Autism: Technology & Communication - Part 2

Gwendolyn Meier Eberhard, SLP, MT Villa Esperanza Services

!geberhard@villaesperanzaservices.org

Moving to Budapest!

Moving to Budapest!

AAC AssessmentThe snapshot

• Test of icon recognition (e.g., TASP)

• Present a few systems

• Final recommendation

The full assessment

• Initial impression

•System trial/teaching period

• Final recommendation

Teaching Hungarian

• HOW are we teaching this new language?

Hungarian:

• More likely to learn in meaningful chunks at first

• Before segmentation occurs

Is there someone here who speaks English?!Beszél itt valaki angolul? !(BE-seyl it VÅ-lå-ki ÅN-go-loul)

Where is the toilet? !Hol van a mosdó? !(hol vån å MOSH-doa?)!

Teaching AAC• HOW are we teaching this new language?

In AAC:

• More likely to learn sequences made meaningful by the reaction they elicit

!

Teaching Hungarian• HOW are we teaching this new language?

Hungarian:

• Flashcards?

• Scripted interaction?

• Conversation?

How are we teaching this new language?

Contexts:

• Labeling?

• Requesting?

• Answering questions?

• Scripted interaction?

• Conversation?

Taught through:

• Icon recognition?

• Verbal cues?

• Motor patterns?

• Gesture cues?

• Visual cues?

Teaching Language in Autism

• Use strengths to shore up weaknesses

In autism:

(-) Auditory weakness

(-) Symbolic weakness

(+) Visual strength

(+/- ?) Motor skills

Teaching Language in Autism

• Modeling and Augmented input highlight the auditory boundaries between words

‣ Human speech alone does not

Teaching AAC Language

• Neurons that fire together, wire together (Hebb’s rule)

In AAC:

• Hearing language

• Seeing language

Model and Expand Language

In typical development

In AAC development

Images: Joan Cafiero, 2004 via Tannish & Farrall, 2013

Synonyms

• Modeling Language

• Augmented Input (AI)

• Aided Language Input

• Aided Language Stimulation (ALgS)

• Aided Language Support

• Simultaneous Communication

Aided Language Input/ Aided Language Stimulation

Definition:

• A communication strategy, where a communication partner teaches symbol meaning and models language by combining his or her own verbal input with selection of vocabulary on the Augmentative and Alternative Communication (AAC) system.

AAC Institute, retrieved online 2013

Aided Language Input/ Aided Language Stimulation

• This is done by simultaneously selecting vocabulary on the AAC system while speaking to the augmented communicator (AC).

Aided Language InputI, me, mine like have go

you see help stop

want come more no, not

pudding cup popcorn pretzels

crackers apple oranges

Aided Language Input

Low Tech / High Tech

2 Purposes for Augmenting Input

 1.  Words  are  modeled  to  s.mulate  use  of  core  vocabulary    and  encourage  communica.on  exchange.    

•Modeled  words  do  not  need  to  be  repeated  back    

•  Language  matches  the  process  of  normal  language  acquisi.on  

•The  augmented  communicator  sees  and  hears  language  produced  via  an  AAC  system  

•EVENTUALLY  says  that  language  him/herself  on  the  AAC  system

Gail VanTatenhove, 2014

2 Purposes for Augmenting Input

2.  Words  are  modeled  to  give  an  example  of  what  the  augmented  communicator  could  say.    

•  Communica.on  partner  might  verbally  say  “you  could  say  ....I  want  to  play  that  game”    

•  While  modeling  “I  want  to  play  that  game.”    

•  THE  HOPE  -­‐  the  augmented  communicator  repeats  part  or  all  of  the  language  modeled

Gail VanTatenhove, 2014

Multi-Sensory LanguageModeling & Augmented Input

• See the visual, See the movement, Hear the auditory feedback, Experience the natural consequence

Picture-Supported Input

Input with Pictures

Output with Pictures

General Intervention Principles

Functional & Fun

• Communication is not something you can force a person to do

• It must help the person achieve their own purpose or function:

• Get something they want

• Avoid something negative

• Connect with others

• Share an opinion

Interesting Motivating

Useful

General Intervention Principles

• FUN! - Learning occurs when positive emotion or affect is present

General Intervention Principles

Person-Directed

• Helping the learner feel “in control”

General Intervention Principles

Person-Directed

• Personal power and control are critical to becoming an independent, internally motivated communicator

The power to:

• Control what and when activities occur

• Control the pace of an activity

• Express both positive and negative opinions

General Intervention Principles

Good Teaching

• Follow the person’s lead

• Build on the person’s interests

• Carefully use barriers

• Be surprising and novel

• React naturally

Modeling with Pogg

General Intervention Principles

Good Teaching

• Be honest about communication attempts - be an interpreter

• I hear you using your voice to talk to me, but I don’t know what you are saying

• Use the words on your [system] so ANYONE can understand what you want

General Intervention Principles

Model Language

• Provide short but complete verbal models

• Provide aided language input - when you talk to help in picture comprehension and learning simple language structure

General Intervention Principles

Model Language

• Demonstrate expressive language on their system or a second system

Modeling / Augmented Input at Early Language Stages

• Requires pre-planning

• Occupies valuable ‘real estate’ on the visual display

I want to say

Modeling / Augmented Input at Early Language Stages

• Takes dedicated modeller(s)

