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Sunday, December 23, 2018

What Are Your Faves? Top 3 Posts of 2018

To round off the year, I thought I’d do a quick round-up post of the top 3 posts of 2018.  In case you want to re-read them in their entirety, here are the links to each:

In the 30 Million Word Gap, I talked about some chilling statistics. The average 3 year old in a middle-class household hears about 6 million words per year.  The average deaf child the same age and background (and in a signing home) sees approximately the same number of signs.  
But the average nonverbal 3 year old sees 0 instances of someone using pictures to communicate.
According to Von Tetzcher (1997) “the difference between their own expressive (and for some also receptive) language and the language used by significant people in their immediate surroundings” is a critical factor in the acquisition of language for AAC users.  
There is an assumption in all major theories of language learning that the individual is surrounded by others in the environment using the same language system.    
Even in second language learning the importance of immersion has been noted. Learners of second languages need to participate in an environment that exposes them - immerses them - in experiences with that language in order to become competent communicators.
I’ve done a number of posts about Aided Language Stimulation and Aided Input. Reminders about just how invaluable this is cannot come along too often, I think.

Being a Good Partner to a child who uses AAC is also important for all communication partners to read or hear about.  We need to create a positive communication environment, remember to respond to all communication attempts, and use the AAC system to communicate TO them.  
So, yes, just another variation on the theme.

And finally, I talked about presuming competence, with a quote from Buckminster Fuller, ““There is nothing in a caterpillar that tells you it’s going to be a butterfly.” 
Invariably, at some point in every one of my students’ academic careers has been the question, “Are we expecting too much? Or too little?”  With higher expectations we’ve seen these students succeed at tasks “we” thought they could not. We’ve discovered literacy skills in students who have, historically, not even been taught to read.  We’ve discovered communication skills in students we thought would never learn beyond, perhaps, some basic requesting.
The bottom line: 

“All individuals, regardless of the severity of their disability, have the basic right to ongoing instruction that will help them develop versatile communication skills.”  (Geist, Erickson, et al, 2016)

I’ll see you all in the New Year. In the meantime, keep on talking.

Sunday, December 16, 2018

Like to Forget the Holidays? You’re Not Alone.

Holidays can be times of joy and peaceful celebration.  But they can just as easily be times of stress and anxiety. For our students who lack communication skills, they can be doubly stressful.  Not knowing what is happening, what is coming, and how to get their communication needs met in an out-of-usual environment can make our nonspeaking students more than usually anxious. And how does that anxiety appear to us?  Often as behavior we describe as “angry,” “aggressive,” or “wild.”

None of these is really what the child means to communicate, most of the time. We all too frequently see the manifestation of emotions as other than what the child is actually feeling.  This can be seen in neurotypical children, as well, particularly when they are too young to have the words they need.

Likely even your typical children hate being dragged to and fro and told to be on their best behavior.  You can usually explain to them why this needs to be, in language they understand, and many of us have even resorted to “bribery” - oops, I meant to say reinforcement.

To help your language disordered child, however, I have some tips that might help.

  1. Communicate expectations visually.  Make a simple visual display that shows the child where they are going, when, and with whom, as well as what they can expect while they are at the destination.
  2. You might want to make a contingency map; showing the child a desired outcome (that bribe I mentioned above) and what they need to do to receive it, vs what behavior will result in its removal.
  3. If you insist upon a certain mode of dress that is out of the norm for them, try these clothes on beforehand and eliminate any areas of discomfort.  An uncomfortable child will not be a compliant child.
  4. Make sure you have a way for them to communicate to you. This is where your AAC system comes in, of course. But if your child doesn’t yet have a robust system, at least have a simple core word-based board that offers choices of symbols for ‘What is wrong’ and ‘How I’m feeling.”  If possible, also have a choice of comments they can make during the event or get-together; “I like this,” and “I don’t like,” at a minimum.
  5. If there will be unusual activities, try to plan ahead by doing some simple simulations to practice what they will need to do.  Again, keep communication going in both directions.

