Birmingham Early On AAC

Augmentative and alternative communication & Language

START

ARIEL METZGER MA CCC-SLP AAC Consultant, Oakland Schools

HandOuts We will use throughout the day

handouts

Purpose

Increase or reinforce knowledge around AAC and building authentic language with non-speaking and minimally speaking students

What is AAC?

Augmentative and Alternative Communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants and ideas. We all use AAC when we make facial expressions or gestures, use symbols, pictures, or write.

+BASICS

https://www.asha.org/public/speech/disorders/aac/

Types of AAC

• No-Tech
• Lite/Mid Tech
• High Tech

Lorem ipsum dolor sit amet consectetur

There are AAC options for EVERYONE! Options for stduents who are visually limited, blind, deaf/blind, orthopedically impaired and more.

Who might use AAC?

Who can benefit from AAC?

Anyone that has a condition that affects speech. Such as autism, cerebral palsy, language delays, traumatic brain injury, stroke, aphasia, temporary medical conditions such as a tracheotomy

Any individual that has communication needs and their use of speech is limited in any range of settings.

isaac.org

isaac.org

Mindset around AAC

• Why is communication important?
• Why is communication important to you and how does it help you?

• It is just as important for our students and it is our job to get them there!
• We need to believe that:
• Everyone can and will learn language
• Even though it may take time :)

+MINDSET

Read through the communication bill of rights and share 1-2 that speak to you

Myths about AAC

• AAC hinders or stops further speech development
• Introduction of AAC correlates with the improvement of natural speech- even in situations in which no speech therapy has been given (Romski & Sevcik, 1993)

• There are prerequisite skills that my child must achieve before AAC is introduced.
• There are no known cognitive or other prerequisites that are necessary for a child to use AAC. (Kangas & Lloyd, 1988)
• AAC is a last resort in speech-language intervention.
• AAC should be used to prevent communication 'failure' before it happens, not after all other options have been exhuasted

There are still many misconceptions or myths about AAC that exist today. Parents often have questions and concerns when we first start introducing AAC to their child about the impact it will have on their child’s language development.

+Myths

Romski, MaryAnn PhD, CCC-SLP; Sevcik, Rose A. PhD Augmentative Communication and Early Intervention: Myths and Realities, Infants & Young Children: July-September 2005 – Volume 18 – Issue 3 – p 174-185

Early Intervention Considerations: -Natural Language Acquisition -Disability: lifelong, future with speech

5 Signs a Student Needs AAC

Core Vocabulary

Core Vocabulary is a researched base set of frequently used words.

Studies show that the 350 most frequent words in a person's speech account for 80% of the actual words spoken

Beukelman, D. R., Jones, R. S., Rowan, M. (1989). Frequency of word usage by nondisabled peers in integrated preschool classrooms. Augmentative and Alternative Communication, 5, 243-248. doi:10.1080/07434618912331275296 Adapted by Chris Bugaj from content created by Bruce R. Baker from The Pittsburgh AAC Language SEminar Series

How do we build communication and language with AAC?

Core Vocabulary

• Core words represent 80-85% of the words we communicate every day

• These highly frequent, flexible words allow multiple opportunities to communicate a broad range of purposes all day, every day with everyone.

• Includes various word classes (pronouns, verbs, descriptive words, questions)
• Can demonstrate a variety of communicative functions allowing multiple communicative opportunities with potential for expanding utterance length

Beukelman, D. R., Jones, R. S., Rowan, M. (1989). Frequency of word usage by nondisabled peers in integrated preschool classrooms. Augmentative and Alternative Communication, 5, 243-248. doi:10.1080/07434618912331275296 Adapted by Chris Bugaj from content created by Bruce R. Baker from The Pittsburgh AAC Language SEminar Series

Oakland Schools Core Vocabulary Let's Try It! Use the Core Board to create 1-3 word messages: 1. Protest/Refuse 2. Request 3. Share/Get information 4. Social Interaction

Fringe Vocabulary

• Makes up 20% of our words
• Specific to a subject or individual
• Can be used only in a specific situation
• This is often what parents want to focus on (before they learn about core vocabulary!!)

