Implementation of Proloquo2Go for Students with AAC Needs

Implementation of Proloquo2Go for Students with AAC needs

Eric Sailers, M.A., CCC-SLP | Expressive Solutions

Disclosures

Owner of Expressive SolutionsTrainer for n2yConsulted for Assistiveware

Giveaway

Participation - Entries in the giveawayGiveaway - iTunes cards will be given away

Overview

Intro

Hands-On: Proloquo2Go

AAC Team

Communicative Competence

Proloquo2Go

P2G + AAC Strategies

What’s New in Proloquo2Go 4

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 or pictures, or write.

• People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth.

References: 1

Types of AAC

• Unaided communication systems – rely on the user's body to convey messages. Examples include gestures, body language, and/or sign language.

• Aided communication systems – require the use of tools or equipment in addition to the user's body. Aided communication methods can range from paper and pencil to communication books or boards to devices that produce voice output (speech generating devices or SGD's) and/or written output. Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages.

References: 1

Evidence-Based Practice

EBP

Current Best Evidence

Clinical Expertise Client/Patient Values

The goal of EBP is the integration of: (a) clinical expertise, (b) best current evidence, and (c) client/patient perspectives to provide high-quality services reflecting the interest, values, needs, and choices of the individuals we serve.

References: 2

References: 3

AAC system should be:PresentConsistently organizedModeledRecognized as a voiceUseable across contexts

Evidence-Based Practice

EBP for Proloquo2Go

Evidence Implementation

Provide aided AAC models and recasts for symbol combinations (Binger & Light, 2007).

Adult selects two or more items to model communication.

Provide aided AAC models and recasts for grammatical morphemes (Binger, Macguire-Marshall, Kent-Walsh, 2011).

After a child uses a noun or verb without the correct ending, the adult selects the item.

Use AAC to develop phonological and literacy skills (Light & Drager, 2007). Practice spelling CVC words (e.g., dog).

Increase participation and social interactions (Light & Drager, 2007).

Facilitate greetings and topic initiation to improve social interactions.

Core words enable syntactic, semantic, and pragmatic functions (Banajee, Dicarlo, & Stricklin, 2003).

Use core vocabulary organization to express a variety of language functions.

References: 4 - 7

EBP: Patient’s Perspective

We need to look at every aspect of our lives, from the time we wake up in the morning, until we get up the following morning. We need to be able to communicate 24/7 like so-called “normal” speaking people do. (Pistorius, 2004, p. 3)

References: 8


• 5 minute conversation • Use Proloquo2Go to communicate in a group • No speaking or writing • Express your thoughts and feelings about the Common Core curriculum

• After the 5 minute conversation, we will complete a self-evaluation form

Self-Evaluation Form

References: 9

References: 10

AAC Team

AAC Team Responsibilities

• Provide and encourage opportunities for student participation

• Reinforce the use of the AAC system • Encourage peer interaction • Work on educational goals

References: 9


Speech-Language Pathologist (SLP) or AAC SpecialistEvaluate and recommend AAC technologiesManage vocabulary selection for communication pagesProvide training to the studentCollaborate with teachers on curriculum adaptationTrain instructional assistants and teachers in AAC

References: 9


Special and/or Regular Education TeacherHelp the SLP select vocabulary for communication pagesTeach and adapt curriculum as necessary for studentsCollaborate with the SLP on strategies for participationCreate communication opportunitiesProvide the SLP with feedback on the AAC system

References: 9


Instructional AssistantsProvide device instruction to studentHelp student maintain the deviceCollaborate with the team on strategies for participationProvide student with opportunities to use AACWork with student on appropriate social language skills

References: 9


StudentLearn how to use the AAC deviceInitiate use of the device for various communication tasksDevote time to learning AAC strategiesHelp maintain the deviceUse total communication to express needs/ideas/preferences

References: 9


Family MembersHelp with vocabulary instructionHelp provide AAC device instructionEncourage their child to use the AAC systemMaintain and troubleshoot the AAC deviceShare feedback on use of AAC at home & in the community

References: 9

“There’s more to life than cookies.” - Janice Light

References: 6


• In 1989, Janice Light defined communicative competence based on functionality of communication, adequacy of communication, and sufficiency of knowledge, judgment, and skill

• In 2003, Light expanded the definition to say the attainment of communicative competence include a variety of psychosocial factors as well as barriers and supports in the environment

• In 2014, Light revisited the definition as she considered the dramatic changes in the AAC field occurring since 1989. She argued the essential goal of intervention has not changed, yet how the communication goals are achieved has changed.