There are, of course, lots of other suggestions I could make, but I don’t want to overwhelm you any more than you want to overwhelm the child.  My key point is - of course - communicate to the child and make sure he can communicate to you.
You can right click to download this very simple board, or drag and drop.

Looking for more communication tips and strategies for using AAC with a child? Check out my book, “Make the Connection!: A Practical Guide to Parents and Practitioners for Teaching the Nonverbal Child to Communicate with AAC.” Available on Amazon in paperback and Kindle.

(This is an associate link.)

Happy holidays! And, keep on talking!!  I'll talk to you next year.

Sunday, December 2, 2018

Talking About Stories

Last week I spoke about giving gifts of interactive toys that can build language. This week, I’m going to talk about some books for the season and how to read to build language. (This post contains affiliate links)

First up, a couple of classics; including The Mitten and Hibernation Station. The former is read by parents and teachers everywhere. The Mitten is a story about a boy who loses a mitten in the snow and all of the animals who crawl inside to keep warm. It’s a terrific book for practicing sequencing and talking about animals. You can describe, compare, and contrast the various woodland animals.

Hibernation Station is another book that focuses on winter for the animals in a wood. There’s so much fun descriptive language in this book to build children’s vocabularies. The animals are big and small, shy and loud, sleepy and playful. And, an added benefit - the story rhymes. So practice those phonological awareness skills.

For fans of Mercer Mayer’s Little Critter, try reading “Just a Snowman.”  There is so much going on in this book that children who live in snowy areas can relate to. There are lots of activities about which we can ask Wh-questions and help kids learn verbs.

Last, but not least, is the old classic “The Snowy Day.”  In this story Peter goes on a winter’s day adventure, having fun alone the way.  There are a couple of sequences within the story, and you can break down re-telling into segments of inside and outside activities. Ask Wh-questions.  Talk about the descriptive words in the story. Use core words, like walk, drag, hit, throw, build and cold.

If you're looking for some language activities to extend the story, try these resources.
Hibernation Station
Snowy Day 

Next week, I'll talk about some more toys that foster language. Until then, keep on talking.

p.s. Looking for a book to give a parent? Look no further. Give the gift of communicating! Give "Make the Connection!: A Practical Guide to Parents and Practitioners to Teach the Nonverbal Child to Communicate with AAC."

Sunday, November 25, 2018

Talking About Toys

Last year I wrote a couple of blog posts about ways to use various toys to build language - just about this gift-giving time of year.  You can read those posts here and here.

So, this year, I’m going to do a little of the same, but with a slightly different format. (This post contains affiliate links).  This week and next I will be pointing out some cool toys and books and ways to use them to build your child’s language, whether he is an aac user or not.

Melissa and Doug toys came out after my kids were grown, so I'm not as familiar with them.  All of us parents can appreciate the manufacturer trying to instill a love for cleaning in our children. But if you’ve read any of my posts about using routines to build language, you can anticipate how I feel about this toy.  

This Let’s Play House Dust! Sweep! Mop! set gives us an opportunity to use core verbs and adjectives, such as; clean, sweep, mop, push, help, brush, wipe, pick up, put.  The added bonus is, of course, a small area of clean.

This tea party set is perfect to pair with the Toca Boca Tea Party app.  I wrote a blog post about using this app in therapy, which can, of course, also be done at home.  There are many opportunities within the app - or just in playing tea party without the electronic plug-in - to make requests, descriptions, and comments.  From “I want…” and “I like…” to “Oh no!” upon spilling and “Help me” during the washing of dishes.

There is a tendency to shy away from toys like telephones that require the user to talk when a child doesn’t speak.  But given an aac system, there is no reason why your child can’t have a conversation. And this is a great way to pretend and build skills at the same time.
Telephone toys are a staple of SLP toy boxes. I still have some pink plastic phones from a kit that’s decades old!  You can work on greetings, recounts of experiences, answering and asking questions.  Have “conversations” with favorite characters or even community helpers. What would you say if you were calling a doctor? A pizza parlor? A grandparent?