Fringe Vocabulary Let's Try It! Use the Core Board to create 1-3 word messages: 1. Protest/Refuse 2. Request 3. Share/Get information 4. Social Interaction

Communication with nouns vs core words

Let's give it a try!

• I want
• you want
• go get
• I like
• I do not like
• I do not want
• who want
• look
• I want make
• what (kind)
• mine

Now use core! What could you say/ask about a cookie?

What does this mean?

+Core

+Noun

+Communication

The Ultimate Goal:

To use core, fringe and literacy together to create spontaneous, novel language!! We must have specific words that are important to us and include fringe such as people or items we like! Most important "Functional Skills" is Communication and Literacy!!!

A Gentle Reminder...

Core Vocabulary + Fringe = Your Instructional Materials Fringe = The Real Thing

Specific Noun/Topic Boards

Don't need pictures/boards for fringe items, use what is around you!

Enhanced Alphabet Instructional Routine

Expanding on Core 32

Core 48

Core 72

More than Oakland Schools Core

Proloquo Proloquo2go LAMP WFL TouchChat Word Power TD Snap

There are too many words!

Research Shows

• The optimal grid size is between 45-96 words (assistiveware)
• Small grid sizes make it harder to explore language and learn new skills (assistiveware)
• Students must relearn the location and motor patterns of all the words when the grid size is increased
• Small grid sizes do not allow for modeling of rich language

Think about building language....how can we do this with only a few words?

+Grid Size

Aided Language Input

Fancy name for Modeling!

Aided Language Input

• Using the student's AAC system or core board, talk to the student. Show them how to talk using AAC!

Models naturally occurring communicative exhcanges

Model

Talk to your student using AAC! ALI is speaking AAC

Model

Shows the importance of using the AAC system

Model

From: http://praacticalaac.org/strategy/using-aided-language-input-to-build-communication-opportunities/

How to Model

• Demonstrate how to use AAC

• Model key core words with speech
• Model on a core board or AAC system
• Make do with the words you have
• Don't worry about grammar
• Take the child's lead
• Attribute Meaning
• Don't shout/clap or say 'good job'

Lorem ipsum dolor sit amet consectetur

We want to model without expectation!

Demonstrate how the symbols work, but do not require your child to use the symbols you have used. You are not modeling what you want the student to say...... YOU ARE SHOWING THEM WHAT IS POSSIBLE!

+Endless

Self Talk and Parallel Talk

"I put them on" "I do more" "finished"

"You got it" "You put it in" "You have more"

Use AAC and verbal speech to describe what you see the student doing

Use AAC and verbal speech to talk about and describe what you are doing!

Model Without Expectation

• Accept and respond to all forms of communication, gestures, facial expressions and body language
• Head to Toe Communication

Attributing meaning

Give meaning and purpose to what you student is communicating! Telling students what they did to communicate with us and helping them build understanding that their behavior is something they could do in the future to influence how a person responds to them.

Attribute Meaning

Honor the student's attempts to communciate and respond to it

Attribute Meaning

Honor the student's attempts to communciate and respond to it

Attribute Meaning

Honor the student's attempts to communciate and respond to it

AAC Reconsiderations

Imitation vs Modeling

• The purpose of modeling is not that the student does what we do, but instead learns how to generate spontaneous language!
• We want to create ENGAGEMENT to inspire, invite, encourage, and motivate communication

Lorem ipsum dolor sit amet consectetur

PROMPTING

We need to use natural cueing to help build student language. We should not be telling the student what to say or be using any sort of hand over hand prompting.

Abuse Prevention

Why is this important?