• Like oral language development - aided language development also TAKES TIME

General Intervention Principles

Learning Language & Symbols

• Words are learned in a single context, but quickly broaden in their meaning

“GO”

1. (Electronic toy with movement, light or music)

2. Make sure individual is attending to AAC device.

3. Select “GO”. Say, “Go”

4. Say, “Make it go.”

5. Say, “Want to make it go?”

• Other Ideas for ways to use “GO” in conversation include: Getting to the car or down a school hall in increments, playing music a bit at a time, leaving out the door

General Intervention Principles

Learning Language & Symbols

• Words are learned in a single context, but quickly broaden in their meaning

“TURN”

1. (When motivated by book reading)

2. Make sure individual is attending to AAC device.

3. Select “TURN”. Say, “Turn.”

4. Say, “Turn the page.”

5. Say, “Want to turn the page?”

• Other ideas for using “TURN” in conversation: Spinning toys, play with office chair, jack-in-the-box,

General Intervention Principles

Learning Language & Symbols

• Expand concepts - language learning is a continual process of decontextualization. Using the same words:

• In different activities

• With different people

• In different settings

• Teach language and pictures in context

“DIFFERENT”

1. (Preferred and less preferred activities to choose)

2. Provide less preferred item in the presence of a more preferred item.

3. Make sure individual is attending to AAC device.

4. Select “DIFFERENT”. Say, “Different”

5. Say, “I want something different.”

6. Say, “Want something different?”

• Other Ideas for ways to use “DIFFERENT” in conversation include: When disinterest is obvious - model the language and offer another choice, food & drink choices, recreational app choices.

“GO IN”

1. Make sure individual is attending to AAC device.

2. Select “GO” and “IN.” Say, “Go in.”

3. Say, “I want to go in.”

4. Say, “Would you like to go in?”

• Other Ideas for other words to use in conversation with “GO” include: Out, up, down, left, right, on, off, here, there, etc.

From: The Pixon Language and Learning Activity Notebook, Gail VanTatenhove, 2009

“TURN UP”

1. Make sure individual is attending to AAC device.

2. Select “TURN” and “UP.” Say, “Turn up.”

3. Say, “I want to turn it up.”

4. Say, “Would you like to turn it up?”

• Other ideas for other words to use in conversation with “TURN” include: Down, it, on, off, left, right, around, back, over, this, that

From: The Pixon Language and Learning Activity Notebook, Gail VanTatenhove, 2009

2-word Phrases with Core Vocabulary

• what that, what is, what do

• want help, I help, help you, need help

• do that, you do, I do, do it, do more

• it all gone, that all gone

• look that, look there

• more that, want more

• give me more, get more

• do again, look again, get again

• different thing, do different, different one

• want stop, stop that, all done this

Modeling / Augmented Input at Early Language Stages

General Intervention Principles

Learning Language & Symbols

• Use motor skills to learn the location and the language - Receptive ID is not a prerequisite

Core Words in ASD

Core Words as Request

• Receptive ID for PUT and ON?

• How is she going to learn to use “Put” + “on” to request?

What about now?

Teaching AAC Language

• Neurons that fire together, wire together (Hebb’s rule)

!

• Hearing

• Seeing

• Add motor pattern

= Multi-sensory stimulation

General Intervention Principles

Hiding / Visual Masking

• Focus on target words

• Reduce random word selection

Getting Started with Core Vocabulary

• again

• all done

• all gone

• different

• do

• help

• look

• more

• stop

• what

• turn

• different

Getting Started with Core Actions

• come

• get

• give

• go

• have

• make

• put

• tell

• see

• take

• turn

• watch

General Intervention Principles

Hiding / Visual Masking

• Support person-directed therapy - in response to a new topic, quickly reveal hidden vocabulary in app

General Intervention Principles

Hiding / Visual Masking

• Support long-range planning - hiding in a robust vocabulary leaves words there for later learning (reducing development time)

General Intervention PrinciplesDISADVANTAGES of Hiding

• Limits aided language input

• Limits person-directed interaction

Getting Communication Going

In autism we know we can teach:

!!

Cause-and-Effect Requesting !!!

Cause-and-Effect Rejecting

!

• Builds “buy-in”

• Adds pay-off to the effort of communicating

• BUT DON’T STOP HERE!

• It’s very easy to get stuck on requesting

START with One-word/One-button Requesting for items, actions or recurrence (“more”)

Early Pragmatic Communicative Functions

• Attention Directing

• Requesting

• Rejecting

• Greeting

• Self-Expression and Self-Assertion

• Naming

• Commenting

• Giving Information / Requesting Information

In ASD, modeling is essential to:

First) Model the use and power of additional functions of communication: attention directing, commenting, sharing opinions, greeting!

Oops - Sorry - I like it - I don’t like it - Look - Oh man - That’s funny - gross - etc.

In ASD, modeling is essential to:

First) Model the use and power of additional functions of communication: attention directing, commenting, sharing opinions, greeting

Then) We can worry about teaching the vocabulary/symbol location for these functions - after they know WHY

Getting Started with AAC

Early Communication Goals:

• To encourage the communicator to direct the behavior or actions of others and the course of any activity with words instead of behavior.

• To expand the person’s ability to request and direct action with core action words

✦ Also Model: Comments and sharing opinions

Getting Started with AAC

Early Participation Goals:

• Deliver a whole-button message (efficient)

• Participate in a social scripted interaction

Thank you!

Email: geberhard@villaesperanzaservices.org !

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