Social Networks · 2020-01-09 · Chapter II of Social Networks: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners Manual

Social NetworksSocial NetworksA Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners

I N V E N T O R Y B O O K L E T

Sarah W. Blackstone, Ph.D.Mary Hunt Berg, Ph.D.

In collaboration with the Berkeley Study Group:

Patricia Dowden, Ph.D. Gloria Soto, Ph.D.

Coco Liboiron, M.A. Elisa Kingsbury, M.S.

Mary Wrenn, M.S. Mary Hunt Berg, Ph.D. Sarah Blackstone, Ph.D.

©2003 Augmentative Communication, Inc. All rights reserved.

Updated Version 2012An Attainment Company Publication

2012 Attainment Company, Inc. Printed in the United States of America

ISBN 1-57861-792-8

Attainment Company, Inc.P.O. Box 930160 • Verona, Wisconsin 53593-0160 USA

Phone: 800-327-4269 • Fax: 800.942.3865www.AttainmentCompany.com

The photo of teacher and students is printed courtesy of Raghavendra Rao and ISAAC.

A

Table of Contents

I. Identifying Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

II. Skills and Abilities of the Individual. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

III. Circles of Communication Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

IV. Methods of Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

V. Representational Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

VI. Selection Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

VII. Strategies That Support Interaction . . . . . . . . . . . . . . . . . . . . . . . . . . 18

VIII. Topics of Conversation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

IX. Types of Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

X. Summary Sheets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Please note: It is not possible to administer the Social Networks Inventory without carefully following the Inventory Booklet Instructions. These are located in Chapter II of Social Networks: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners Manual.

I n v e n t o r y B o o k l e t

4 Inventory Booklet

I. IDENTIFYING INFORMATIONPLEASE NOTE: Refer to pages 18 and 19 of the Manual for definitions and instructions.

INDIVIDUAL WITH COMPLEX COMMUNICATION NEEDS m Male m Female

NAME ___________________________________________________ ID CODE __________________________ AGE _______

CULTURE (Note: Change categories as needed)

m European American m Asian American m Hispanic/Latino

m Native American m African American m Other ___________________

DIAGNOSES – Check all that apply

m Amyotrophic lateral sclerosis m Developmental delay unknown m Parkinson’s disease

m Aphasia m Down syndrome m Traumatic brain injury

m Autism spectrum disorder m Dysarthria m Verbal apraxia

m Cerebral palsy m Hearing impairment m Visual impairment

m Cognitive impairment m Motor impairment

m Degenerative condition m Other, please specify ______________________________________

INFORMANT

NAME _________________________________________________________________________________________________

Relationship of informant to individual m Circle 1 m Circle 4 m Individual with communication needs

Length of time informant has known individual m less than 1 year m 1-2 years m 2-5 years

m 5-10 years m more than 10 years

ADDITIONAL INFORMATION

DATE OF INTERVIEW __________________________ INTERVIEWER’S NAME _________________________________________

Consent form m Yes m No

Relationship of interviewer to individual m Speech-language pathologist m Teacher

m Rehabilitation consultant m Other, please specify _____________

COMMENTS

Inventory Booklet 5

II. SKILLS AND ABILITIES OF THE INDIVIDUALPLEASE NOTE: Refer to page 19 of the Manual for definitions and instructions.

LANGUAGE AREAS

RECEPTIVE LANGUAGE m age appropriate m moderate impairment

m mild impairment m severe impairment

HOW MEASURED m formal tests m educated guess

m informal measures m don’t know, needs further assessment

m structured observations m other____________________________________

SPEECH m age appropriate m moderate impairment





EXPRESSIVE LANGUAGE m age appropriate m moderate impairment





WRITING m age appropriate m moderate impairment





READING m age appropriate m moderate impairment





6 Inventory Booklet

RELATED AREAS

ADAPTIVE BEHAVIOR m within normal range m moderate impairment


HOW MEASURED m written assessment report m don’t know, needs further assessment

m structured observation m other___________________________________

m educated guess

VISION m within normal range m moderate impairment




m educated guess

HEARING m within normal range m moderate impairment




m educated guess

MOTOR m within normal range m moderate impairment




m educated guess

COGNITION m within normal range m moderate impairment




m educated guess

Inventory Booklet 7

III. CIRCLES OF COMMUNICATION PARTNERSPLEASE NOTE: Refer to pages 20 and 21 of the Manual for definitions and instructions.

