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"To communicate is like breathing air in and out. It is impossible not to do. It is the heartbeat of our own existence! It is the cornerstone upon which everything is built.”
--Paul Marshall
CURRICULUM MODIFICATIONS USING
AAC
Jeanne Tuthill, MA, CCC-SLPSimmons CollegeNovember 2014
FRIDAY NIGHT TOPICS
Introductions/Course Syllabus/Assignments
What is AAC? Teaming/Laws Myths/Truths of AAC
FAVORITE WEBSITES
aac.unl.edu/yaack
www.aacintervention.com
Praacticalaac.org
www.lburkhart.com
http://teachinglearnerswithmultipleneeds.blogspot.com/
Spectronicsinoz.com
www.janefarrall.com
http://www.pinterest.com/lasenders/
Favorite Websites
What is AAC?
AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
“AAC refers to an area of research, clinical, and educational practice. AAC involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of individuals with severe disorders of speech-language production and/or comprehension, including spoken and written modes of communication.” (ASHA, 2005)
AAC is a System with four primary components
1. Symbols2. Aides3. Techniques4. Strategies
What is AAC?
1. SYMBOLS (VOCABULARY)
CUP
COMMON PICTURE SYMBOL SETS
List from Kate Ahern:http://teachinglearnerswithmultipleneeds.blogspot.com/2009/06/picture-and-photograph-symbols-sets.htmlSpectronics Symbol Set Comparisonhttp://www.spectronics.com.au/article/symbol-set-comparison
MAYER-JOHNSON
BoardmakerPicture Communication Symbols (PCS)
BoardmakerThin Line Series
DYNAVOX
Dynasyms
SYMBOLSTIX
MINSPEAK/UNITY
Semantic compaction
PIXONS
More info about the Pixons Projecthttp://www.aacinstitute.org/Resources/ProductsandServices/Pixons/
Gail Vantatenhove free resources: http://www.vantatenhove.com/products.shtml
2. AIDES (EQUIPMENT)Low tech to High Tech
3. TECHNIQUES (ACCESS)
EYE POINTING AND EYE GAZE
4. STRATEGIES
Aided Language StimulationModelingExpansion and elaborationRecasting
Prompting_________________________
Using multiple modalitiesRepairing breakdowns
AA
C u
ser
C
om
mu
nic
ati
on
Pa
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FACILITATED COMMUNICATION
ISAAC (International Society for Augmentative and Alternative Communication)
http://www.candleaac.com/files/ISAAC_Position_Statement_March%2018.pdf
ASHA
http://www.asha.org/policy/PS1995-00089/
AAC TOOLS
UNAIDED VS. AIDED
UNAIDED COMMUNICATION
• Pointing• Gestures• Eye pointing• Facial Expression• Body Language• Behavior
•Manipulation(of people)
•Vocalizing•Sign Language•Tactile Signing•Speech
You only need what you can take with you into the shower.
-Lyle Lloyd, Perdue University
UNAIDED AACADVANTAGES & DISADVANTAGES Non-verbal
Communication is natural
Most people understand simple gestures – even from other cultures
It’s quick Easy to Use Doesn’t require any
special equipment/always available
‾ Signing requires enough fine motor control
‾ Signing (aside from simple gestures) not understood by most others in the community
‾ How do you communicate about more than “here and now”?
‾ Eye pointing, facial expression, body language can be subtle or easily misinterpreted
AIDED COMMUNICATION
USING “STUFF” to communicate!
Objects(Full scale, Miniature, Partial)Pictures/Symbol-based systems
High tech or Low Tech Word/letter-based systems Braille
AIDED ADVANTAGES & DISADVANTAGES Visual language Constant, not fleeting Flexibility and
richness of language that can be created
Lot of choices for ‘symbol’ selection
Variety of accessibility features for those with physical issues
‾ Something that has to be carried around and made accessible
‾ Requires some focus to be on the device/ system rather than on the communication partner
‾ Must be updated on a regular basis (new words added)
From: Linda Burkhart, Total Augmentative Communication in the Early Childhood Classroom
Multi-modal Communication!
