Transcript: Augmentative and Alternative Communication and Vocabulary Selection


  • Welcome posted by Jackie Hess on Apr 01, 2007

    Welcome to both those of you who are newcomers to the Family Center's online discussions and to those of you who have participated before. As you know, this discussion will last throughout the month of April. That gives us plenty of time to delve into the topic in depth. You can ask both general and specific questions, relate experiences, and post resources. If you have any technical difficulties in accessing the discussion or its resources, please send us an email at fctd@aed.org. We hope you'll return to the discussion often. Please don't worry if you haven't been able to read all of the posts; we're all in this together and you'll find it a welcoming and supportive online community.

    • Re:Welcome posted by niki stevens on Apr 09, 2007

      Thank you. My name is Niki Stevens. I am currently enrolled in a motor, communication and sensory deficits class. These discussions will be an invaluable tool to help me become more acquainted with teacher/ parent issues surrounding assistive technology. Nice to be here.

  • welcome- a parent's perspective posted by Robin Hurd on Apr 01, 2007

    Welcome to the April discussion on AAC and vocabulary selection. AAC serves as a voice for children who are not able to speak fluently. When properly set up and supported, AAC becomes the way that these children can learn of the wonders of language-the rhythm of words and syllables, the magic of asking and receiving, the joy of conversation, the mysteries of grammar and the organization that language supplies to our thoughts.

    As we talk about how to choose and support vocabulary on an AAC system, it's important to stop and think about how children who are learning to talk use their words. I have 4 sons, two who speak and 2 who use AAC. My oldest son's first word (he is verbal) was "juice", but to him it meant "anything liquid". This is very typical of a child who is just beginning to talk. One word can represent a whole category of items. He used this word to label things, as well as for requesting a drink. My middle son's first word (he is also verbal) was "backhoe" and when he said the word, he meant that specific type of vehicle. He used the word to label the backhoes that drove by our house every day. Which child got more use out of his first word?

    Because we see regularly developing children using the few first words they have learned in a variety of ways to get the most communication from them as possible, we also expect to see this from early communicators who use AAC. So the first words we provide on an AAC system and focus on teaching should be words that can be used in multiple ways to communicate as much as possible.

    What might some of a typically speaking child's first words be, and how might these few words be used in multiple ways?

    Robin Hurd

    • Re:welcome- a parent's perspective posted by lcb05 on Apr 02, 2007

      Hi Robin,

      I have four children. My youngest uses an AAC device. I know that all of my children had the word "UP" and "EAT" among their first words. "UP" referred to pick me up or I want to go upstairs. "EAT" referred to I'm hungry, I want to eat, I ate, and all variations.

      Linda

    • Re:welcome- a parent's perspective posted by Renee on Apr 02, 2007

      My cousin's son's first word was "duck" first aptly said while at a lake looking at a duck. It then became his word for all nouns. Although he had a learning disability throughout school, he's just been accepted into a doctoral program in neuroscience.

    • Re:welcome- a parent's perspective posted by Jane, SLP on Apr 02, 2007

      My daughter's first care provider lived on a farm, with dogs, cows, ducks, and cats. At about 15 months, Katie's first word(s) were doggy (pronounced "doddy"), daddy, ducky (pronounced "duddy"). "Daddy" was specific to her dad. However, doggy referred to any 4-legged animals (dogs, cats, cows) and ducky referred to larger sized birds (ducks, geese, swans, etc.). Additional meaning was conveyed by vocal inflection changes. (We could tell how excited she was to see her daddy when her voice went into high pitch mode, vs. a more matter-of-fact pitch when she was labeling.) She also used a specific gesture (pointing) with a more generic phrase, "dat un" (that one), to indicate wants, preferences, and choices. By 2, she was speaking in at least 3-4 word sentences, representing a variety of communicative functions (questions for information, comments, statements, demands, refusals, requests, etc.).

      • Re:welcome- a parent's perspective posted by robin hurd on Apr 02, 2007

        What great examples of early, multi-use words! Normally developing children who are just learning to talk use the few words they have to mean different things than we as adults might use those words to mean(a "DUCK is any large bird, a "doggy" is any 4 legged animal). They also rely heavily on generic words like "dat un" (that one) when their limited vocabulary fails them.

        How does this apply to kids who use AAC? If we look at AAC as an artificial voice for children who cannot rely on their speech, then we should expect to see some of the same types of things as children with AAC develop their language skills.

        Often, however, a child with AAC who refers to all animals as "dogs" would be corrected, and assumed to be "not ready" for AAC yet because he or she was not able to accurately label objects.

        The only difference between an AAC system and speech, language wise, is that a child is limited to the vocabulary on the AAC system, and has not a way of changing the voice inflection to mean different things.

        Where the biggest difference often comes in is with the way we support a child who uses AAC, versus the way we support normally developing children who are learning to talk.

        Because children who use AAC are generally learning to use words at a later age than their peers, we tend to want to hear them talking like other kids their age. The temptation is to program in lots of sentences or phrases, so that the child has "immediate success" in communicating. However, we lose the language learning that takes place in the early stages of talking if we don't provide opportunities to use words one by one.

        Providing words that can be used in a variety of ways is so important on an AAC system, because of the limits of vocabulary. When a child is just beginning to learn to use AAC, "that one" is just as important to be able to say as it is for a child who is just learning to speak, and needs generic words to help communicate despite a small vocabulary. "What's that?" was another important phrase for my verbal sons as they learned to speak; it provided a way to initiate conversation despite having a reduced vocabulary and skill with words. Eventually, "that car" or that cup" was useful to communicate specific desires.

        So, as we consider whether to put the phrase "that one" or the single words "that" and "one" on an AAC system, we can see that there is great value in being able to isolate the word "that" and use it in several different ways. It can be used by itself with a gesture to indicate a choice, can be combined with the word "one" or a noun to be more specific about the choice, and can be used to ask a question and initiate an interaction "what's that?"

        • Re:welcome- a parent's perspective posted by Nicole on Apr 02, 2007

          Thanks for bringing up the point of prestored sentences. I find more and more devices with these limiting messages. I think they may be great for students with lower IQ's. But it is not a way to teach language users to generate or learn language. Isn't that what we want our AAC devices to ultimately provide for our students, clients, children or whomever we are concerned about?

    • Re: welcome - a future teacher's perspective posted by Bryony on Apr 15, 2007

      Hello. I am enrolled in a college course, entitled 'Introduction to Special Education'. I am joining this discussion with great interest but with no experience with an AAC device. I have read all of the discussions on the transcript. It sounds like this is a crucial discussion for parents, teachers and professionals (and the children using the devices).