ORIENTATIONUse diagrams on pages 26 and 27 of the Manual for this section of the interview.

ASSISTIVE TECHNOLOGY USE

TOOLS CURRENTLY USING HOW HELPFUL

COMMUNICATION-RELATED TOOLS

Non-electronic communication aid m very helpful m helpful m so…so m not helpful

Dedicated speech generating device (SGD) m very helpful m helpful m so…so m not helpful

Communication software/app on a computer or mobile device (e.g., tablet smartphone, MP3 player) m very helpful m helpful m so…so m not helpful

Phone (e.g., cellphone, landline, speaker phone) m very helpful m helpful m so…so m not helpful

Text on a mobile device or computer (e.g., texting, social networking, email, instant messaging) m very helpful m helpful m so…so m not helpful

Video on a computer or mobile device (e.g., videoconferencing) m very helpful m helpful m so…so m not helpful

Other communication tools. Please specify. _________________________________________ m very helpful m helpful m so…so m not helpful

OTHER AT TOOLS

Power wheelchair m very helpful m helpful m so…so m not helpful

Manual wheelchair m very helpful m helpful m so…so m not helpful

Glasses m very helpful m helpful m so…so m not helpful

Hearing aids m very helpful m helpful m so…so m not helpful

Cane m very helpful m helpful m so…so m not helpful

Walker m very helpful m helpful m so…so m not helpful

Pointer (head, hand-held) m very helpful m helpful m so…so m not helpful

Electronic pointer (e.g., eye gaze, laser, infrared technologies) m very helpful m helpful m so…so m not helpful

Switch(es) m very helpful m helpful m so…so m not helpful

Other AT tools. Please specify. _________________________________________ m very helpful m helpful m so…so m not helpful

ADDITIONAL COMMENTS

8 Inventory Booklet

CCP WORKSHEET

1Individual’s life partnerse.g., mom, Billy (brother)

2Individual’s good friends

e.g., Joe (cousin), Maria (neighbor)

3Individual’s acquaintancese.g., Jen, Matt (classmates)

4

5

Unfamiliar partnerse.g., people on listserves (ACOLUG),

store clerks

Partners who are paid

e.g., Mrs. Jones (teacher), Mr. Cho (SLP)

Inventory Booklet 9

IDENTIFY IMPORTANT PARTNERS

NAME CIRCLE

Individual’s primary communication partner _________________________________________ _______

Most skilled communication partner _________________________________________ _______

Partner with whom the individual spends the most time _________________________________________ _______

Individual’s favorite partner _________________________________________ _______

Communication partner most willing to learn new skills _________________________________________ _______

Partner most willing to teach other people how _________________________________________ _______

to communicate with the individual

ADDITIONAL COMMENTS

IV. METHODS OF EXPRESSIONPLEASE NOTE: Refer to pages 21 to 23 of the Manual for definitions and instructions.

CHECK ALL METHODS THAT APPLY:

m facial expression/body language

m gestures

m vocalizations

m manual signs/sign language

m speech

m writing/drawing

m nonelectronic communication aid

m dedicated speech generating device (SGD)

m communication software/app on a computer or

mobile device (e.g., tablet, smartphone, MP3 player)

m phone (e.g., cellphone, landline, speaker phone)

m text on a mobile device or computer (e.g., texting,

social networking, email, instant messaging)

m video on a computer or mobile device

(e.g., videoconferencing)

m other communication tools; please specify. _______________

10 Inventory Booklet

CHECK THE PRIMARY METHOD FOR EACH CIRCLE:

1

2

3

4

5

m facial expression/body languagem gesturesm vocalizationsm manual signs/sign languagem speechm writing/drawingm nonelectronic communication aidm dedicated speech generating device (SGD)





m communication software/app on a computer or mobile device (e.g., tablet, smartphone, MP3 player)

m phone (e.g., cellphone, landline, speaker phone)m text on a mobile device or computer (e.g., texting,

social networking, email, instant messaging)m video on a computer or mobile device

(e.g., videoconferencing)m other communication tools; please specify. ______________

















Inventory Booklet 11

ADDITIONAL INFORMATION: For each method the person CURRENTLY uses, indicate the following information and provide examples.