BUT REMEMBER! AAC IS NOT…
It’s not just “the stuff”It is not just high tech devices.AAC devices are not a “magic wand” or a “quick fix”It does not mean the abandonment of efforts to establish or improve natural speech.One size definitely does not fit all!
WHAT ELSE IS AAC?AAC is an interdisciplinary field of professionals who provide the variety of perspectives necessary when working with students who have Complex Communication Needs (CCN)
SLP AT SpecialistSPED (or Gen. Ed.) Teacher OTParents/Caregivers PTParaprofessionals Vision SpecialistBCBA
WHO DO WE SERVE?
http://depts.washington.edu/augcomm/03_cimodel/commind1_intro.htm
Emerging Communicators
An "Emerging" communicator does not have a RELIABLE method of EXPRESSIVE communication through SYMBOLIC language.
PRIMARY GOAL : EMERGENT COMMUNICATOR
Identify the first method of expressive symbolic communication
PRIMARY GOALS FOR: CONTEXT DEPENDENT
expand vocabulary with variety of partners in a variety of contexts
Independent Communicator
PRIMARY GOAL FOR: INDEPENDENT COMMUNICATOR
The individual’s own goals and desires for improved communication.
WHEN DO WE IMPLEMENT AAC?
o Communication needs not meto Risk of developmental/language
delayso Deviant speech production
mechanismo Impact on future speech abilities
AAC intervention commences at the individual's existing language level versus waiting for him or her to attain a certain skill; more of a "try and see" rather than a "wait and see” strategy
Goossens, 1989McGregor, Young, Gerak, Thomas, &
Vogelsberg 1992 Romski & Seveik, 1988
SUMMARY OF A REVIEW OF THE LITERATURE(SILVERMAN, 1995)
Decreased Increased
frustration temper tantrums hyperactivity “bizarre” behaviors
self-confidence independence social interaction attention span involvement in class
activities physical relaxation awareness of others participation in self-
care
MYTHS/TRUTHS OF AAC
MYTHS/TRUTHS #1AAC is only for people who do not communicate verbally.
True or False?
False. AAC can be used by a wide variety of communicators.
In fact, we all augment our communication through gestures, facial expressions, and we increasingly use symbols to understand and interact with our environment.
MYTHS/TRUTHS #2The primary purpose of communication is to express wants/needs.
True or False?
False. For most people, in most situations, expressing wants and needs is secondary to social expression.
"I know many parents and educators who are so happy to have their child be able to just express their needs. I think people who do this are doing a great disservice to their child; because there is so much more to life and communication than just expressing needs.“Jon Feucht, 2003 Edwin and Esther Prentke AAC Distinguished Lecturer
Communication Functions
PURPOSES OF COMMUNICATION INTERACTIONS
Information transferSocial closenessSocial etiquetteCommunication of wants/needs
Janice Light (1988)
Communicate with oneself/internal dialogue
Beukelman & Mirenda (2005)
Changing Purposes of Communication
WANTS
&
NEEDS
Social Interactions
& etiquette
Sharing Information Sharing
InformationSharing Information
Social
Interactions
& etiquette
The importance of different communication purposes changes over our lifetimeJ. Cumley, 2001
Based on J. Light, 1988, 1997, 2005
Social
Interactions
& etiq
uette
WANTS
&
NEEDS
WANTS & NEEDS
MYTHS/TRUTHS #3The use of AAC will interfere with a child’s vocal/speech development.
True or False?
False. Published literature and clinical experience supports the assertion that AAC does not interfere with a child’s natural ability to develop vocal/verbal communication. …
Using augmentative communication is not an indication of giving up on vocal communication.
(Resources on Wiki: Myths of AAC)
MYTHS/TRUTHS #4Is it necessary for a child to understand specific concepts or have a certain level of cognition before introducing AAC?
True or False?
False.
Use of symbolic words and concepts does not have to wait until children understand those concepts.