      I heard a lot of frustration about using the devices and the limitations of that (since each person processes information differently and then is limited to what the device provides as language).
      A child's first word might be 'bee'. They might want to express something about that (either out of fear or curiosity and delight). "bee hurt", "look bee" "bee go" etc... it sounds like such a huge undertaking to try and create the best device and program it in such a way that the particular user can find it easy and satisfying (instead of it taking long to find the words and being frustrating).

      I can only imagine someone's delight, when they are finally able to communicate and be 'heard' by their family, friends and teachers!
      I applaud all of you for your input on this discussion board.
      Bryony in NC

  • Missing clues posted by Sandy Pollack on Apr 02, 2007

    Given the wide range for early communication (how early and at what rate children develop vocabulary) when should parents become concerned? In my case, I think we missed a lot of early clues to my son's subsequent issues because I knew the elements of his world so well (his experiences, books, videos, things in the house) that when his answers to questions were mis-matched in terms of what a typical child might say, I could always find some connection with his experience base. In that light, his answers often seemed creative and interestingly odd, rather than inappropriate and indicative of a neurological problem. In hindsight, I wish I had taken his unusual answers more seriously.

    • Re:Missing clues posted by robin hurd on Apr 02, 2007

      Sandy,

      I am assuming that your child is verbal, but has language delays. This is beyond the scope of our topic, which deals specifically with children who use alternatives to speech to communicate, but I will give a quick answer, based on our experience with our middle son, who is verbal but had unusual language development due to an Autistic spectrum disorder.

      Every child when first learning to talk uses words differently than adults do. This is what makes it so tricky to know if you are looking at a "phase" or a language delay. I had our middle son evaluated for his strange way of using words when he was 4, and was told to just wait it out and give him time to sort it out himself. When he was 7, we got the Autistic spectrum diagnosis, which explained the language "quirkiness" we saw in him.

      We expect him to continue to describe the world in unusual ways, since his brain processes the world differently. In the meantime, we work on specific language issues that make interacting with others a problem: confusing opposites, for example. ("the bath is too hot" when in reality it is too cold.) It is also perfectly OK to view his descriptions of the world as "creative and interestingly odd". The different perspective he shares with us can help us catch a glimpse of the world the way it looks to him.

      Some of the things that we do to help this verbal son with his language issues also help our sons who use AAC. Currently, there is a chart of photos of children expressing different feelings hanging in our kitchen. Our verbal son has used it to help him sort out his feelings and use words to tell us about them, and our sons who use AAC are currently doing the same thing to help them use words to tell how they feel. We also have used scripting with our middle son (writing out some possible things he might say in a given situation). This technique is helpful for our sons who use AAC, as well. For a long time we have had a "polite things to say to your parents" chart hanging on the wall. It included such bits of wisdom as "just a minute; I want to finish what I am doing first" and "Can you help me with this?" If the responses were less than polite, we directed him to the chart and re-played the interaction, using the chart as a help to select a better way to say it. For our sons with AAC, we use scripting to provide hints on what words they already know might help them to describe what they are learning in school. (this also helps the staff, by the way, to model words the boys know when teaching them.)

    • Re:Missing clues posted by niki stevens on Apr 09, 2007

      My son was speech and language delayed as a result of being premature. When he began communicating at age two, his verbal expression was only a point or grunt. At 3 years old he would speak all sorts of non-sensical, "gibberish", like he had created a language all of his own. This went on until he was four years of age. What was effective for him was the early intervention services that were provided free of cost through our county's pre-k exceptional childrens program. They were able to assess and evaluate his needs and put him in a home-based program with speech services. By the time he was in kindergarten, he was speaking in full sentences and began reading sight words. By 5th grade he had tested out of services alltogether. Now at 18, he is 52nd out of 458 in his senior class. In his situation I feel the early intervention was key for his success.

  • Early Words - A professional perspective posted by Katya on Apr 02, 2007

    I see many children as part of my clinical practice that are using AAC interventions, and parents are asking questions about what are the next steps to build communication skills. One method to evaluate the effectiveness of the AAC intervention is to see how the system supports vocabulary and grammar skill development. One of the diagnostic tools I use is to compare the vocabulary selection and organization with the research on Brown’s Stages.

    You may have heard about a child’s language skills being at, “Brown Stage I” or “Brown Stage III.” In his book "A First Language", Roger Brown described five stages children progress in mastering basic semantic (vocabulary) skills and acquiring the first fourteen morphemes (smallest unit of meaning) of the English language.

    These are the five stages with the age ranges and what to look for in terms of word and morpheme use.

    Stage I -- Semantic Roles and Syntactic Relationships
    MLU 1.75 Earliest 18 months; latest 27 months
    See mommy. See daddy.
    Find it. Hide it. Fix it.
    Mine. All gone. Up here/Over there.

    Stage II -- Grammatical Morphemes and the Modulation of Meaning
    MLU 2.25 Earliest 21 months; latest 30 months
    That's daddy's nose.

    Stage III -- Modalities of the Simple Sentence (Yes/no questions, WH questions, negatives, & imperatives)
    MLU 2.75 Earliest 23 months; latest 37 months
    Who is this?
    What is this?
    I can't swim.

    Stage IV -- Imbedding of One Sentence within Another
    MLU 3.50 Earliest 26 months, latest 44 months
    Now, where's a pencil I can use?
    That's a box that they put it in.

    Stage V -- Coordination of Simple Sentences and Propositional Relations
    MLU 4.00 Earliest 27 months, latest 48 months
    You snap and he comes.
    I did this and I did that.
    We went up to Foxboro and there were slides.

    Brown, Roger W. (1973). A first language: The early stages. Cambridge, MA: Harvard University Press.

  • Early Words posted by Pam Byars on Apr 02, 2007

    I have a 9 year old who has been attempting to use an AAC device for the past 2-3 years. We started her with age appropriate language but she is just not really using the device to communicate and mainly uses it for school work (to answer questions on a test or worksheet). We have exhausted professionals in our area because she has some challenges with access in general but I am wondering if it may be beneficial to go back to stage one and start over with the "early words"?!

    • Re:Early Words posted by Amy M on Apr 02, 2007

      We have that problem also, with my almost 8 year old, who is using a PRC Device. We just purchased the Literacy Through Unity word study program for her, and it starts with I, CAN, WILL, NOT, and ON. She uses it for very little at school, and the adults around here know very little about how to use the device. This program will teach them all together, starting with Basic words, and moving on.