FACIAL EXPRESSIONS/BODY LANGUAGE m Yes m No

FREQUENCY m most of the time m some of the time m rarely m never

EFFECTIVENESS m most of the time m some of the time m rarely m never

INTELLIGIBILITY Who best understands? _________________________________ Which circle is this partner in? ________

Example 1 ______________________________________ Example 2 ____________________________________________

GESTURES m Yes m No




Example 1 ______________________________________ Example 2 ____________________________________________

VOCALIZATIONS m Yes m No




Example 1 ______________________________________ Example 2 ____________________________________________

MANUAL SIGNS m Yes m No




LENGTH OF TIME USED? m less than 6 months m 6 months to 1 year m 1 to 3 years m 3 to 5 years m more than 5 years m don’t know

SIZE OF VOCABULARY? m 1-4 signs m 5-10 signs m 11-25 signs m 26-50 signs m 51-100 signs m more than 100 signs m unlimited

Example 1 ______________________________________ Example 2 ____________________________________________


SPEECH m Yes m No





SIZE OF VOCABULARY? m 1-2 words m 3-5 words m 6-10 words m 11-25 words m 26-50 words m more than 50 words

Example 1 ______________________________________ Example 2 ____________________________________________

WRITING/DRAWING m Yes m No





SIZE OF VOCABULARY? m 1-2 words m 3-5 words m 6-10 words m 11-25 words m 26-50 words m more than 50 words m unlimited

Example 1 ______________________________________ Example 2 ____________________________________________

NON-ELECTRONIC COMMUNICATION BOARD/BOOK m Yes m No

Describe types ___________________________________________________________________________________





SIZE OF VOCABULARY? m 1-10 items m 11-20 items m 21-50 items m 51-75 items m 76-200 items m more than 200 items m unlimited


ELECTRONIC COMMUNICATION DEVICES m Yes m No

DEDICATED SPEECH GENERATING DEVICE (SGD) Name of device(s) _______________________________________





SIZE OF VOCABULARY? m 1-10 items m 11-20 items m 21-100 items m 101-500 items m more than 500 items

Example 1 ______________________________________ Example 2 ____________________________________________

COMMUNICATION SOFTWARE/APP ON A COMPUTER OR MOBILE DEVICE Name of software/app(s) __________

_____________________________________________________________________________________________________





SIZE OF VOCABULARY? m 1-10 items m 11-20 items m 21-100 items m 101-500 items m more than 500 items m unlimited

Example 1 ______________________________________ Example 2 ____________________________________________

PHONE

Describe type of phone _________________________________________________________________________________

_____________________________________________________________________________________________________





Example 1 ______________________________________ Example 2 ____________________________________________


TEXT ON A MOBILE DEVICE OR COMPUTER Describe device ______________________________________________





Example 1 ______________________________________ Example 2 ____________________________________________

VIDEO ON A COMPUTER OR MOBILE DEVICE Describe device _____________________________________________





Example 1 ______________________________________ Example 2 ____________________________________________

OTHER COMMUNICATION TOOLS m Yes m No

Please specify _________________________________________________________________________________________

_____________________________________________________________________________________________________





Example 1 ______________________________________ Example 2 ____________________________________________


V. REPRESENTATIONAL STRATEGIESPLEASE NOTE: Refer to page 23 of the Manual for definitions and instructions.

CHECK ALL REPRESENTATIONAL STRATEGIES THAT APPLY:

m object-based m manual signs

m photographs m auditory

m pictographic-based sets/systems m other______________________________________________

m orthographically-based ______________________________________________

OBJECT-BASED m Yes m No

Example _____________________________________________________________________________________________



INTELLIGIBILITY Who best understands? _______________________________ Which circle is this partner in? __________

PHOTOGRAPHS m Yes m No

Example _____________________________________________________________________________________________




PICTOGRAPHIC-BASED SETS/SYSTEMS m Yes m No

Example _____________________________________________________________________________________________





ORTHOGRAPHICALLY-BASED m Yes m No

Example _____________________________________________________________________________________________




MANUAL SIGNS m Yes m No

Example _____________________________________________________________________________________________




AUDITORY m Yes m No

Example _____________________________________________________________________________________________




OTHER

Example _____________________________________________________________________________________________





VI. SELECTION TECHNIQUESPLEASE NOTE: Refer to page 23 of the Manual for definitions and instructions.

CHECK ALL SELECTION TECHNIQUES THAT APPLY:

m direct selection using a body part m scanning/nonelectronic

m direct selection using a tool m scanning electronic

m iconic coding m other _____________________________________________

m alphanumeric coding

Give description/example of how person uses techniques to communicate.