"People with disabilities are twice as likely as people without disabilities to experience sexual assault. People with developmental or intellectual disabilities are seven times more likely to be sexually abused than people without a developmental disability. Females are the most at-risk; women with develompental disabilities are 12 times more likely to be sexually assaulted than women without a developmental disabilitiy." (MPR, 2018) via AssistiveWare, Reducing Vulnerability for Nonspeaking People

Decision Making and Problem Solving

Teaching students preferences: "Like" or "not/do not like" Honoring "stop and no/not"

Let's not discourage communication. Focus on engagement and open ended questions!

AAC Best Practice

Keep These Things in Mind.....

Ask Open Ended Questions/Phrases for Engagement

Failure Free with Feedback

Attribute Meaning

When we 'quiz' and 'question'..... students do not want to learn or use AAC/Core vocabulary. We want to build engagement and a desire to communicate!

Honor the student’s attempts to communicate and respond to it

What are you thinking? Weather Unit: "What types of weather are there?" "Tell me more....", "I see you (smiling, frowning) you might feel..."

AAC Best Practice

Keep These Things in Mind.....

AAC Must be Within Reach

Guided Access

AAC Travels Everywhere!

• Use Guided Access to ensure the student uses the iPad for communication purposes
• The student's caseload teacher or school SLP can help set this up

• 3 second rule
• An AAC must be in reach within 3 seconds
• Must be available for modeling and for student use

• A student's AAC device goes with them in the hallway, art, gym, recess, field trips, the cafeteria, etc.

Classroom Support, implementation and reflection

Communicative Functions and Purposes

Self Reflection and Observation Form

AAC Classroom Supports

Large Core Board

Let's think through where to put the large core boardWhere is instruction taking place? Where is an accessible location for all teaching staff and students? What are some daily routines/activities that you do now, where you could add in the large core board?

Individual Core Cards: should we use them or not?

Remember....

All symbols are abstract and must be taught in AAC What does this say? Without being taught what the symbols mean, we cannot assume any student will know the meaning behind the symobl without language being taught alongside the symbol.

Remember....

Language Development Takes Time! Learning how to use AAC to communicate will Take Time! The biggest challenge to students with language difficulties is not language itself. It is the idea that students cannot learn it. adapted from Chris Bugaj

Teach a core word each day! Click on the word you want to teach and it will give you an entire slide deck of teaching material with that specific core word! Click on the image to get more information!

Why core word of the DAY, not WEEK?

Take Post it Notes and Mark Core Words

Mark Core words that are in the text and core words you could use on the page: Example: Look there are doughnuts on his head! I like doughnuts! They are all smiling! It looks like they like doughnuts too!

Shared Reading

Follow the CAR

Starts with teachers guiding students, encouraging their engagement and interaction and supporting communication! Teachers read with students not to students.

• Lead with a COMMENT
• ASK for or invite participation
• Attribute meaning to communicative attempts
• RESPOND by repeating and adding more

Shared Reading

Create a Book

Find a Book ORWrite a Book-Pattern Book (I Like) -Classroom book -MadLibsThen work on preferences: Like or do not like the book

• Tarheelreader.org
• Use Shared Reading approaches
• Attribute meaning to communicative attempts
• RESPOND by repeating and adding more

Social Media Fun

Professional Learning

TAACL and AAC 101

6 Session Foundational LearningAAC Basics: Take Online Anytime

Questions

THANKS

Please Contact your Speech Therapist for more information on getting AAC devices!

Got an idea?

Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:

• Visit the Analytics settings;
• Activate user tracking;
• Let the communication flow!

Got an idea?

Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:

• Visit the Analytics settings;
• Activate user tracking;
• Let the communication flow!

Got an idea?

Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:

• Visit the Analytics settings;
• Activate user tracking;
• Let the communication flow!

Got an idea?

Use this space to add awesome interactivity. Include text, images, videos, tables, PDFs... even interactive questions! Premium tip: Get information on how your audience interacts with your creation:

• Visit the Analytics settings;
• Activate user tracking;
• Let the communication flow!