      On topic, I found that it was neccessary early on, to put FUN words on her device, that other kids her age would typically say. She used to use pages primarily on a Vantage. Now, we are in the process of making her categorize the words, by parts of speech or a general category, like animals. Then she will be able to guess an approximate area in which her words will be in. We found that adding a simple phrase like OH NO, gave another child access to wanting to learn where at least THAT phrase was. We have made a game out of it. Whenever either of the girls make a mistake in speech, they both go for OH NO, on the device. It has to be fun.

      If they don't have access to typical words, they may not want to use the device at all, which is one of our main problems. Things like "Go away", "leave me alone", or, my all time personal favorite as a mom of 4, "I'm telling".

      Early on, we found that the best way to help a child communicate is to give them a chance to. I had a son who hardly said any words at the age of 3. We asked the doctor, and he told us it may be very easy to get him to speak. Told us to stop giving him everything he needed or wanted, BEFORE he asked for it. Within a month, he was talking. As parents, we know our children so well, but we are robbing them inadvertently, of the chance to say "I need" or "I want". With the 7 year old with apraxia, the first words they taught her, starting at about 1 year old, in sign language, were MILK, MORE, WANT, MOM, DAD, HOME, SLEEP, EAT, DRINK, PLAY, LOVE, ALL DONE or FINISHED, and HELP. Those few words pretty well cover the basis of a 1.5-3 year old's world.

    • Re:Early Words posted by Nicole on Apr 02, 2007

      I am currently assisting a child who uses an AAC device at a school. I have been teaching myself to program and use his AAC device (Mercury) in hopes that I can teach this child language. I have been trying for almost 2 years and I am struggling as well. I see this being a common trend and I want to stop it. These children need help but where is our help? Too many of us feel lost and without help. How can we all help each other? We have exhaused professionals (which are few). We are having sucess with education on the device but lack communication.

      • Re:Early Words posted by Terry Gibson on Apr 06, 2007

        The lesson plans (free, but you must subscribe and receive them by email) for teaching English as a second language (ESL) at: http://esl.about.com/cs/onlinecourses/a/a_ecourses.htm
        have some great ideas for the content of sessions for practicing language in group work and through role play.

        The group approach and role play can overcome difficulties that can arise in a one-to-one therapy session, e.g. when I am working with my son and trying to be both communication partner and the one who models and prompts his side of the conversation on his device. He sometimes gets mixed up and repeats 'Why' when I was asking him a question and not suggesting his response. I/You and Your/My/Mine can also get mixed up for the same reasons.

        ESL lesson plans, in conjuction with AAC therapy materials like Amy's (see post Re:Signing vocabulary to VOD by Amy M on Apr 04, 2007) and those available for download from Gail Van Tatenhove's website:

        http://www.vantatenhove.com/materials.html

        could give our children practice in using language as a subject in its own right, away from the AAC system, but still teaching the system at the same time, and giving them the opportunity to internalize the meaning of the words in real, interesting and fun ways, that can then be generalized to their use of their AAC systems.

        Here are some details of Gail's therapy materials, many of which are for Unity, but which can be modified for other systems by replacing the symbols/icons:

        Pronoun Phrases Flip Book
        http://www.vantatenhove.com/showfree.php3?id=62
        This flipbook is for learning the icon sequences to the common ‘Telling’ and ‘Asking’ phrases, e.g. ‘I, You, He, She, It… etc both before and after ‘Have, Do, Will, Am, Are, Is, Would, Could, Can…’ etc.

        Gail's pronoun phrase flipbook is a visual prop to help teach the Unity pattern for saying pronoun phrases but is an excellent idea to make for any system or as a stand-alone prop, and to use in the ways mentioned in posts here, e.g. in using pronoun/verb phrases to describe what is happening in magazines and books and life.

        Indefinite Pronoun Wheels (Any time, any place, anywhere. Everybody, somebody, nobody)
        http://www.vantatenhove.com/files/Indefinite.pdf

        The wheels are used (1) as a visual aid to help both children and adults to understand how the pattern works for the Indefinite Pronouns and (2) as a prop for a variety of Indefinite Pronoun games and learning activities.

        This resource is for Vantage / Vanguard but could be modified for other systems, where the patterns may be similar.

        Gail's ‘Parent's Guide to Teaching Minspeak’ (PDF file)
        http://www.vantatenhove.com/showfree.php3?id=168
        introduces the Unity category icons to parts of speech as characters and gives teaching and practice ideas which could be applied to other systems.

    • Re:Early Words posted by Katya on Apr 02, 2007

      Your posting sounds very similar to concerns expressed by the family of a child I saw the past two days. Although the primary reason for the referral related to solving access, the family soon realized other issues related to vocabulary and pre-stored message organization. Tackling building communication competence is extremely difficult if access remains problematic. Children using up resources to select messages or generate utterances, because access requires so much energy, concentration, and motor planning may be thinking that AAC is more work than it's worth.

      Our discussion this month is about vocabulary and AAC, but other factors influencing success with AAC interventions get identified quickly, don’t they? Let’s tackle one issue at a time – vocabulary. Access definitely merits time in the spotlight! Perhaps another discussion could be devoted to the decision-making process for alternative access. Please, understand I don’t want to dismiss this important issue, and feel free to email.

      That being said, we can cite the research related to early words, but can’t say which words are going to empower a particular child to be motivated to communicate. From my experience, I’ve been surprised at many early word combinations that created such delight and mischief using voice output. I’m sure Robin can share some novel surprises from her boys. These are unpredictable! Once uttered, usually the situation cannot be re-created with the same effect. However, the natural reinforcement from the environment certainly impacts or empowers the child to want to talk more.

      Self-exploration and self-discovery of vocabulary available on the AAC system is a key strategy for children to start using words interactively. That’s why I feel early voice output is so critical for children, because self-discovery is possible – hearing the spoken word as the location or button is hit during exploration.

      • Re:Early Words posted by Pam Byars on Apr 02, 2007

        I wanted to reply to your statement, "Self-exploration and self-discovery of vocabulary available on the AAC system is a key strategy for children to start using words interactively." I have been told this by others in the field and truly believe that this is probably true BUT I also need to know what my, and others around her, role is. Do I respond to everything she says using the device? This is the original advice and it got really frustrating when she said "mom" 20 times to continue to respond. Her younger siblings didn't even make it to 20, they time out way before that and quit responding to her at all.

        I truly want to find a way for her to communicate and I believe that the AAC device is the way to go. I am just truly frustrated with the lack of knowledge by professionals about the devices and the lack of training on appropriate vocabulary, programming, and use given to users and their support network.

