Beginning Communication for Non-verbal students

Cheryl Livingston, MS, CCC/SLPAugmentative Communication Facilitator

Handout

https://www.youtube.com/watch?v=iOVm8q0mCYA

Reasons we communicate –

Participation - Engagement - Requesting - Directing / Manipulating others -Commenting - Social exchange - Questioning - Sharing information –

Pyramid

How do we communicate?

Facial Expression – smile, frown, grimace, _____Vocalize – laugh, cry, whine, coo, ________Look – gaze, stare, look back and forth, _______Reach – grab, touch, _______Reject – push away, hold up hand, _______Point – index finger, whole hand, ________Gesture – wave, motion come here, “talk to the hand”, ___Sign – more, finished, play, _____Verbalize – uh oh, (saying words, phrases, sentences), ___Activate AT – Big Mack, Device, Switch, _______Write / Text / Type – pencil /paper, phone, computer, __

How to promote communication:

• We will talk about your communication style as well as the student’s.• We will talk about what motivates the student to communicate.• We will talk about supports to help the student understand and

expand their communication.

Autism and Communication (Griffin 2010) part 1.avi Autism and Communication (Griffin 2010) part 2.avi Simone Griffin

https://www.youtube.com/watch?v=m7WuYK_1Vps&feature=youtu.be https://www.youtube.com/watch?v=zIqN_Ppjv9U

http://www.pisp.ca/strategies/documents/SteppingStonestoDevelopingCommunicationSkills.pdf

http://www.pisp.ca/strategies/documents/EmpoweringtheStudenttobeanEffectiveCommunicator.pdf

• Position yourself so your child can easily engage with you.• Create anticipation by pausing “Ready, steady ……..”• Create communication opportunities by withholding items.• Provide a little help and then let your child join in • Use picture boards to help with choice making• Use pictures to help extend your student’s communication.• Use picture sequences to help your child understand how things work.• Create choices with color, size, texture, shape etc. • Use games to teach the use of appropriate gestures.• Mix things up a little so your student keeps motivated.• Adding props can help increase motivation and create choices!• Use the student’s specific interest and introduce something new.• Keep learning happening: Introduce new concepts. • Think about how certain toys can support communication.• Encourage the student to participate in everyday activities. • Comment about what you are doing.• Talk about what and why you like certain things. • Teach kids to be kids!• Make the most out of 5 minutes.• Have fun & share your excitement.

Begin with the philosophy of PRESUMING COMPETENCE, Communicate Accordingly and Create Communication Opportunities:

Communication Opportunity Foundations • The communication opportunity must be meaningful to the learner- Believe it or

not, this is often hardest to do, because what is meaningful to the learner might not at all make sense to you. However, it is really important to being effective.

• The communication opportunity must be authentic – Set up ‘real’ ways for the opportunity to be available to the learner. Make the situation and materials fit the opportunity.

• The communication opportunity must look and feel age appropriate- This may seem obvious but sometimes interests do not coincide with age appropriateness. If the toy or materials are for younger learners, you can categorize them as that and put them into a context of the older learner (e.g., writing a book about ‘barney’ or making a video about ‘barney’.). If you are doing science make sure the pictures, experiment, materials look adult like even if the response mode is at the one word/symbol level.

• The communication opportunity may begin with choices- We all do better with choices and each choice is a communication opportunity. Choices can include: topics to ‘talk about each week’ in a month, vocabulary words to work on, materials to write with, who to talk to, etc…the list of choices is limitless.

Communication Opportunity Foundations con’t.

• The communication opportunity may need to be a communication temptations- Communication temptations are structured situations designed to entice communication. Communication temptations may involve lock boxes or cabinets, enticing pictures, leaving out key ingredients or utensils, being absurd, and much much more. The only difference between communication temptations for younger and older learners is the acting skills and creativity of the facilitator.

• The communication opportunity should be cool. The ‘cool’ factor is important for everyone.

Strategies to Facilitate Learning from the Communication Opportunity

• Think Aloud Strategy- Speaking about your thoughts as you work through different communication processes gives the learner insight into how you solved a problem, how you experienced an event, how you are thinking and helps them learn how to as well.

• Aided Language Input (ALI)- Use AAC when you talk. ALI is modeling AAC Style.