References: 8

Functional Communication

Emphasis on outcomes in the real worldExpress needs and wantsExchange informationDevelop social closenessParticipate as required in social etiquette routines

References: 8

AAC Expectations

“It is no longer sufficient for individuals with complex communication needs to have access to the means to simply request a preferred food or activity; rather they need access to communication to build friends with peers, to learn at school, to share their expertise on the job, to manage their health care needs, and to participate as full citizens of society.”

References: 8


Operational CompetenceOperate and maintain equipment Linguistic CompetenceLearn vocabulary and grammatical rules Social CompetenceAcquire conversational and social skills Strategic CompetenceIncrease rate, develop compensatory and repair strategies

References: 8

Assessment of Communicative Competence

• Augmentative & Alternative Communication Profile • Assesses AAC skills (for any AAC system) of the student and communication partner(s) across 4 areas of learning: Operational, Linguistic, Social, Strategic

• Rate skills on 1-3 scoring system (1 = seldom, 2 = sometimes, 3 = frequently) based on observations

• Determine current and desired skills for the student and communication partner(s) across the 4 areas of learning

• Skills in desired skill levels may be considered for direct or indirect intervention

References: 11

Communicative Competence in IEP Goals

• Operational Competence • Given her communication system and a natural or indirect verbal cue (hint), Jane will independently navigate screens she needs to start or continue her message at least five times per day across all school and community settings.

• Linguistic Competence • Given his communication system of 9-12 core words and ongoing aided language stimulation across the school day, Joe will communicate for three different purposes (such as greeting, commenting, requesting, labeling, asking and answering questions) during a 20 minute group activity with no more than two indirect verbal cues (hints).

References: 12

Communicative Competence in IEP Goals

• Social Competence • Given his communication system and intensive aided language stimulation, Joe will use the core words, "like" and "don't like" to indicate preferences and opinions in naturally occurring situations across the school day at least three times per week with natural and verbal cues.

• Strategic Competence • Given her communication device and an unfamiliar communication partner, Jane will independently use communication repair strategies such as explaining how her communication system works, asking for additional time to compose a message or requesting the communication user give her space as appropriate at least twice per two-week data collection period.

References: 12

Goals of AAC

• Increase participation and social interactions • Express a range of communication functions including wants and needs, social communication, sharing information, and joint attention

• Develop a range of semantic concepts to support diverse communication

• Build a greater complexity of language structures (syntactic and morphologic) to support more complex communication

• Build phonological awareness and foundations for literacy development

References: 13

Spontaneous Novel Utterance Generation (SNUG) - You can say what you want to say, when you want to say it, to whom you want to say it.

Goals of AAC

References: 14

Intervention for Communicative Competence

Descriptive Teaching

Core Words

Aided Language Stimulation

AAC implementation strategies to achieve goals

Proloquo2Go +

AAC Strategies

Proloquo2Go

Proloquo2Go Overview

• Full-featured AAC system with research-based vocabularies and over 14,000 Symbolstix symbols

• Various views include Grid, Recents, and Typing to communicate text and/or symbols in the app or shared outside of the app

• Parts of speech are organized and color coded • Fully customizable with symbols or photos • Several configurable options for appearance, speech, access method, interaction, grammar, prediction, vocabulary, restrictions, and more

• Backup and password options

Demo

Proloquo2Go Overview

1. Evaluate and choose an AAC system 2. Select AAC system design 3. Customize the vocabulary 4. Teach the AAC system

Implement an AAC System

1. Evaluate and choose a system

• iPad with Proloquo2Go • Other AAC solutions

• Other apps and high-tech devices • Signs and gestures • Choice boards • Communication boards • Communication books • Low-tech AAC (e.g., BIGmack, Step-by-Step)