Last of all for this week, is this fun-looking food truck.  I know we spend too much time working on language around eating.  For some of our children, food is the universal motivator.  For others, who are picky eaters, here is your opportunity to expand their horizons without a battle of wills to try some for real.
Practice making requests, and frame them as an “order.” Have the child offer you choices, ring up your purchase, ask questions, and make comments.  The stove lights up and the sink is interactive. Talk about them, and have fun!

Next week  I’ll offer some fun winter book choices. Until then, keep on talking.

Sunday, November 18, 2018

Are You Tempted? Using Temptations in Intervention

One of the most powerful ways to teach others to be good communication partners to AAC users is to teach them about temptations.  (Now, I’m going to say that word really quietly, because in my house that usually means there are cat treats involved.)

But, seriously, use of temptations is not as widespread as it needs to be in the world of AAC.  And they’re so easy.  Parents are often worried that doing the modeling and teaching and trialing with AAC will be just that many more “things” to juggle.  But when I explain that this can be as easily accomplished as providing too small a portion at meal or snack time, or not jumping right in when they observe their child’s need for help, or even providing 2 or more choices, they begin to relax.

Weatherby & Prizant (1989) formalized the term “communication temptations.” Temptations are nonverbal actions that encourage the child to communicate.  By increasing the opportunities to practice communicating, we can increase the child’s use of communication. 

Sometimes you might hear the term ‘sabotage,’ which is essentially the same type of action, but with a less wholesome-sounding name.  We set up situations that the child has to solve - preferably by communicating - to get what he wants. 
Sometimes we provide something that tempts the child; sometimes we use something he doesn’t want, but we give him anyway.
Some really simple examples, beyond those named above, can include these:

  • Hand washing - remove the towel, or put soap on the child’s hands without turning on the water
  • Playing with toy cars, trucks, or trains - run the vehicle off of the table and leave it there, or when the vehicle comes to you; holding onto it instead of pushing it back to him
  • Meal times - forget to give the child utensils, or provide the wrong one (such as a fork for eating soup), or simply put a favorite item out of reach.
  • Making a favorite item inaccessible - don’t automatically offer the item when the child reaches or cries or tugs at you. 
  • Giving small portions - be careful with this strategy, too, to avoid frustration. Cut an apple into pieces and don’t provide the whole apple at once. On the other hand, don’t provide only 1/8 of the apple at a time, hoping to maximize communication opportunities. Model “Give” or “More” 
  • Creating a need for assistance - place the desired item into a sealed container, or out of reach, move the remote control for the T.V. or DVD player. Provide models for “Help” and “Want” and “Go.” 
  • Interrupting a favorite activity - blow bubbles only 1 or 2 times and wait, watch a part of a show then pause it, provide 2 colors of crayons but not the rest. Provide models for “More” and “Go” and “Do.” 
  • Offering something the individual does not like - model “No” or “Not” or “Different” or “Stop”  
  • Providing an activity with a part missing - model “Want” or “Give” or “Help” or “More.” (you can find more suggestions in my new book*)

    I’ve also used these: 
    • A carefully guarded clear snack bag
    • A racetrack with no cars
    • Giving a cookie to everyone but the ‘target’ child
    • Putting on his socks but no shoes, then getting up to leave the room or house

    And I’ve had a parent tell me she put her child in the bathtub but didn’t add water.

    Probably my favorite evaluation activity involves a portable DVD player and a selection of movies.  After the child chooses a movie or cartoon to watch, I let it run for a few minutes, then hit “Pause.”  I’ll start by modeling “More,” or “Go.”  The next time, I’ll look expectantly to see what the child will do.  I rinse and repeat as often as necessary; carefully balancing frustration, motivation, and saturation.  When I can move a child from no response to “more” to “go more” to “go more movie,” I’m quite pleased.

    When you’re thinking about those 200 opportunities each day to build a competent AAC communicator, think about ways to tempt the child, and plan how you will be a good model.  I’ve even had parents tell me they’ve practiced their “expectant look” in the bathroom mirror.

