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ARIEL METZGER MA CCC-SLPAAC Consultant, Oakland Schools

Augmentative and alternative communication & Language

handouts

HandOutsWe will use throughout the day

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

Purpose

Today's Outcomes

Learn how to implement and use AAC with students

Learn about core vocabulary and the important role it plays in building language

Learn what AAC is and who can benefit from it

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

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

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

  • No-Tech
  • Lite/Mid Tech
  • High Tech

Types of AAC

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isaac.org

isaac.org

Who might use 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

Who can benefit from AAC?

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

Felicia Bowers

COMPETENT COMMUNICATORS

All Students in Oakland county will become

When they want

To whomever they want

Communicate what they want

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

MINDSET

MATTERS!

YOUR

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

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

+Myths

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.

Transition Aged Students

+Myths

Myths about AAC

  • If a student hasn't learned AAC by now, it's too late to learn
    • With appropriate research based strategies, AAC can be learned at any age
  • We shouldn't focus on AAC because we need to be working on 'functional skills'
    • Being able to communicate one's needs, thoughts, and ideas is the most functional skill a human being can have
  • My student doesn't like/want/refuses to use AAC
    • It is likely that the student was taught AAC using non research based strategies. They may have been forced to use AAC rather than invitied.

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.

5 Signs a Student Needs AAC

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

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

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

Core Vocabulary

How do we build communication and language with AAC?

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

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

Oakland Schools Core VocabularyMultiple Meanings: Go: There you goGo for it!Go through,Where did it go?Go up.Let's go!

Oakland Schools Core VocabularyLet's Try It!Use the Core Board to create 1-3 word messages: 1. Protest/Refuse2. Request3. Share/Get information4. 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 VocabularyLet's Try It!Use the Core Board to create 1-3 word messages: 1. Protest/Refuse2. Request3. Share/Get information4. Social Interaction

+Communication

Let's give it a try!

Communication with nouns vs core words

  • 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?

+Noun

+Core

What does this mean?

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!!)

Core Vocabulary

  • Words can be combined to make multiple messages
  • Can express functions of communication (request, refuse,
  • share information, socialize)
  • Can be used in any environment

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...

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

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

Specific Noun/Topic Boards

Enhanced Alphabet Instructional Routine

Expanding on Core 32

Core 48

Core 72

Oakland Schools TouchChat Tour

ProloquoProloquo2goLAMP WFLTouchChat Word PowerTD Snap

More than Oakland Schools Core

+Grid Size

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

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
WORK

Where did the fun go?!?

Think before you shrink....

Universal Supports

No Tech Supports for Communication that you can start using TODAY!

+info

Access to a universal core vocabulary dramatically increases opportunities for learning and use! Providing these communication supports allows students access to visibly represented language as an intervention strategy prior to and while personal AAC systems are being considered.

Universal Core Supports

Universal Supports

+info

Information adapted from Rachel Langley, AAC Specialist, Assistiveware presentation ATIA 2024

Auditory
Symbolic/Visual
Written

Dual Coding Theory states that we process information across two distinct channels: Written and Symbolic. In schools, this means that a quality instructional strategy is to not only give directions and content in a written format, but also provide a visual or graphic. With AAC, we have a tool that provides two visual modalities plus auditory.

Universal Core Supports for all students

Universal Supports

Universal

Fancy name for Modeling!

Aided Language Input

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

Model

Talk to your student using AAC! ALI is speaking AAC

Model

Models naturally occurring communicative exhcanges

Model

Shows the importance of using the AAC system

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

Aided Language Input

  • 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'

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How to Model

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

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

Self Talk and Parallel Talk

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

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

Point to or highlight the symbol being used

Free Choice

Academics

Snack/Lunch

Circle Time

Model core throughout the day

Make sure core/systems are available throughout the day

Everyone should be modeling!

Encourage symbol use, without requiring it

HOW AND WHEN SHOULD WE USE AAC?

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encourage symbol use without requiring it

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Think about this...

If we as 'teaching staff' have competent communication skills and cannot effectively communicate using an AAC device, then we cannot expect any student to use an AAC device and develop communication competency with their systemAdapted from Elder and Goossens', 1994

  • Telling the child to 'look' each time
  • Saying 'good job' after each interaction

Modeling Video

  • Modeling without expectation
  • Allowing time for the student to look at the device
  • Modeling with a point and verbal word

Let's Try it out!

Your student is pointing to something. What could you model on the core board to respond to them?

Let's Practice!

You are helping your student get ready to go outside. What could you model on the core board while helping them get ready?

Let's Practice!

Your student is playing with blocks. What could you model on the core board while playing with them?

Let's Practice!

Your student is coming in to the classroom. What could you model on the core board when you first see them come in?

Let's Practice!

You are working with a student doing an art project, how can you communicate with them using the core board?

Let's Practice!

How core can be used throughout the day!

Chart Paper:What is your schedule like?What core could you model during daily routines?

The average 18-month-old has been exposed to 4,380 hours of oral language at a rate of 8 hours/day from birth. A child who has a communication system (AAC) and receives speech/language therapy 2 times/week for 20-30 minutes will reach the same amount of language exposure (in their AAC language) in 84 years.

Statistic from Jane Korsten - QIAT Listserv 2011

Give meaning and purpose to what you student is communicationg!

Attributing 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

Attribute Meaning

Shared Reading: Attributing meaning to what students are doingNotice: Teacher and Paraprofessional roles in modeling and attributing meaning

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

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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.

"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

Abuse Prevention

Why is this important?

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

Decision Making and Problem Solving

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

"The student never uses their AAC device."

Communication only develops with opportunity!If a student isn't using their device...we need to reassess what WE are doing!

Your content is good, but it’ll engage much more if it’s interactive

- Genially

Keep These Things in Mind.....

AAC Best Practice

Failure Free with Feedback

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!

Ask Open Ended Questions/Phrases for Engagement

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

Attribute Meaning

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

Keep These Things in Mind.....

AAC Best Practice

AAC Travels Everywhere!

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

AAC Must be Within Reach

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

Guided Access

  • 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

Keep going! It will take time, just like learning language does!

It's okay to make 'mistakes'!

Don't get stuck! Model important words!

Classroom Support, implementation and reflection

Self Reflection and Observation Form

Communicative Functions and Purposes

AAC Classroom Supports

Individual Core Cards: should we use them or not?

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?

Remember....

All symbols are abstract and must be taught in AACWhat 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!

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

Follow the CAR

Shared Reading

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

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

Create a Book

Shared Reading

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

5 minute fillers???

Social Media Fun

6 Session Foundational LearningAAC Basics: Take Online Anytime

Professional Learning

TAACL and AAC 101

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

Questions

THANKS

Write up AgendaBring sticky Notes for ideas of core phrases Stick them up on paper??Bring out all different types of AAC (GoTalk, 3D printables Talkable etc.)Hands On breaksGet up and go to the bathroom/move around while we do activities?Bring out Large Chart Paper

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!