2. Select AAC system design

• Considerations • Developmental level • Receptive and expressive language skills • Literacy skills • Physical access • Visual issues • Environment / situations where AAC is needed

2. Select AAC system design

• Activity Specific (Basic Communication) • PODD • Semantic • Core Word

Activity Specific Design

Activity Specific Design

• Great for young developmental level, first AAC exposure • Difficult to quickly change topic during activity • Difficult to have display for every possible activity • Limited linguistic flexibility

Core Word Design

Core Word Design

• Small number of words makes up most of what we say • Place frequently used words near the top of the hierarchy where they can be reached fastest

• Place less frequently used (fringe) words at the bottom of the hierarchy because they don’t need to be accessed often

• Organize hierarchy so that it is easy to figure out the route to the word you want

Who should use core word design?

• Good categorization skills • Understand that nouns and other activity-specific words are hidden from immediate view

• Language learners who have “out-grown” activity-specific organization

• Physical access skills and visual processing suited to large number of items per screen

Core Words

Core Words

• 50 words account for 40-50% of what we say • 100 words account for 60% • 200-400 words account for 80% of all words spoken • Quick access enables effective and efficient communication

References: 15

Core Words

• Core vocabulary comprises high frequency words (e.g., ‘I’, ‘you’, ‘like’, ‘go’, ‘it’, ‘on’, ‘up’) that are about 80% of words we use everyday. Core vocabulary should be a main part of all AAC systems because it enables most flexibility across most contexts.

• Fringe vocabulary comprises low frequency words (e.g., ‘mountain’: ‘glacier’, ‘crevasse’) and are used about 20% of the time. Personal vocabulary also in fringe vocabulary and used to express individual needs, interests, work, school, and community needs.

References: 16

Core Words

Parts of speechPronouns, verbs, adjectives, prepositions, articles, conjunctionsDynamic Learning Maps (DLM) word frequencyNo nouns in first 50 wordsOne noun in first 10018 nouns in first 20037 nouns in first 30082 nouns in first 400

References: 17

DLM Core First 40

1. I like not want2. help it more different3. who she you he4. where up on in5. me make get look6. what need are is7. some put all this8. don’t that go do9. when finished can here10 open turn stop over

References: 17

Monthly Core Words

References: 18

Core Words

• AAC goal: Spontaneous Novel Utterance Generation (SNUG) - say anything to anyone, anywhere, anytime

• Most effective AAC system for SNUG is literacy - say anything with 26 symbols

• Next most effective is core words - with 50-400 words, say 40-80% of what most people say

• Much less effective for SNUG • Noun-based (e.g., PECS) • Pre-programmed phrases/sentences • Activity specific displays

References: 14

3. Customize the vocabulary

• Administer a vocabulary selection questionnaire • Consult the manual and/or support resources for the vocabulary map

• Choose the layout via the # of columns suitable for the student

• Add and/or edit the default vocabulary using preferred vocabulary in a fringe folder

References: 19

Select the # of columns

• Consider the following factors: • How small of a target can the user press consistently without errors?

• How small a target can the user discriminate visually? • Would the user benefit from keeping the location of buttons constant as he/she learns new vocabulary?

Progress through core words

• Increase the # of columns in the Appearance Options • Provide time for the user to adjust, as his/her vocabulary has moved positions and increased

• Hide and reveal buttons • Minimizes new learning needed as the user progresses in vocabulary size. The user must physically access buttons for a high # of columns per page, but be at a language level better suited for a low number of columns per page.

References: 20

Hide and reveal buttons

1. Find the ‘target number’ of columns based on physical access 2. Find ‘starting number’ by determining # of buttons that closely

matches user’s language skills. Try a different number of columns and see when the user gets confused.