Waiting until a child demonstrates understanding of what is presented to him or her may promote passivity.
Tell me and I'll forget; show me and I may remember; involve me and I'll understand. --Chinese Proverb
Tell me and I'll forget; show me and I may remember; involve me and I'll understand. --Chinese Proverb
Developing language skills through AACmay be of critical importance if the individualis to make functional cognitive gains as well.
Infants & Young Children ,Vol. 18, No. 3, pp. 174–185
MYTHS/TRUTHS #5We should start with just a few words/concepts/symbols/signs/etc… until the student proves understanding and then add more words a little at a time.
True or False?
TYPICAL EXPRESSIVE LANGUAGE DEVELOPMENT
First word by approx. 12 months
By 18 months5-20 words
By 2 years150-300 words
By 3 yearsapprox. 1000 words
TYPICAL RECEPTIVE LANGUAGE DEVELOPMENTFirst word by approx.
12 monthsBy 18 months5-20 wordsBy 2 years 150-300 wordsBy 3 years
approx. 1000 words
Understands 50 words
Understands 200 words
Understands “just about everything”
SPEECH AND LANGUAGE MILESTONES
Adapted from the American Speech-Language - Hearing Association’sHow Does Your Child Hear and Talk? (http://www.asha.org/public/speech/development/chart.htm)
BIRTH TO 3 MONTHS
Receptive Language:
Startles at loud sounds
Quiets or smiles when spoken to
Seems to recognize familiar voices
and quiets if crying
Increases or decreases sucking in response to sound
Shared attention with another person
Expressive Language:
Makes pleasure sounds (cooing and gooing)
Cries differently for different needs
Smile when he/she sees you
http://www.asha.org/public/speech/development/chart.htm
4-6 MONTHS:
Receptive Language
Moves eyes in direction of sounds
Responds to changes in tone of your voice
Notices toys that make sounds
Pays attention to music
Emerging two-way engagement (peek-a-boo)
Responds to name
Expressive Language
Babbling sounds more speech-like with many different sounds including /p/,/b/,/m/
Chuckles and laughs
Vocalizes excitement and displeasure
Makes gurgling sounds when left alone and when playing with you
http://www.asha.org/public/speech/development/chart.htm
7 MONTHS TO 1 YEAR:
Receptive Language
Enjoys games like pat-a-cake
Turns and looks in direction of sounds
Listens when spoken to
Recognizes words for common items like "cup", "shoe", "book", or "juice“
Begins to respond to requests (e.g. "Come here" or "Want more?")
Expressive Language
Babbling both long and short groups of sounds ex: "tata upup bibibibi“
Uses speech/non-crying sounds to get/keep attention
Uses gestures to communicate (waving, holding arms to be picked up)
Imitates different speech sounds
Has one or two words (hi, dog, mama) around first birthday.
http://www.asha.org/public/speech/development/chart.htm
WHAT CAN I DO TO HELP? BIRTH TO 1 YEAR
Reinforce the baby's communication by making meaningful eye contact, and imitating vocalizations.
Repeat/Imitate laughter and facial expressions.
Teach the baby to imitate actions, such as peek-a-boo, pat-a-cake, or waving bye-bye.
Talk while you are doing things ex: dressing or feeding
Talk about where you are going, what you are doing, and who or what you'll see.
Talk about colors, practice counting, teach animal sounds
http://www.asha.org/public/speech/development/chart.htm
Video 2Video 1
People are the most important component in developing communication skills.
COMMUNICATION
a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior
LANGUAGE From Merriam-Webster Dictionary
a systematic means of communicating ideas or feelings by the use of conventionalized signs, sounds, gestures, or marks having understood meanings
a formal system of signs and symbols including rules for the formation and transformation of admissible expressions
We need to primarily be using systems that organize language not fragmented sets of communication boards or pictures.
https://www.youtube.com/watch?v=Vib2__BDCXc
BE A BUBBLE BLOWERNOT A BUBBLE POPPER