        • Re:Early Words posted by Robin Hurd on Apr 02, 2007

          I think that it is very important to let our kids who use AAC have time to "talk to themselves" and learn the rhythm of language as well as to find words that may be useful in the future. My verbal children spent time in their car seats talking to themselves as we drove. Often, it wasn't about communication, just about playing with the rhythm of words.

          When my sons began to explore their new AAC systems, they spent a lot of time just pushing buttons. Because they were at the point of putting together words in their sign language, I answered them when I heard 2 or more words that made sense together. So, I may have ignored, mom, mom, mom..., but if I heard "want mom", I answered them. They also could point, so when someone walked into the room they wanted to talk to, they would point and we knew to wait and listen. In the first week of trials on the AAC system, Caleb pointed to his oldest brother and then said "fat pig" and laughed uproariously. Older brother made a big deal of being called a name, and Caleb continued to do this every chance he could for several weeks, because it got such a great reaction from his brother. I know I didn't teach him those words, and I doubt his SLP did, either! He found them when exploring, and then got someone's attention and used them like any little brother would.

          One of the things that makes us so frustrated about kids who are learning AAC is that we know how we would learn to use it, if we lost our speech. "Just show me where the words are on the device, and I'm going to be putting them together to say stuff". With children who have never been able to speak, it's not enough to just show them where the words are on the device. They also need to learn "where the words are" inside of their brains! We call this learning language. If children who use AAC can hear, they are able to learn some things about language just by listening, however, much of what we know about how to use words is best learned by using words, and seeing what happens. Unfortunately, there aren't any short cuts to this; it just takes practice. What we can do, though, is provide plenty of practice. So much of a child's time using AAC at school tends to be "show me that you know this" instead of real conversations. Whether at home or at school, we can set aside time to have a real conversation. Even a couple of minutes where the adult is not in a hurry and can listen and respond goes a long way toward building language skills. This talking time can be combined with a story, so that literacy and language skills are worked on simultaneously. "How do you think she feels? What do you think will happen next?" are great comprehension questions, as well as great questions to allow the child to talk about something meaningful. An animated adult who is enjoying the story and responding to what the child says can take the performance pressure off of the child and make this a time everyone looks forward to. Parents, don't hesitate to suggest this as "homework" for your child, in place of drilling on letters or numbers.

          • Re:Early Words posted by Kristy Dodd on Apr 09, 2007

            I agree with you about letting a child play with the AAC device. It is important that the individual know all aspects of their device. They need that time to play and learn the device. Young children do sit and talk to themselves all the time and a child who is using an AAC device needs to be able to do that as well. A child at the school I work in has an AAC device and he is allowed time each day to work on his AAC device and push buttons and play to see what all is on the device. You can hear him laughing thoughout the pod at the items he is seeing on the screen and the words he is able to put together. This time is some of the most valuable time he has in the classroom and he is able to better communicate with the other children because of this time he has daily.

            • Re:Early Words posted by Katya on Apr 09, 2007

              Thank you for sharing this Kristy! I really appreciated hearing that the school was providing this valuable time on the device. It's great to observe a child when they realize they've found a great word! Sometimes this activity can turn into the child "teaching" other children in the classroom words on the system or how to use the device, too. You're so right in your observation!

              • Re:Early Words posted by Robin Hurd on Apr 10, 2007

                What a wonderful story, Kristy! How awesome to hear of the laughs as the child learns something new.

                • Re:Early Words posted by Katya on Apr 11, 2007

                  I want to continue our look at early or first words using AAC. Like it or not, the adults are the ones putting the words and selecting the symbols to represent the words on AAC systems. So being aware of the evidence-base to support these critical decisions is important.

                  For your information, I want to summarize some of the findings from a study by Adamson, Romski, Deffebach, and Sevcik titled “Symbol vocabulary and the focus of conversations: Augmenting language development for youth with mental retardation.” The two year study reports the use of speech-output devices by 12 youths with moderate or severe mental retardation and severe spoken language disability. For the study, the words were listed as vocabulary types and categories as Referential: food or drink, leisure, place, utensil OR AS Social-Regulative: affirmation/denial, conative, emotive, greeting, politeness term, qualifier. I believe it would be safe to say the referential words were extended or fringe vocabulary since they were all nouns. The social-regulative words were core.

                  Here’s the list the social-regulative words in alphabetic order:
                  Be quiet
                  excuse me
                  Good
                  Goodbye
                  Help
                  Hello
                  I’m finished
                  I want
                  I’m sorry
                  More
                  No
                  please
                  Stop
                  Thank you
                  Wait
                  Yes

                  I’m not going to going into detail about the results, practitioners should be aware of the research methodology and conclusions. Parents can feel assured that their insights into what words are important are supported by the study. I just want to quote from the paper as published in JSHR in 2003:

                  “The study has an important clinical implication regarding initial vocabulary selection. Our findings suggest that the symbol vocabulary that youths with severe mental retardation can learn may have been underestimated by limiting their composition to concrete nouns. Practitioners may wish to expand their initial vocabulary selection to include social-regulatory symbols. The provision of such vocabulary may facilitate symbol development, community inclusion, and ultimately alter perceptions of an individual’s competence.”

                  We’d love for you to share the earliest words you remember a child using AAC say on their devices, especially amusing or eye-opening experiences for others.


                  Adamson, L. B., Romski, M. A., Deffebach, K. & Sevcik, R. A. (2003). “Symbol vocabulary and the focus of conversations: Augmenting language development for youth with mental retardation.” Journal of Speech and Hearing Research, 35, 1333-1343.

                  • Re:Early Words posted by Rebecca K on Apr 12, 2007

                    Social-regulative words are a sore spot with me. I have a son with autism. His SLP wanted to teach him "please" and "Thank you" as first words. Whenever he wanted something he had to add "please" and then he had to thank the person who gave it. What normally-developing child is required to be so compulsively polite? I think he had no idea (and may still not) what those words meant - they simply made the interaction with others a cumbersome experience.

                    • Re:Early Words posted by Katya on Apr 12, 2007

                      To tell the truth Rebecca, I never try to teach or recommend stressing "please" and "thank you." I don't particularly like the term "social-regulative" either. However, as a research study I can appreciate why the authors would have selected to use it. Also, I have to agree that the SLP seems a bit obsessive with politeness by choosing these examples for a child's first words.

                      Actually, in my lectures I label the "social-regulative" words as core vocabulary, and people can make a decision about prioritizing the word list. Look over the list again, and see that most of the words empower a child to take control of communication.