3. Set the # of columns to the ‘target number’ and go to the home page 4. Find the list of words and folders for the ‘starting number’ in Appendix

B (pg. 113) of the Proloquo2Go 3 manual 5. Tap on edit mode, select all the buttons not on the list for ‘starting

number.’ Tap the Properties tab, scroll to visibility, and tap hidden. 6. Determine if you want to keep/demote folders that don’t appear on

the list for the ‘starting number.’ 7. Exit edit move. Over time, gradually reveal buttons and promote

folders.

References: 20

Examples of hidden buttons

References: 20

• Add a user with core word vocabulary • Set the ‘target number’ to 8 and ‘starting number’ to 5 • Tap buttons to speak, combine buttons to speak from the message window, and navigate folders

• Edit a button’s text and symbol. Add a button with a photo in a fringe vocabulary folder.

• Move buttons to priority levels (primary, secondary, storage)

• Navigate to different views and use them • Conjugate verbs and pluralize nouns

Hands-On with Proloquo2Go

Demo

Hands-On with Proloquo2Go

4. Teach the AAC system

Strategies


Aided Language Input

Partner-Augmented Input

Natural Aided Language

Aided Language Acquisition

AKA

AKA

AKA

AKA

Aided Language Stimulation (ALS) is 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.


References: 21

Input = OutputIf the expectation is verbal output, verbal input is requiredIf the expectation is AAC output, AAC input is requiredIt is difficult to map verbal input to AAC outputSo, Aided Language Stimulation is essential


References: 22

Implement ALS

• Model core words by touching them in the student’s AAC system as you say a sentence

• Modeling is talking, not asking questions. Catch yourself before asking a question.

• Focus on commenting and making statements. Model what you/the student/a peer is/are doing or did.

• Model a range of functions in natural contexts • Instead of prompting, provide expansions and recasts of the student’s input using ALS

References: 23

Do This Not That

Model the target, “I want __________.”

Only ask questions, “Do you want __________?”

Model without any expectations

Move through prompt hierarchy

Model in natural contexts Model in contrived situations

With ALS, remember to

References: 3

ALS Video

References: 24

ALS Tips

Tips to keep in mindConsider zone of proximal development when modelingBe patient with your progress, and keep at itGet comfortable - use main screen(s) firstStart off by modeling core words only in the sentenceIt helps us choose our words carefullyVisual reminders from colleagues to stay on trackIt helps us recognize errors in customizingIt’s contagious - the more you do it, the more others willKids love seeing us take on the role of the learner

References: 25

ALS with Proloquo2Go and Unique

References: 26


Circled core words on 7 column home screen of Proloquo2Go

Demo



• Use core vocabulary to describe concepts rather than programming fringe vocabulary words that won’t be used again

• Reduces need to remember the location of rarely used fringe words

• Provides additional practice using core words in creative and authentic ways

• Saves time!

References: 27


Referential Style Descriptive Style

Need large vocabulary of words rarely needed daily

Need smaller vocabulary of words used daily

Requires least amount of thinking - rote memory

Requires creative thinking re: concepts & vocabulary

Highest memory demand with the least pay-off

Focus on info in the lesson, not new pages & symbols

References: 27


References: 27


• Core word appearances - grid sizes replace columns • Vocabularies - Basic Communication, Intermediate Core, Advanced Core

• Enhanced user interface for editing • Share folders between devices • Core word templates • And more!

References: 28

• Purpose - Motor planning & language development • Each folder displays as combination of a template and its own contents

• Template shared by multiple folders and matching home page

References: 29

Core Word Templates

Core Word Templates

Home Page Breakfast PageReferences: 29

Contact

Email - [email protected] - @ExpressiveSolsFacebook - ExpressiveSolutionsLLCWebsite - expressive-solutions.com

http://expressive-solutions.com

References

1. Augmentative and Alternative Communication - http://tinyurl.com/ob5uv29 2. Evidence-Based Practice (EBP) - http://tinyurl.com/o7najed 3. Building Classroom Communities to Support AAC Users - http://tinyurl.com/

nlbvks8 4. Binger, C. & Light, J. (2007). The effect of aided AAC modeling on the

expression of multi-symbol messages by preschoolers who use AAC. Augmentative and Alternative Communication, 23, 30-43.