Strategies to Facilitate Learning from the Communication Opportunity con’t.

• Turn Taking as Speaker & Listener- Participate in the activity, be a communication partner rather than always telling the learner what to do.

• Decrease Questions- Questions are a demand for all of us. No one likes to have demands and pressure placed on them to communicate.

• Wait & Signal- Use the expectant pause often as a way to show the learner you expect them to take a ‘conversational turn’.

• Following Learners Lead- This means be willing to diverge from topic at times when something more meaningful to the learner comes up.

• Repetition with Variety- Keep presenting communication opportunities that work in a variety of setting, with different materials, with different people, etc. The more repetition with variety of prAACtice, the more likely for the language to generalize.

10 Premises for Teaching Requests to Beginning Communicators• Requesting is a communication skill that is often a fun goal to target because the

end result should be ‘giving’ the learner what they want. Here are some underlying premises when teaching requests:

• The learner LOVES or places IMPORTANCE on what they are requesting• The facilitator may need to LOOK for & ACCEPT what the learner prefers• MOTIVATION and INTEREST can be TAUGHT with frequent and varied practice in

predictable routines• Communication temptations give requesting more CLARITY for the learner• Learners can request WITHOUT being asked a question (in fact, it helps with

spontaneity)• Requests can be facilitated through CHOICE MAKING• Requests and choices GO WAY BEYOND food & objects• The facilitator can MODEL requesting and choice making and then give the

learner a turn.• There can be monthly, daily, hourly, minute, or even second CHANGES in

preferences, motivations, and interests• Frequent OPPORTUNITIES for requests and choices are the key to TEACHING

SPONTANEOUS communicationDon’t worry, if requests get over used (it is a good problem to have) because once that happens then you can vary how to honor the overused request (i.e.,visual limits – 3 breaks per day, 1 McDonald trip per day/week, etc), “sorry, no more”, “later”, etc.).

Helpful Handy Hints©

Finding ReinforcersBehaviours Observed

Type of self-stimulation

Spinning discsLaser discsSpinning toysSand Egg timers or oil droppersSnow globesTV or videoComputer screensaver programmes

The student gazes at lights or out of the window, fixates at rotating objects, looks at his hands or flaps his fingers in front of his eyes.

Visual

Light toys (such as spinning fan or ball)Flashing toys (such as bouncing ball or stress toy)Spinning topsWind-up toysColoured acetate sheets

Executive toys (such as swinging balls)Sparking toys (such as toy gun or spinning toyKaleidoscopeView MasterCoil toys

Useful websites SEN Switcherhttp://www.northerngrid.org/ngflwebsite/sen/intro.htmPriory Woods Schoolhttp://www.priorywoods.middlesbrough.sch.ukwww. Sensory World.com

Reinforcer Checklist

Communication vs. Language

The process through which we exchange information

The structure through which we communicate

message method

Give Time to Respond

Respond to All Communication Attempts

Embed Opportunities for Choice

Ask Open-Ended Questions –Communication Not Compliance

Janet Lehr

Yes/No

The NOT Symbol

http://praacticalaac.org/

Tags5 Things AAC aided language input aphasia Apps ASD assessment communication core vocabulary core words implementation ideas inclusion intervention language literacy resources schools semantics SGD video visual schedule visual supports vocabulary

EMC

https://www.youtube.com/watch?v=OV35UNwlZUU

EMC Sensory Assessment

Name: ______________ Date: _______ Examiner(s): ______________

1. Vestibular – Provide movement for the time indicated for the activity andthen pause for 5 seconds. Record response.Examples – rocking, swinging, bouncing, spinning

2. Proprioceptive – Provide stimulus for 10 seconds and then pause for 5seconds. Record response. Examples – applying vibration, messaging, wrapping snugly

3. Tactile – Provide stimulus for 10 seconds and then pause for 5 seconds.Record response.Examples - immersing hands or feet in water, placing hands or feet on/in

rice, shaving cream, washing with washcloth

4. Visual – Move stimulus through central visual field and all four quadrants(2-3 seconds per quadrant) and then withdraw from sight for 5seconds. Record response and describe any differences across visualfield quadrants under the corresponding column.Examples - pinwheel, light up toy, mirror