                      On the other hand, I remember standing over my children trying to make them say "please" and "thank you," (especially at church) and say it without attitude. I, also, remember my kids pulling at me (especially in stores) repeating the word "please" over and over again when they really wanted something. And, evidentually the words came automatically.

                      These words shouldn't be forced, but should be learned naturally, with incidential teaching experiences, by model, and most effectively at home based on parental expectation.

                    • Re:Early Words posted by RP on Apr 16, 2007

                      While I have just read through this discussion transcript as a class assignment, and am amazed at what I have just learned about children and their use of AAC devices, this was the only subject I felt qualified to comment on. I should say passionate instead of qualified. I was raised to say "please and thank you" and have chosen to raise my children in the same way. I just wanted to say that when you asked "What normally-developing child is required to be so compulsively polite?" I would say that my 5 yr old daughter, who has no learning disabilities, was taught to say these words as soon as she was able to say her first words. She said, "ju" (juice)and I responded with "juice please." She repeated me, "ju peez" then got juice. And my 2 1/2 year old son who has been seeing a speech therapist for 8 mo. was taught in the same manner as my daughter. He is now speaking in full sentences, but very few of the words are recognizable. He calls milk "par." But when he says "par," I respond with "milk please," and he repeats "par peez." While they may not know the full meaning, they seem to know that they are using good manners. With that said, I don't necessarily think these have to be taught first if it seems to cause a child stress. Perhaps you can reintroduce them every so often until he can use them without it being a bad experience. Good luck!

                      • Re:Early Words posted by Robin Hurd on Apr 20, 2007

                        In various parts of the country, children are taught to say yes sir, no sir, yes, ma'm, no ma'm. Some of this is local custom. However, the way children learn this is just as you described, by family training and support in the most comfortable environment for the child.

                        Some of these social customs are tricky to make decisions about when a child has no speech, and possibly other complicating factors such as autism.

                        An example similar to this is when Joshua went to kindergarten. He had just gotten enough motor skills to approximate a wave a few months before. For the first 4 years of his life, his only way to greet others was to smile and make eye contact. When he entered kindergarten, his classroom teacher was so upset that she had to prompt him every morning in order to get a wave from him as he entered the building with his AAC system still in his book bag. She expected that after the first day or 2 he should just know that a wave was expected in reply to her greeting. Josh knw that he was disappointing her in some way, but he had no idea what was expected. After all, he was giving the smile and eye contact that had served him well for the first 4 years of his life, and suddenly this grown-up had changed the rules and he didn't know what they were.

                        Building social skills is a process. Children progress in their social skills when they know what the expectations are. As adults who work with young children using AAC, we need to be clear on what we expect, and pick and choose what social skills are top priority and reasonable expectations. This will vary depending on where we live, what disability the child has(asking some children with autism to make eye contact is just not realistic) and on the preferences of the parents. Often by talking as a team, a compromise can be worked out.

                        In Joshua's case, the teacher and I talked about Josh's recent ability to wave and the way of greeting he had before, and she decided that she would explain to him how happy it made her when he waved his hand, so she knew that he heard her and was glad to be in her class. Two explanations of that, and her need to prompt him was reduced to once a week. A couple of months later, he only needed prompts occasionally. And the best part was, both Josh and his teacher felt much better about the whole thing after the first talk. (By the way, this was not an IEP goal, it was just a preference that his teacher had)

  • Generalization posted by Nicole on Apr 02, 2007

    I need help generalizing the low tech behavior into high tech. Does anyone have any suggestions? The child I assist can use low tech beautifully but when I try to generalize the same patterns onto the device he seems very confused and uncomfortable about what he is supposed to do. How can I help in this transition? Is this just practice? Are there any practice activities?

    • Re:Generalization posted by Robin Hurd on Apr 05, 2007

      It seems to make sense to make the new, high tech system with exactly the same pictures and words as the low tech system. In our adult minds, it would make the transition easier. However, often to a child, having the same words on the high tech system as the old, low tech system makes the transition harder. "Why should I use this new system, when I can say all that in my old way? The old plan has always worked fine for me, and I don't understand why I should change it", the child seems to think.

      Even though eventually we want the child to be able to say everything on the new device, including the things he communicates the old way, it often helps to make the new AAC system a step above what he or she was able to do on the old system.

      By demonstrating that the new AAC system gives the child more communication power than the old one, we can achieve that initial "buy-in" that makes the child willing to try new things.

      Don't get me wrong, the child still needs access to his old words. It's just that the focus on the transition needs to be on the increased potential of the new ssytem, even if that means the old low tech system is still used somewhat.

      See what happens if you spend the bulk of your efforts in teaching a few new things that can be communicated with the high tech system, while modeling the old words on the new system when they fit in context.

      As an example, if the old system contains the words "want, more, go", but the new system is set up with pronoun phrases "I am, you are, he is..." and some additional verbs, you can integrate the 2 by focusing on the pronoun phrases to describe a story, but using the verbs "go" and "want" as needed, but focusing on the new verb options available on the new system. Expect the child to practice using the pronoun phrases on the new system, and plan on modeling the verbs yourself, both on the old system (if they are there) and the new one.

      When my sons were just starting out on their AAC systems, we had a great time practicing pronoun phrases with pictures cut from one of those country magazines that takes reader submissions. The proud families that read those magazines send in the most interesting pictures of their kids/grandkids! We could talk about kids sleeping in the back of a truck, riding on their daddy's shoulders, sitting on a big pumpkin, etc.

      Once you convince the child that he or she can be more powerful, more communicative with the new way of talking, getting the old vocabulary to happen on the new device will be much easier.

    • Re:Generalization posted by Terry Gibson on Apr 06, 2007

      I wonder if you could make use of any common denominators there are between how you 'navigate' to a word on the low tech system and how you navigate to the same word on the high tech system? Perhaps by making a flashcard for a word that includes on it all the symbols that represent the steps necessary to reach that word, on either system, and not just the symbol for the target word.

      I'm imagining that you have a contents page with symbols that point to pages of word groups, e.g. person/people words, verbs, position words, questions, and that within each category there may be further selections that have to be made to reach sub categories or 'more' of a category.

      The symbol sequence or file path to a word usually has at least two components, category + target, and often three or more. Even a static overlay on a high tech device usually requires the activation of more than one button to say a word.

      If you point to each symbol on the flashcard in turn as you navigate your child's comms book, this might be a useful key to him realising the similarities in how both systems are navigated, and may help him to generalise his knowledge of his low tech to his high tech aid.

      Hope this helps.

