling consistency that is needed.

So, to those staff who have become disillusioned with AAC, I say:
“Don’t give up. Don’t stop modeling consistently, Don't lose confidence in yourself or the student. Don’t conclude that he can’t learn to communicate.
Do keep on modeling as much as possible.  Do find the most motivating activities that engage your student (and yes, these are sometimes difficult to figure out).  Do find as many different ways and contexts to model that core word in genuine communication interactions.”

More next week. Until then, keep on talking! 










Sunday, August 20, 2017

AAC: 7 Ways to Get Started with Young Emerging Communicators

One of the classrooms I was consulting to over the past couple of years was a class of medically fragile students with Complex Communication Needs. At the time, there was not a lot of AAC going on.
Fortunately, for both myself and the students, the teacher was very open to adding more Assistive Technology. So, here are a few of the elements we added to her classroom:



1. At circle time, the teacher used a Big Mack button to have students respond to taking attendance. Access was an issue for many of the students. So, where the BigMack button was held was a big issue. And this was just 1 single response.

2. One of the students had the motor skills to touch a target with her hand independently, and the ability to use more words. I made her a PODD book, and demonstrated how to provide Aided Language Stimulation consistently. I provided support monthly throughout the school year.

3. At one point, this student needed to have something that was more compact. Aides were having a difficult time dealing with her behavior in the room, which included trying to contain flailing arms and legs and head butts.
       So, since they told me they couldn’t handle the PODD book, and I wanted to make sure whatever AAC I was providing was getting used consistently, I backpedaled and went to a small (20 symbol) core word board, with some activity specific fringe words (presented in pages of 6 symbols) for the 2-3 favored activities she would spend some time in.

       This student had some cortical vision issues, so these symbols were printed with bright red and yellow and high-contrast symbols where available.

4. For other students, I looked at adapting books and encouraged the teacher to do more read aloud and shared reading with specific objectives in mind. For the students in this class who were going to be involved in shared reading activities, she needed a way for them to respond to questions or make comments. For most, this involved using eye gaze.
       So, we went from the teacher holding up a 2-choice array to a version of an E-tran board with 4 choices, and then 8. Thus, student response choices were quadrupled in a short period of time. And, with multiple boards with this many choices, there was a bigger array of responses possible.

5. Speaking of read aloud time, this was another opportunity to use the Big Mac buttons or a Sequencer. Recording the repeated line of text gives students a way to participate. Recording sequential lines gives them even more opportunities.

6. Access was the biggest problem with this group of students. I added visual cues and communication opportunities in as many places as possible. We looked at a variety of different switches for them to use and I pushed Partner Assisted Scanning as a no-tech mode. (District purchasing processes are still a mystery to me. All I know is it usually takes forever.)
       We looked at SCATiR switches, toggle switches, sip-n-puff, pillow switches, and more. Fortunately, we also had access to the California Assistive Technology Exchange (CATE) loan program. This allowed trials of a wider variety of switches we would have had access to.

7. I made large, 3X5 card sized symbols so that there was a classroom sized communication board that was core word based, that was large enough for all the students (with the exception of those totally blind) to see, that was high contrast for students with vision disorders, and whose symbols were easily removed one at a time during instruction time to emphasize use of the target core word. Any opportunity to use a core word is important.
       Access to symbols needs to be as easy as possible. Putting these cards into a large pocket chart provided that quick and easy access to enough core words that the teacher could use them seamlessly in instruction.

       Using aided input during routines is a great way to introduce the core vocabulary in consistent formats. With this particular group of students life was full of routines. Between changing diapers and clothes, washing up, feeding (which for a number of them was via G-tube), and other daily care routines there were a lot of times throughout the day when the same sequence was carried out and talked through. Perfect opportunities to provide aided language.

In my 40+ years of working with children with little or no speech, I’ve learned a lot. The field of AAC has learned a lot. I like to think we now know enough to give every child, no matter the disability, a voice.
I’ve seen it happen. I’ve seen it work. And my hat is off to all those SLPs and teachers and paraprofessionals who make it work every day, even when it seems a Sisyphean task. We just need to continue to provide the input and presume competence.

And……keep on talking, with pictures.



Sunday, August 13, 2017

Competing for Definitions? More Games for AAC

Some districts in the U.S. are already back to school. Some wait until after Labor Day.  Either way, I have one last bit of summer fun with a purpose.  We’re going to have students practice making referential definitions with use a hint of competition.

Referential definitions are at the heart of a lot of vocabulary instruction for nouns.  A district attorney once challenged me on this particular objective.  He wanted me to prove that creating referential definitions mat a state standard.  (Mostly I think he didn’t know what I was talking about).  


Teachers around the world ask kids to provide referential definitions all the time.  “Wha is Saturn?”  “What is a peninsula?”  “Tell me about a giant sloth.”

In my version, we put visual symbols on the table for the critical elements: categories, adjectives, function, place, materials.  The SLP turns over a picture of a relevant item.  If your students are all able-bodied you can have them rush to grab relevant symbols. 
     
       The catch is that once they have chosen a symbol they must be able to answer that piece of the definition.  If they can’t, they forfeit their turn/points/move.  They also have to put the symbol back on the table, where another student can take it.  

Students can take only 1 symbol per turn. After everyone in the group has had a turn, students can scramble for the remaining symbols.  Students with the most symbols/points/spaces on the game board “win.”  In fact, all of your students win in the vocabulary development game.


Back to school fun in my next posts, so, in the meantime, just……..keep on taking.


Sunday, August 6, 2017

AAC Vocabulary BINGO

Are you ready for one more way to have fun finding words?  Try a game of BINGO.  You can use any group of vocabulary words.  You can take the words from curriculum areas, from books, or from whatever thematic topic your or the teacher are working on.  Create multiple BINGO cards that use the same words; just vary their positions on the cards.



And………..voila!  Another fun game for finding vocabulary in the AAC system.  If you’ve been talking about Spring, use Spring-related words; such as grow, plant, big, tiny, dirty, insect, flower, bud, bloom, robin, nest, hatch, warm, sunny, rain, etc. (If you don't want to make your own, try my Everything for Spring resource, complete with BINGO game)

If you’ve been working on answering Wh-questions, try BINGO cards with random vocabulary that includes people, animals, and characters, actions (verbs), places, and time words (clock and calendar).  As you call out a word, students have to tell what kind of a Wh-question it answers before they can place a marker on it.


Simple, but effective.  Kids love playing BINGO games.  Above are a couple of examples of BINGO cards I’ve used.  You’ll find the full resources they came from in my TPT store if you like saving time and reducing your work load.


Keep on talking!