5. Auditory – During each trial, present sound at midline, behind and slightlyabove the head. Allow 10 seconds for music and 3 seconds for noisemakers. Pause for 5 seconds. Record response.Examples - noise maker, whistle, music

6. Olfactory – To differentiate between reflexive and purposeful responses,pass an unscented item under the nose for 3 seconds. If response toscented and unscented items is the same, the response is most likelyreflexive (level 1). Score response made within 3 seconds ofpresentation or removal while allowing 20 seconds betweenpresentations. Record response.Examples – scents = shaving cream & aftershave, scented markers, garlic essential oil = orange, vanilla, peppermint7. Gustatory – Provide taste of food. Score response made within 5 secondsand then allow additional time necessary for food to be consumed.Record response.Examples – grapefruit, soy sauce, honey, alum

EMC Communication Assessment

How does the child communicate:

ProtestDiscomfort or PainHunger or ThirstRemoval of preferred activityDesire for moreWants / needs other than aboveYes / noResponds to requestResponse to social interactionAttention to peopleAttention to activityInitiates interaction

Symbol Consideration Table for “dog”Object

•duplicate•miniature•remnant

Photograph…of objects or activity (not person engaged inactivity)

Line Drawings…of objects or activity (not person engaged in activity)

Gesture/Touch Cues ex. pat hand to thigh

Signs

Spoken word

Written word dog

Joey and his dog

“dog”

Sym

bol S

etm

ore

dem

andi

ngle

ss

dem

andi

ng

Every Move Counts Clicks and ChatsJane Korsten, MS/SLP Terry Foss, M.Ed.Lisa Berry, MOTR/L (2007)

Considerations in Symbol Selection

• Vision• Hearing• Motor abilities• Individual preferences• Age appropriateness• Cultural or ethnic influences• Skill levels (cognition, perception, processing)

Rush 2009

Pragmatic Organization Dynamic Display Communication Books

PODD

The Six Phases of PECS

PHASE IHow to CommunicateStudents learn to exchange single pictures for items or activities they really want.

PHASE IIDistance and PersistenceStill using single pictures, students learn to generalize this new skill by using it in different places, with different people and across distances. They are also taught to be more persistent communicators.

PHASE IIIPicture DiscriminationStudents learn to select from two or more pictures to ask for their favorite things. These are placed in a communication book—a ring binder with Velcro® strips where pictures are stored and easily removed for communication.

PHASE IVSentence StructureStudents learn to construct simple sentences on a detachable sentence strip using an “I want” picture followed by a picture of the item being requested.

Attributes and Language ExpansionStudents learn to expand their sentences by adding adjectives, verbs and prepositions.

PHASE VAnswering QuestionsStudents learn to use PECS to answer the question, “What do you want?”.

PHASE VICommentingNow students are taught to comment in response to questions such as, “What do you see?”, “What do you hear?” and “What is it?”. They learn to make up sentences starting with “I see”, “I hear”, “I feel”, “It is a”, etc. Videos

Natural Language Development

• Brown’s stages of language development:1. Single Words2. Two-Word Phrases3. Two-Three Word Phrases & Sentences

• Why would we expect an AAC user to develop differently?

• Vocabulary Acquisition Studies:– 9-13 words per day from age 1½ - 6– 3 year old vocabulary: over 1000 words– 5 year old: up to 3000 words

I don’t know where to start. What words do I teach first?

• Teach the first words children learn

WordsINoYes/yeamythewantis itthatagomine

youwhatoninheremore outoffsomehelpall donefinished

25 core words comprise more than 90% of the total words used by 34 toddlers whose speech was recorded

Banajee, DiCarlo & Stricklin, (AAC 2000)

Vocabulary Instruction for the Beginning Communicator: 5 Philosophies

• Vocabulary instruction involves a systematic TEACHING process. Add vocabulary as an activity on the daily schedule and then have a mini-schedule for the specific vocabulary instruction activities for that day. Praactical AAC introduced general steps for vocabulary instruction . For the beginning communicator, also apply an errorless learning paradigm. Gradually, add comprehension checks, but do not wait for ‘proof’ of comprehension because we often notice that the beginning communicator will demonstrate comprehension during ‘unexpected opportunities- or when you are least expecting it.