    I remember reading, a while ago, a post from Dr. Carole Zangari about temptations and smiling to myself as she recounted cutting m&m’s into 1/4ths because I have done that very same thing. (I actually once had a student who could bite an m&m into even smaller pieces than that, but that’s a story for another day).

    One of the key points I do remember from Carole’s post was the use of a time delay procedure to prompt the child.  I have a fondness for time delay prompting that harkens back to my research days. It is so effective for teaching skills without building prompt-dependency.  And while the research has been around for decades, it’s still not consistently taught to clinicians and certainly not to parents.

    So, when you’re talking about implementation practices with your team - including parents - remember to talk about  motivation through temptation. And be sure to remind them not to frustrate the child by using this too much!


    Saturday, November 10, 2018

    Do You Know These Top 5 Core 2-Word Phrases?

    Far too many students never make it to the symbol sequencing stage of AAC use.  Whether because of presumed lack of potential or lack of knowledge about how to move students along beyond single words, we end up with many AAC users who are not communicating as competently as they could - and need.

    One study (the reference for which I was unable to find in the rat’s nest of my files) rated these the top 5 2-word core word phrases: put on, take off, clean up, get out, fall down.
    I’m willing to bet that by the time you read all 5 you were already thinking of the contexts in which you use these every day.

    1. Put on - your clothes, your shoes, your jacket, your hat & mittens
    2. Take off - your clothes, your shoes, your coat, your cap
    3. Clean up - your room, your desk, the classroom, the bathroom, the kitchen
    4. Get out - of the car, your room, the house, that place you should not be
    5. Fall down - the stairs, the ladder, on the uneven/rocky ground

    I’ve decided to make some implementation resources for these, starting with this free mini- booklet.  Download (just right-click or drag to your desktop), then print the page below. 

    1. Fold the page in half length-wise, then open.  
    2. Fold it in half top to bottom, then fold each open end into the middle fold.  
    3. Open those two folds again, leaving the paper folded in half. 
    4. Cut along the dotted line from the fold half-way down.  
    5. Open the page again. Re-fold lengthwise. 
    6. Holding the paper at both ends, push them in towards the center, causing the center fold to separate.  
    7. Now you can see the booklet has formed.  
    8. Press all creases to form the book.

    What you should end up with is a paper that looks like this. Note that pages 1& 6-8 will be up-side-down when flat. Because the paper folds in half, they will end up right-side-up.

    When I did therapy in a school district, I used to make these booklets with my students all of the time. We made up our own stories, made how-to booklets, and used them to re-tell stories.  The students always liked having their own book to take home.

    Enjoy this little booklet. There will be more to follow. In the meantime......keep on talking!

 An affiliate link to the kind of toy to buy for your children with language disorders this holiday season.

    Sunday, October 28, 2018

    But My Kid Can’t Do That!

    Have you heard this from parents or staff?  I have.  Many times.  You show staff and families what to do with a child’s AAC system, teach them how to model effectively, talk about using a robust core vocabulary.  And then someone says; “But this kid can’t.  That’s too hard. I’ll never be able to do that with him.”

    AAC resource book

    We work with students who are severely disabled; sometimes in language, sometimes motorically, and sometimes in both of those and even more ways.  But we need always to remember that we don’t really know what these students are capable of and what they are not.  
    We don’t know until we try.  And even then, oftentimes it is not the child who “fails,”  but US.  We fail.  We fail to find the teaching strategy or motivating activity or system of…….insert concept here.
    presume competence

    Far too often I see people “give up” on teaching a student a skill because they haven’t “gotten it” yet, so they must not be able to.  And far too infrequently do I hear teams say, “This isn’t working. What else can we do?  What can we change? What else might work?”

    There are a couple of buzz phrases floating around in special education.  They include “Least dangerous assumption” and “Presume competence.”  The second has become a bit contentious, as people ask, “What are we presuming, exactly? What is competence?”