    • Re:Generalization posted by patty on Apr 09, 2007

      Don't know if this will help but...
      My son used a lower tech device for about 6 years. And he pretty much mastered it/maxed out the potential...I knew he needed and could be a better communicator given the right device. But it was scary, because it was so different. His motor patterns to use the old device were so strong and he was very quick with it all.
      We made sure that words that he needed to answer questions and express simple needs, etc were readily available and concentrated on those first-to give him a comfort level. yes, no, more, hi, bye, etc. (he's a social kid, so greetings were important) But they weren't even in the same location. Some we made sure were, but most were not. He also could tell a joke on his old device (we'd program a joke of the day), so we decided to teach him to tell jokes on his new device quickly also. The process to tell a joke required more sequencing, so he'd get the idea of that at the same time...but telling jokes was motivating to him.
      He actually used both devices for awhile. Side by side they'd be. We didn't want to take his comfortable, old voice away too quickly.
      He's the one who fairly quickly handed me his old device one day and we never looked back. Once he felt comfortable knowing he could communicate his needs and also some fun stuff, once he realized the power of his new voice...it's been uphill ever since. I also have learned to not go too, too fast teaching him more language. He is very interested in learning new things, given we go at the right pace. Concentrating on a few words and all the ways he can use them is much more effective. I found myself getting so excited about all the possibilities because the device can do so much, that I would tend to get scattered. My son has cognitive disabilites as well as being non-verbal and he is also blind. Yet, he has gone from a device with sentences programmed in, to using unity. He is in single hit, but is starting to speak in sentences. He is also a good speller, so that helps when he can't find the right word.
      ~Patty

      • Re:Generalization posted by Katya on Apr 09, 2007

        Dear Patty,

        A few participants have commented or asked questions about AAC and children with visual issues. Would you mind starting a new thread on the topic of AAC and vision, and sharing how your AAC intervention dealt with blindness? This would make the information easier to locate.

        I want to pull together some evidence on vision and auditory scanning, but your contribution to this topic would be greatly appreciated. I think your personal experience would be a good start to discussing how to handle vocabulary access for this challenge.

        Thank you for your consideration, and what you've offered already to the discussion.

  • Lots of Questions for consideration posted by Lynne on Apr 02, 2007

    A lot of the literature speaks to programming devices for people with motor impairments and normal intelligence. What do we provide for the students with limited cognition and those with ASD & restricted social interactions & language structures? What kind of layout or framework do we provide, for example on a dynamic display device? Do we color code? Do we provide phrases on a single button? How do we make decisions about using quick responses for social interaction versus providing vocabulary for creating novel phrases? And of course, what vocabulary do we actually use? I've heard many professionals speak to providing more generic vocabulary and then reframing the questions so that the student can reply (not names of planets, but "the big red one" or the small one").

    And then, how do we go about teaching them the layout of the device and the appropriate context to use it? Is it only in the natural enviroment, or do we set up an ABA protocol to teach it?

    • Re:Lots of Questions for consideration posted by Robin Hurd on Apr 02, 2007

      What great questions! Hopefully by the end of the month we will have addressed them all!

      I want to tackle the questions about teaching kids on their AAC system, especially those who have other issues: Autism, cognitive impairments, etc. One of the things to keep in mind when working with students who use AAC is that they may not generalize well. They may not be able to take a word they learned in a drill and practice setting with a flash card and carry it over into a natural setting and use it appropriately. Why? Because children who have never spoken have not yet internalized English, they will need support to not only learn the location of the word, but also to build a mental structure around that word: how it can be used in real life, what it means, how it fits into a sentence, etc.

      In order to teach children who use AAC to actually use the words they learn in natural settings, we need to have a plan. First of all, pick the words you are going to focus on, and make this a short list-- a few at a time. Then think of all of the ways the child might be able to use this word. What questions might you ask the child that would use this word in the answer? How can this word help the child to make his world change? You can write short scripts to help everyone who works with the child support the use of these words, you can say these words verbally, you can model them on the device, you can use flash cards, but what must happen is the child must develop a mental sense of what this word can do.

      When Joshua first learned the word “now” it was in a speech therapy setting with me sitting in to help locate new words as needed. The therapist often rewarded the boys with bits of their favorite video. Our goal was to get beyond “I want “ phrases and have some conversation. However, Joshua’s goal was to watch a part of that video! He kept saying, “I want sleeping beauty”, and the therapist promised he could watch it next time he came. Josh was not happy! We wanted to see how he would communicate to the clueless grown-ups. “Why are you angry? When do you want to watch the video?” the therapist asked. Josh didn’t know any words he could use to answer that question. I whispered the word “now” and he said “yes” and got excited. So I showed it to him; he now had his first power word! With it, he was able to reach his goal of watching that video. For the next two weeks, “now” was our focus word. We spoke it, asked questions that required it as an answer, but we didn’t have to model it on the device. He was so excited to have access to that word, that he remembered it himself.

      Not every word we have taught has caught on that quickly, but the process is much the same, even if it requires more modeling and practice to become able to use it in natural settings and without a prompt. At times, we have also spent time teaching what the word means; an example of this is top, middle, bottom.

      • Re:Lots of Questions for consideration posted by Amy M on Apr 03, 2007

        One of the words my daughter used first using her device was a kid's favorite, WANT. Then, it came to teaching pronouns, I want, you want, they want. Then the lesson was on a noun. Her favorite thing in the whole world is chocolate milk. Had to teach her it is a drink, then a specific drink. At which time, she also got to practice saying juice, water, Pepsi, Diet Pepsi. She woudn't get it unless she said " I want chocolate milk" on her device.

        Then, it progressed to who she wanted to get it for her. That was a lesson on names. She wouldn't get it, unless she used her sister's name or mommy on there, after I want chocolate milk, "mommy". Then, I thought that sounded rude, and we are always telling our Typical kids to say please and thank you. That became the next lesson, which is everyone's favorite part on the device. Exclamations, opens a new world for them to express themselves. So, phrases like "Please", Thank you", "Oh no!", "Go home", "WAIT!","Slow down!", all got learned very quickly. To this day, after about 4 years of having the device and various techniques and various amounts of device usage, about the only whole sentence she can actually say on the device is "I want chocolate milk please mommy." Even when we switched her from 45 to 84 locations in the fall, she found that sentence on her own, because she knew how to break the words down into categories.

        But for the most part, she is in first grade, we have worked on nouns and verbs this year, and a bit on adjectives to describe the nouns. And it went right along with what the other kids were doing in class. We discuss the parts of speech a lot, and even have it in her IEP, that she learn them. On the Vantage, the verb is always C3 after a category word, and the noun is always B10, after a category word.

