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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.