Introduction to AAC

Kate Ahern, M.S.Ed.

AAC Bootcamp

Easter Seals MA

August 2014

Underlying Principles

Everybody Communicates

AAC Definitions

AAC

Augmentative and Alternative Communication

Why do we communicate?

• Light, 1988• Communicate

wants/needs

• Information transfer

• Social closeness

• Social etiquette

• Beukelman & Mirenda added: • internal dialogue

Can your users communicate for all five?

The Least Dangerous Assumption

• “The criterion holds that without conclusive data educational decisions should be based on assumptions which, if incorrect, will provide the least danger for independent functioning.” Anne Donnellan

• Behavioral Disorders, v9 n2 p141-50 Feb 1984

We see…

what we expect to see.

Without Educational Data: Presume Competence

• Situations in which it may be impossible to have evidence• Severe apraxia (Rett Syndrome,

some cases of CP, Angelman Syndrome)

• Severe physical disabilities

• Movement disabilities

• Multiple sensory disabilities (Deafblind)

• Co-morbid cases of neglect – in the home or educational neglect

Cannot physically

access communicati

on materials.

Presume Competence

Dx with condition

assumed to cause severe

developmental delay

Medical condition

affect alertness

Check Your Assumptions

• Historical Belief of Severe Developmental Disability is NOT Educational Data

• Research into many disabilities is proving that many individuals have been underestimated leading to improper interventions, educational and residential placements (Down Syndrome, Fragile X Syndrome, Rett Syndrome, Angelman Syndrome, Deafblind)

• Learners with presumed moderate to severe disabilities are more likely to suffer from educational neglect

• Data from children who have not been taught to communicate only indicates a lack of teaching/appropriate intervention not a lack of potential to communicate

What if Annie Sullivan did not presume

competence?

What if you don’t?

Communication Bill of Rights

By the National Committee for the Communication Needs of

People with Severe Disabilities

TASH and ASHA

Bill of Rights

Multimodal Communication

• Facial expressions

• Vocalizations

• Body Movements

• Eye pointing

• Gestures

• Verbal Approximations

• Speech

• Sign Language

• Pictures Exchange Communication System (PECS)

• Communication Boards/Books

• Pragmatic Organization of Dynamic Display (PODD)

• High Tech Communication Systems (Tobii, Dynavox, PRC, Saltillo, tablets with apps)

Making Multi-Modal Communication Meaningful

• Honor all communication attempts that are meaningful and understandable – don’t force a user to “say it again” with a device (or sign or their voice)

• Use multi-modal communication yourself

• If you wish to demonstrate how something could be done in another mode, go ahead!

Types of AAC

Types of AAC

Unaided• No tools needed

• Sign language

• Gestures

Aided• Use of tools needed

• PECS

• Communication Boards/Books

• Technology based systems

Types of AAC

Low/Light TechHigh Tech

A few words about symbols:

1. Myth of symbol hierarchy is pervasive (object, photo, drawing, words)

2. Use of objects and photos can lead to lack of generalization and overuse of nouns

3. Studies have shown that both iconicity (transparency) and the meaning assigned to a symbol by adults and peers affect learning symbols for communication

GesturesEnhanced Natural Gestures

(ENG)Keyword Sign

Signed Exact English (SEE) American Sign Language (ASL)

1. Gestures are motions made by a communicator that send a message, may not be universally understood

2. ENG are non-contact motions taught by shaping a communicators natural movements

3. Keyword Sign Language is the practice of using manual signs to communicate important words in a sentence or phrase

4. SEE is a manual form of spoken English where a sign replaces/matches every word

5. ASL is a unique and full language that is communicated using manual signs, it has its own grammar, idioms and culture

Picture Exchange Communication System (PECS)

1. A system of Augmentative Communication Instruction that begins with a 2:1 staff to client ratio and focuses on teaching mands through intraverbals through a strict ABA methodology

2. PECS is NOT what picture symbols are called and is NOT any notebook/picture trading systems that is in use

3. Clinicians and partners should be trained by Pyramid Consultants

4. Misused the system can be overly reliant on mands/nouns and miss opportunities for social closeness and other functions

Pragmatic Organization of Dynamic Display

(PODD)

1. A system and method of Augmentative and Alternative Communication available in both low and high technology versions

2. Vocabulary is arranged so that user can flow through a conversation

3. Methodology focuses on Aided Language Stimulation and communicate partner training

4. Originated in Australia with Gayle Porter, currently one certified trainer in USA, Linda Burkhart

5. System can appear overwhelming to those not trained, there is a learning curve to using and modeling PODD

Communication Boards

Flipbooks

Generally used in conjunction with a static communication board or device Flipbooks often contain words that allow users to expand sentences and provide more context to their communication than using a single board or page alone.

Static Display Devices

Dynamic Display Devices

Other Tools in the AAC Toolbox

Visual Supports

Visual supports are any tool presented visually that supports an individual as he or she moves through the day. Visual supports might include, but are not limited to, pictures, written words, objects within the environment, arrangement of the environment or visual boundaries, schedules, maps, labels, organization systems, timelines, and scripts. They are used across settings to support individuals. (National Research Council, 2001).

Classroom Natural Aided

Language Communication Boards/Systems

1. Using posters (make at an office store) or decals (CafePress will make them) or just enlarged photocopies you can have a classroom sized communication board for modeling

2. Using a projector or smartboard you can display a communication app or software for use for modeling

Wearable AAC and Reminders

The Latest Research

Multiple Modes• Key to successful

communication• Light,-Collier,-&-Parnes, 1985

• Blackstone-&-Hunt Berg, 2003

• Light-&-Drager, 2005

• Binger-&-Light, 2006

AAC Does not Impede Speech • AAC has no impact or

sometimes (over 80% of the time) increases natural speech• Romski-&-Sevcik,-2005

• Millar,-Light,-and-Schlosser-2006

The Latest Research

The Best System• Research supports using a

system with evidence based implementation, no one system is “best”• Mirenda-(2003,-2005)

Not Enough Language • Most young children using

systems that do not have enough language for communication or to even learn to communicate • Binger-&-Light,-2006

• Hustad-et-al.,-2005

Directions in Research

Visual Scenes May Be Helpful• With younger children (1-3)

using visual scenes that depict and entire concept with outlined hotspots can be helpful, more research needed • Fallon,-Light,-&-Achenbach,-2003

• Light-and-Drager-(2005)-

Finding a symbol is easier than finding a page • Individuals may need help

navigating to the correct page of their book or device, using screen shots of pages may help find the correct page• Drager-et-al.,-2003

• Light,- Drager,-McCarthy,-et-al.-(2004)