        So, the first steps for teaching language for us, is to teach the noun or verb, then build from there. Verbally, when she was little, "Ball bounce" was good enough. Now we add a single hit word "The ball bounce." Then a different form, "bounced". Then an adjective. "Pretty ball". Then, we teach prepostions, "over". Then, we give it a direction of where or how it bounced, "there". Then the whole sentence is the next part we work on. "The pretty ball bounced over there." The last part, since the rest of the class knows to capitalize the first letter, and to put a period on the end, she almost always gets the period by herself, and usually remembers to see if the first word is capitalized.

      • Re:Lots of Questions for consideration posted by Katya on Apr 03, 2007

        Several of those posting have asked about where to start or what words to “teach” first. Here is a reference I use as a starting place for reviewing initial vocabulary decisions. The word list is from a study by Banajee, DiCarlo and Stricklin(AAC, 2000) that collected language samples from toddlers in an early intervention classroom.

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

        I you
        no what
        yes/yea on
        my in
        the here
        want more
        is out
        it off
        that some
        a help
        go all gone
        mine finished

        You can see how similar the list is to the Brown reference. With these words children can create pivot phrases or simple word combinations across all daily environments.

        Can you think of activities or routines that many of these words could be used to share the experience? Have fun seeing how you could use these words across situations and activities!


        Banajee, M., Dicarlo, C., & Stricklin, S. B. (2003). Core vocabulary determination for toddlers. Augmentative and Alternative Communication, 19, 67-73.

        • Re:Lots of Questions for consideration posted by Katya on Apr 03, 2007

          I noticed that the table with the 25 core words from the Banajee, Dicarlo & Stricklin study didn't come across aligned correctly in the posting. Here are the top 25 words as a list in frequency order. These words represent 96.3% of the total words.

          I,
          no,
          yes/yea,
          my,
          the,
          want,
          is,
          it,
          that,
          a,
          go,
          mine,
          you,
          what,
          on,
          in,
          here,
          more,
          out,
          off,
          some,
          help,
          all done,
          finished

          • Re:Lots of Questions for consideration posted by Terry Gibson on Apr 06, 2007

            what that
            want that
            some that
            you that
            more that
            that mine
            it mine
            is mine
            yes mine
            off that
            that off
            that out
            I help
            some help
            want help
            it in
            it no in
            it out
            it off
            it on
            I go
            here I go
            here it is
            on here
            some more
            want some
            want more
            want some more
            what is it
            is it
            it is
            is more
            is here
            is off
            is on

            With just a few more words like me, get, stop, put, no, not, do...
            get some
            get that
            get me
            me get
            stop it
            stop that
            me that
            me want
            no go
            not go
            no me not
            put on
            put in
            put here
            put it
            help me
            me help



          • Re:Lots of Questions for consideration posted by Terry Gibson on Apr 06, 2007

            In the following article:
            How Far Will 100 Words Get You - by Catee
            http://www.cateeslanguageworld.com/pimsleur/100words.php

            Catee asks 'How many words does it take to read Macbeth?'

            He finds that the 9 most frequently occurring words in Macbeth are:

            the
            and
            to
            of
            I
            a
            Macbeth
            that
            in

            and that just by learning these 9 words a person could recognise 21% of Macbeth.

            He finds that the next 11 most frequently occurring words in Macbeth are:

            my
            is
            you
            with
            his
            not
            it
            be
            but
            your
            have

            and that by learning all 20 words a person could read 31 % of Macbeth.

            Catee also finds that by it would be possible to read 80% of Macbeth by knowing only the 500 most common words. He shows this on a graph rather that providing a long wordlist.

            As well as facilitating a large proportion of spontaneous conversation, if we apply the teaching of these core words to our children's reading, by developing their recognition of these words by 'sight', they will be able to read large proportions of any text, leaving only the 'special interest' and other fringe words to be learned or decoded.

        • Re:Lots of Questions for consideration posted by sb on Apr 03, 2007

          When I talk to speech pathologists in school settings who suddenly have a child with a device and they don't know what to do or how to approach it, I always remind them: Remember what you know about language development. This doesn't change that. This is just the child's "voice." You teach the same things you would teach any child with a language delay.
          I know even I sometimes forget this, and focus on those basic, restricted lists of "wants, needs, and leisure activities" - partially because I also work with adults with severe cognitive deficits and kind of get 'sucked in'
          BUT, it bears remembering. These are still children learning language. If we could just have all our speech pathologists remember that, it probably wouldn't freak them out so much.

          • Re:Lots of Questions for consideration posted by Robin Hurd on Apr 03, 2007

            You are so right! It's just like a verbal child learning language. The only difference is that children learning language on an AAC system are generally older than verbal children when they begin to learn language, so there are competing demands on their time: reading, math, other school work... If we aren't careful, those other demands don't support language development, they distract from it.

            Even when learning about a science topic, for example, a student can use high frequency words to discuss the topic. It just takes a little pre-planning. The beginning of this year, Joshua had a question on his science test: "Why is rain important to the farmer?" His answer: "rain garden go up big." He was able to use words he knew and 3 multi-purpose words to show that he knew the material, while at the same time practicing his language skills.

    • Re:Lots of Questions for consideration posted by Mariana on Apr 09, 2007

      I never used high tech device in my son with AAC. We switched to signs after some quantity of vocabulary. I couldn't imagine a child running, going to some place or the other and looking for a high tech device.
      We used low tech and we currently have one child carrying a book in PECS with all his communication items.
      We look for those worst behaviors and their functions. We always find they are communicative. But we always work in PECS, as they need to learn communication strategies.
      We start in phases:
      modifying worst behaviors and acquiring communication. They can be "I don't want"(to eat, to play, to work), I want to go out, I want to go for a walk, I want fries, I want coke and so on.
      Academic skills go in a separate layer, sometimes only used in one to one session.
      After a good package of vocabulary (about 50 words) we shift to signs.
      We then start to develop grammar and PECS is very good for this work.
      Mariana

    • Re:Lots of Questions for consideration posted by Dee Hoban on Apr 11, 2007

      I think the most important thing to remember is LESS IS MORE. There is nothing more frustrating than a child using a device which is not appropriate. So I always start with low-tech answers such as Big Macks, Step by Steps, comm. boards, static devices, etc. to determine if they are motivated to interact and if so, are they willing to use a device to do so. Without this motivation any device will fail. You can't teach a student to WANT to communicate with you. This desire must come from within. So before we talk about the layout of a dynamic device, please let's consider the issue of motivation. If a student WANTS to interact, try a few low tech devices first. If successful, the move on to something dynamic. I once had student literally throw his PECS book at me in an effort to communicate!! Clearly he needed a different system!