• Vocabulary Instruction Is for EVERYONE. There are no pre-requisite skills needed.• Vocabulary Instruction Involves ALL modalities of Language- Remember to use

activities for vocabulary instruction that incorporate reading, writing, listening, & talking - T.H.E. P.A.C.T.

• Vocabulary Instruction Must Incorporate Many Opportunities for Active Participation. In this context, active participation means multi-sensory active participation. Learners should move, feel, touch, activate, see, hear, and overall experience the vocabulary.

• Vocabulary Instruction Should be Dynamic, Interactive, & Fun. Use humor or seriousness with word presentation but consider the personalities of your learners as vocabulary instruction activities are created. Choose words within a theme that would be meaningful and interesting to learners.

10 Activities of Vocabulary Instruction for the Beginning Communicator

• Use Thematic Teaching and choose Words of the Week. Themes can be chosen based on a pre-determined curriculum from school or on a social basis (friends, playing, etc) or a holiday , etc. Just make it fun and interesting. If possible, have learners choose the Themes and/or the Words of the Week. An activity of ‘deciding’ can be an individual or group process. Have a Theme or Word of the Week choice board. The learners are deciding but you have only included options you are willing to consider. Then use the monthly calendar so everyone knows what will be ‘talked about’ each week or month.

• Read books that include words of the week. Highlight or sticky note the ‘target words’• Use a Word Wall for Words of the Week. Have learners add pictures, objects, remnants, text,

etc. that define, categorize, or semantically relate to the target words. As the word wall becomes an important part of vocabulary instruction and learners are familiar with it, add some visual markers for where different items would be placed (i.e., categories, text, etc. you can even use some creative classifications for example ugly _________ or funny _________).

• Create Word of the Week books. These can be tangible books, folders with pockets, talking power point books, talking photo albums, etc. Keep in mind to use the principles of active participation (i.e., Let learners glue, stick, record speech, type to help create the books).

• Create Word of the Week boxes. Again, keep principles of active participation in mind. Students can put items in a box, decorate the box, close the box, move the box, etc. Remember this is not a test, it is teaching so initially all items for the student to put in the box should be correct options.

• Use word art activities. Make word clouds, embed words in images, word banners, etc. Hang the creations up, Use aided language input when talking about them.

• Create some super fun ways of interacting with the words. Anything goes here- go outside and have a word SHOUT OUT. If learner is using AAC device , turn up the volume or get an amplifier. Learners love the absurd.

• Create Word Recipes. This can be done a variety of ways. Words Recipes can help a learner put together a sentence by adding ingredients (words/or word symbols) to form a sentence that has meaning that ends with eating real food. Word Recipes can also be a traditional recipe which highlights the target word in some way. For example, if the Words of the Week had a theme of ‘Friends’, the food recipe could be ‘friendship’ cookies with specific friendship words written on each cookie, or each cookie could have a single letter and when they are put together it would spell the target words. As parts of the words are ‘eaten’, model or have the learners say the new way the word sounds.

• Play Word Scavenger Hunts. Hide words around an area and then use a ‘sleuth’ costume or props to find the words. This allows for more opportunities to use language facilitation strategies around the words.

• Have an end of a theme Word Party (add ‘positive’ surprises and have a Word Party at a time other than at the end, this can be done to help teach ‘change of schedule’ or ‘surprise’ when using schedules). Word parties can have cool hats with target words, fun food (have learners choose one of the Word Recipes you have done).

Core Word Of the Week – On / Off work on for 2 WeeksOn Ride on Off Having an off day

Turn on Work on Turn off Off and on

Get on Move on Get off It is off now

Put on On the table Take off It is off the table

Jump on On your head Jump off SMART board on /off

Swing on On your own Clean off Turn off lights

Sit on Put it on high / low Day off The computer is on/off

• Shine a flashlight “on” items in the room. Have the students be the director and tell you what or who to put the light “on”.

• Dress a doll, stuffed animal, Weather Bear, etc and “put on” clothes and accessories. Play dress up – enjoy being silly and animated.

• Sensory/motor room / PE - get "on" the swing, "on" the therapy ball, jump "on" the trampoline, fall "on" the matt and climb "on" the ladder, ride on the bike / wagon / sled etc.