    Many of us agree that what we are presuming is that the child, with the proper instruction/intervention can, in fact, become more competent at communicating.  We aren’t presuming that all of our AAC users will be Stephen Hawking.  Most of us who are neurotypical would not ever be in line for that level of competence, communicating concepts that most do not understand.  But we are presuming that our students do not need to be dependent on others for figuring out what their communication wants and needs are and meeting them.

    make the connection aac book

    I’m really excited to be able to provide some wide-spread answers; more widely spread than I am able to do in my little corner of the country (and even tinier corner of the world).  I wrote a book, taking what I know about AAC implementation and trying to broach the topic from the point of view that, “You can do this!”  I want to give parents and SLPs and teachers the tools they need to become effective partners in the process of teaching the child to communicate.

    Then look at the 10 benefits of reading it.  I’ll give you 5 right here: 

    1. Learn how to assess the AAC needs of your children/students & what you need to know as a parent about AAC evaluations:  Learn current trends away from discrete skills based assessments and towards genuine activity based evaluation.  See how to set up child-centered activities and observations to evaluate your students’ skills and needs.
    2. Get simple solutions you can apply to your caseload or child tomorrow:  You will come away with a variety of intervention activities that you can use right away, ideas for introducing and using AAC at home, and ideas for adapting classic therapy activities for nonspeaking learners.
    3. So many words, so little space....the lament of those who design AAC systems for their students.  Learn how to manage your AAC system space effectively by using core and fringe vocabulary strategies.
    4. Take home templates for communication you can use right now:  You will be given sample planning and intervening forms that you can begin to use right away
    5. Use what you already know as an SLP or parent to teach your students/child who use/s AAC:  Many strategies for teaching language apply to all students with communication needs.  Learn how to apply what you already know about teaching and learning strategies for language, as well as acquiring new skill sets to apply.  Learn how to carry over these strategies to home activities so you can communicate with your child.

    So, remember: there are no prerequisites for communication, and children - ALL children - can learn how to communicate effectively.

    Sunday, October 21, 2018

    Wait! What Did I Do? Teaching Students Social Language Skills

    I wrote last week about developing social skills and directly teaching aspects of the “hidden curriculum” to our students.  It is, as you would expect, difficult to teach social skills to some students who do not speak and have limited language skills.

    The best way to teach language skills - including pragmatics - is in context. We tell communication partners all of the time to engage AAC users in genuine communication interactions, and to practice both functional linguistic and “real” social linguistic skills.

    teaching social skills

    I have encountered difficulties in middle and high schools with creating genuine social interactions between students.  Sometimes it’s teachers raising objections, and other times peers just don’t want to be bothered with helping out, or can’t find a time and place to provide some support.
    Whatever the obstacles, do your best to find - and create - social interactions among students.
    social skills

    One way I have been able to make peers unwitting partners is by taking the student with whom I am working and hanging out in the Quad - the Southern California version of the cafeteria.  Watch interactions among his fellow students.  Middle and high schools are full of drama.  It is pretty easy to discover pairs and small groups being happy, angry, sad, excited, etc.

    Observe briefly with your student, and then ask what they think is going on. Did they see the facial expressions and body language? Did those support the words they might have heard?  What might be going on.
    If you have a small group of students, try some role playing.  Simulating experiences is fairly easy. The hard part is thinking of all of the situations you might need to address.

    Judy Endow, in the article I sited last week, gives the example of taking “Free Cookies,” without realizing that really meant ‘1 per customer.’  Your students might be able to recall situations that left them baffled or feeling badly without knowing why.  Other students might be able to offer some suggestions, as well.

    I have a set of questions and problems I created a number of years ago for use with some high school students and young adults.  They have worked well with a number of groups, and are available in my TpT store here.

    verbal problem solving

    A number of years ago I heard Barry Prizant speak. He said that, for young children with ASD, if they knew the “right things” to say on the playground - could run around yelling, “I’m He-Man; King of the Universe,” for example - they were accepted as a part of the playground group.

    There are so many skills we need to teach our AAC users. Answering and asking questions, commenting, explaining feelings, and informing, among others. Let’s not forget those skills that help them to fit in.