5. Binger, C., Maguire-Marshall, M., & Kent-Walsh, J. (2011). Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children with developmental delays who use AAC. Journal of Speech, Language, and Hearing Research, 54, 160-176.

6. Light, J., & Drager, K. (2007). AAC technologies for young children with complex communication needs: State of the science and future research directions . Augmentative & Alternative Communication, 23, 204-216.

7. Banajee, M., Dicarlo, C., & Buras Stricklin, S. (2003). Core Vocabulary Determination for Toddlers. Augmentative and Alternative Communication, 19(2), 67–73.

http://tinyurl.com/ob5uv29

http://tinyurl.com/o7najed

http://tinyurl.com/nlbvks8

8. Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication? - http://tinyurl.com/mkcmgb7

9. Cottier, C., Doyle, M., & Gilworth, K. (1997). Functional AAC Intervention: A Team Approach. Bisbee, Arizona. Imaginart.

10.Toddler with apraxia Asking for Cheese and Cracker using iPad with Proloquo2Go and ASL - http://tinyurl.com/pbr2jrv

11.Kovach, T. (2009). Augmentative & Alternative Communication Profile: A Continuum of Learning. East Moline, IL. LinguiSystems.

12.Meaningful and Evidence-Based Goals - http://tinyurl.com/k3jmk4m 13.AAC Interventions to Maximize Language Development for Young

Children - http://tinyurl.com/62y2zhr 14.Achieving Success in AAC: Assessment and Intervention - http://

tinyurl.com/kb52md5 15.Road to Proloquo2Go 4 - Core Words - http://tinyurl.com/oofclzs

References

http://tinyurl.com/mkcmgb7

http://tinyurl.com/pbr2jrv

http://tinyurl.com/k3jmk4m

http://tinyurl.com/62y2zhr

http://tinyurl.com/kb52md5

http://tinyurl.com/oofclzs

16.Join Together Core & Fringe Vocabulary - http://tinyurl.com/kgv8zyg 17.Dynamic Learning Maps Core Vocabulary - http://tinyurl.com/

m5wg28l 18.Core Vocabulary Resources for April - http://tinyurl.com/k7lyvhd 19.Fallon, K., Light, J., & Paige, T. (2001). Enhancing Vocabulary

Selection for Preschoolers Who Require Augmentative and Alternative Communication (AAC). American Journal of Speech-Language Pathology, 10, 81-94.

20.Proloquo2Go 3 Manual - http://tinyurl.com/jwrhwfx 21.AACtion Point: Aided Language Stimulation - http://tinyurl.com/

od6y94l 22.PrAACtical AAC Strategy Series: Building a Foundation with Aided

Language Input - http://tinyurl.com/ma2elfq 23.Practical Strategies for Implementing Aided Language Stimulation -

http://tinyurl.com/nqfxxpl

References

http://tinyurl.com/kgv8zyg

http://tinyurl.com/m5wg28l

http://tinyurl.com/k7lyvhd

http://tinyurl.com/jwrhwfx

http://tinyurl.com/od6y94l

http://tinyurl.com/ma2elfq

http://tinyurl.com/nqfxxpl

24.One Kids Place Aided Language - http://tinyurl.com/o925hg5 25.AACtual Progress: Learning to Use Aided Language Input - http://

tinyurl.com/oraxsab 26.unique learning system - http://tinyurl.com/ocovgwf 27.Van Tatenhove. G. (2009). Building Language Competence with

Students Using AAC Devices: Six Challenges. Perspectives on Augmentative and Alternative Communication, 18(2), 38-47.

28.Proloquo2Go 4 Manual - http://tinyurl.com/ketnyxn 29.Road to Proloquo2Go 4 - Core Templates - http://tinyurl.com/o7k6nux

References

http://tinyurl.com/o925hg5

http://tinyurl.com/oraxsab

http://tinyurl.com/ocovgwf

http://tinyurl.com/ketnyxn

http://tinyurl.com/o7k6nux

Implementation of Proloquo2Go for Students with AAC Needs

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