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________


1

2

3

4

5

VII. STRATEGIES THAT SUPPORT INTERACTIONPLEASE NOTE: Refer to page 23 of the Manual for instructions and examples.

STRATEGIES THAT CURRENTLY SUPPORT EXPRESSIONIDENTIFY STRATEGIES FOR EACH CIRCLE EFFECTIVENESS

STRATEGIES THAT CURRENTLY SUPPORT COMPREHENSIONIDENTIFY STRATEGIES FOR EACH CIRCLE EFFECTIVENESS

1

2

3

4

5

m most of the time m some of the time

m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never


m rarely m never

1

2

3

4

5

1

2

3

4

5


VIII. TOPICS OF CONVERSATIONPLEASE NOTE: Refer to page 24 of the Manual for definitions and instructions.

9

TOPICS PERSON CURRENTLY USES WITH PRIMARY PARTNER(S)

IDENTIFY TOPICS FOR EACH CIRCLE

TOPICS PERSON WOULD LIKE TO “TALK” ABOUT WITH PRIMARY PARTNER(S), IF HE/SHE HAD THE MEANS TO DO SO

IDENTIFY TOPICS FOR EACH CIRCLE


IX. TYPES OF COMMUNICATIONPLEASE NOTE: Refer to page 24 of the Manual for definitions and instructions.

WHICH CATEGORY BEST DESCRIBES THE INDIVIDUAL’S MOST EFFECTIVE COMMUNICATION, AND WHY?

m EMERGING m CONTEXT-DEPENDENT m INDEPENDENT m Limited contexts/limited partners

m Multiple contexts/multiple partners

PLEASE DESCRIBE WHY YOU SELECTED THE CATEGORY.

X. SUMMARY SHEETSPLEASE NOTE: Refer to page 24 of the Manual for instructions. These sheets should be completed after the interview.


Name

1

23

4

5

DATE TYPE OF COMMUNICATOR

Primary partner (P) __________________________________

Most skilled partner (S) _______________________________

Spends most time with (MT) ___________________________

Favorite partner (F) __________________________________

Most willing to learn (L) ______________________________

Most willing to teach (T) ______________________________

SUMMARY SHEET A – CIRCLES OF COMMUNICATION PARTNERS


Name

1

23

4

5

METHODS CURRENTLY USED THAT ARE:EFFECTIVE NOT EFFECTIVE

1 ______________________ 1 _____________________

2 ______________________ 2 _____________________

3 ______________________ 3 _____________________

4 ______________________ 4 _____________________

5 ______________________ 5 _____________________

ALL METHODS RELIED ON:

m facial expressions/body languagem gesturesm vocalizationsm manual signs/sign languagem speechm writing/drawingm nonelectronic communication aidm dedicated speech generating device (SGD)m communication software/app on a computer

or mobile devicem phonem text on a mobile device or computerm video on a computer or mobile devicem other _________________________________

SUMMARY SHEET B – CCP AND METHODS

DATE__________________________ TYPE OF COMMUNICATOR________________________________________________________

# OF PARTNERS/PRIMARY METHOD

3


4


1


5

# OF PARTNERS/ PRIMARY METHOD

2


SUMMARY SHEET C – SKILLS, STRATEGIES, TOPICS

NAME_____________________________ TYPE OF COMMUNICATOR_____________________________ DATE___________________

EFFECTIVE STRATEGIES THAT SUPPORT INTERACTIONEXPRESSION COMPREHENSION

SKILLS AND ABILITIES

REPRESENTATIONAL STRATEGIES USED

AREAS NEEDING FURTHER ASSESSMENT

SELECTION TECHNIQUES USED

TOPICS OF CONVERSATIONCURRENTLY USED WOULD LIKE TO USE

SKILL AREAS


SUMMARY SHEET D – INTERVENTION PLANNINGUse this form to summarize and highlight relevant findings for each circle.

DATE_________________ TYPE OF COMMUNICATOR_____________________________ INFORMANT(S)________________________

1

2

3

4

5


NOTES

Documents

Social Networks · 2020-01-09 · Chapter II of Social Networks: A Communication Inventory for Individuals with Complex Communication Needs and their Communication Partners Manual