• Practice writing "on" the chalkboard / SMART board/ Dry erase board and stacking blocks "on" top of each other!

Word of the Week con’t

• We use the word “on” frequently to discuss locations. Allow your child to direct you or peers to sit “on” a chair, put something “on” a table or shelf, or stand “on” a stool. Your child could take a turn giving directions during a game of Twister (e.g., “foot on red”) or Hullabaloo (stand “on” a circle).

• Wait for the students to give the direction to “turn on” the lights, SMART Board, computer, music, video, electronic toy, faucet, etc.

• To bring it to the student’s attention – Verbally state when you turn “off” something.

• Wait for the students to give the direction to “turn off” the lights, SMART Board, computer, music, video, electronic toy, faucet, fan, etc.

• Dress a doll, stuffed animal, Weather Bear, etc and “take off” clothes and accessories. Put items on incorrectly. Play dress up – enjoy being silly and animated.

• Sensory/motor room / PE - get "off" the swing, "off" the therapy ball, jump "off" the trampoline, get "off" the matt and take “off” a cover or item that is blocking their use of the equipment.

• We use the word “off” frequently to discuss locations. Allow your child to direct you or peers to get “off” a chair, take something “off” a table or shelf, or get “off” a stool. Your child could take a turn giving directions during a game of Twister (e.g., “foot off red”) or Hullabaloo (jump “off” a circle).

School Survival Skills

• Interacts with adults and peers.• Initiates interactions with adults and peers. • Makes choices from visible and invisible references.• Demonstrates turn taking in small groups.• Demonstrates appropriate attention getting strategies.• Expresses ideas to others.• Communicates with peers and adults.• Asks questions of others.

Vincent, Lisabeth J.; Christine Salisbury, Gail Walter, Pansy Brown, Lee J. Gruenewald and Michael Powers, “Instructional Design for the Severely Handicapped,” W. Sailor, B Wilcox, and L. Brown (Eds.), Brookes Publishers, June 1980

Preschool Classroom Environments that Promote Communication

• Interesting materials• Out of reach objects/materials• Inadequate portions• Choice making• Assistance• Sabotage• Silly situations

From Ostrosky, M. and Kaiser, Ann. Preschool Classroom Environments That Promote Communication, Teaching Exceptional Children, 1991

• Does this just apply to preschool?

Interactive Learning Interactive learning is a strategy used to enable all students to gain information through hands on, interactive means. Interactive learning often involves the use of computers and other tangible equipment, learning materials and resources.

Basic Principles –• The student receives continuous feedback, either from teacher or from

the technology• The student is an active participant rather than a passive one. • The content presented during the interactive learning activity may be

similar to content used for traditional, non-interactive learning (e.g., books or worksheets).

• The learner is in control of the advancement of the lesson to some degree.

• Materials can be easily adapted to accommodate different learning styles.

I just figured out how many hours a typically developing infant is awake and exposed to language via the spoken symbol before they begin to use the spoken symbol expressively at around 12-18 months of age. If you then look at a child with an AAC system who only gets exposure to his system 2 times a week for 20 minutes with the SLP, it will take him 84 years to have experience commensurate with the typically developing child. Taking that a bit further, we don't say language is in it's 'adult form' until between 9-12 years of age. That means that for that length of time, a typically developing child is practicing using the spoken symbol, getting feedback and correction from listeners, seeing it modeled over and over.... now you look at the child with a device who only gets access to the system twice a week for 20 minutes with the SLP - it will take him 701 years to have the same amount of experience as his typically developing counter part.... and all of this assumes that no one is ever sick or takes a vacation.... So when no one wants to use a device until it is 'mastered'.... in therapy..... hmmmm... what IS wrong with this picture... One might assume that an atypical developer might need MORE time to practice, NOT less time...

Quote by Jane Korsten, AT Expert

Visual Supports

Visual Bridges

Student actively reviews and recounts his/her schedule/day at school and brings the information home to share in a visual format.

Activities for Use:• Mark choices on a page of schedule pictures• Copy names of activities from a schedule• Collect food wrappers or advertising pictures from a

community experience• Use digital pictures of objects that communicate the

information• Use fill-in-the-blank sentences• Write original sentences

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PACT Wiki user name - faculty password - faculty

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