Autism: Technology & Communication - Part 2
Gwendolyn Meier Eberhard, SLP, MT Villa Esperanza Services
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: [email protected] !
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