      • Re:Lots of Questions for consideration posted by Robin Hurd on Apr 13, 2007

        I have concerns about the idea that a child must be successful with a low tech system first, before being given something high tech. For my boys, no system that does not include an audible voice was ever accepted or used. It wasn't that they didn't understand what the pictures meant, it was that everyone else made sounds when they communicated, and we were asking the boys to communicate without that important sensory output. By the time we convinced the school to give up the picture exchange and try something else, the boys had invented their own sign language and were putting together sentences with it. So, when the school introduced a mid-tech with voice output(finally) and pre-stored messages, it was not accepted or used, either. The boys had progressed beyond that, language wise, even though their form of communication was by no means standard. Had we been stuck to the protocol of success with low tech methods first, we would not have been able to move on.

        In contrast to the lack of success noted with the low tech and mid tech AAC systems that were introduced, my sons were motivated and made great progress using the high tech AAC systems eventually introduced at age 4--in spite of language and attention delays. The difference between a system that was a struggle to get "compliance" with, and a system that excited initiation and interaction was huge!

        If a student is NOT making progress using a low tech, or any system, then it is time to re-evaluate the AAC system, including the device itself and the teaching methods being used to train the child on the device. It could be that more time is needed to develop skills, but it could also be that the AAC system (device plus teaching method) in use is not a good match for the child in question.

        Someone once said, "Teaching hasn't happened unless learning has occurred." Our job as teachers(both formal and informal) is to make sure that teaching actually is happening; often this requires some re-thinking, research and tweaking of our plans. What a wonderful thing when we can "see the light bulb go off"!

  • Communication posted by jeanne on Apr 03, 2007

    We have a five year old non-verbal little guy that uses sign, gestures and PECS to communicate. He is actively taking turns with me and playing much more functionally. He uses total communication. He shows us that he understands by finger choices. Our Minimerc AT system is due to arrive on April 26, 2007. We want him to be able to ask us questions. He is frequently commenting by pointing to items and having us give him a response. We have started by having me hide and his instructor (hand over hand) signs...where is mommy? How else can we facilitate questions from our little man to anticipate the arrival of our minimerc? He is at or above his grade level cognitively, but cannot speak. Thanks!

    • Re:Communication posted by Robin Hurd on Apr 03, 2007

      What a super question! Making sure that the vocabulary is available to ask questions is so important to help a beginning communicator initiate conversations.

      When we think about questions, one of the first questions a child asks is "what's that?" It is a way of initiating a conversation, as well as to stretch the vocabulary of a mind hungry for language. "Who" is another early question, as the child begins to distinguish between words used for people and words used for things.

      Some of the other question words are dependent on having some prior knowledge. In order for "when" to be meaningful, the child must have some idea about time.(now, later, after lunch, etc.) "How" is a question word that will likely be answered by a sequence of tasks, (with words like first, next, after, last) so understanding how to put things in order makes this question word more meaningful. "Where" is a great question word, but the meaning of words like "in, out, under, over" need to be understood to make the answer to this question understandable. Stressing not only the word "where, but the answer (behind, around, etc.) like you are doing in the activity you described is helping to cement these ideas in his brain. The question words in this batch can be taught at the same time as the other concepts, but it may take longer for these to be used spontaneously, as he must master the concepts that go along with these words in order to understand the answers he will get. Plan for lots of practice with both the question words and the concepts that make the answers make sense.

      • Re:Communication posted by Katya on Apr 04, 2007

        Understanding questions is a big part of being able to answer questions. Sometimes when adults in the environment “know” that a child couldn’t answer a question because the words aren’t on the AAC system, they don’t ask questions that typically developing children would be bombarded with during the day. Children using AAC generally get limited to “boring” yes/no questions – yes, boring! Or, what-questions, because they can make a choice between 2 objects or the AAC system has a lot of common objects (nouns) on the page/display.

        Parents seem to be naturals in talking to their child. Other adults, not necessarily. When I’m working with graduate students in training, I always have them include an auditory comprehension task to start the therapy session. This provides a time to present material that includes “target language structures” we want to child to start using. This time also takes the pressure off of having to give the “right” answer using the device. Reading books is a great opportunity to use question words and model responses. Note: we never require the child to answer during this time. However, if they do, that’s okay too.

        Consider the following for working on where-questions:

        Where? – Children can respond to where-questions by looking (visually searching) and pointing. You can ask, “Where’s your jacket?” “Where’s your ball?” If you observe a child looking for something, you know they have processed the question. When you spot the object, or the child points to the jacket or ball, say “HERE it is” or “It’s over THERE.” You don’t need to load the AAC device with ALL the nouns in your child’s world. The two important words that can be on the device are HERE and THERE. You can then model “here” and “there” using the AAC system.

        I’m hoping some others participating in this discussion might offer some strategies for other question types.

        Some suggestions for working on asking and answering questions can be found in:

        Mawhinney, L. and McTeague, M. S. (2004). Early Language Development: Handouts and Activities. Greenville, SC: SuperDuper Publications.

        • Re:Communication posted by pwcassidy on Apr 06, 2007

          One of my favorite "question asking" was done with a brilliant child and Mom I have worked with for many years. Hide n seek. This was the first activity the then 3 yr old learned the power of her communication device. I have then expanded this to lots of "Hiding games" with kids. We take turns hiding things, trying to find them, having to ask "Where is it?" or "Where are you?" and responding with "Here it is", "Here I am", etc. Usually with a hiding game I can then incorporate a particular category such as colors. Right now we are hiding colored Easter eggs. Where blue? Where yellow etc. The length of the expected utterance is based on where the student is at (one word "where", two words "Where color or where it", three words "where is ___" etc.). Lastly, I make a book with the targeted vocabulary so that others can have a cheat sheet to help them locate and model the vocab.

          • Re:Communication posted by Terry Gibson on Apr 06, 2007

            We also use the 'hide and seek' method for asking and answering questions to use all the pronouns, the verb 'to be', other verbs and the prepositions in, on, under, behind, next to, between, in the corner, outside...

            At reading time our son points and asks us, using pronouns instead of character names e.g. What is/are he/she/they doing/making? What happens next? After that? Who is knitting/painting/...? Who is that? Why is/are he/she/they happy/sad/cross/angry?

            The questions are easier to read here at the simpler level: What do? What make? Where go? Why cross? What next?

            What does that say? and What does that mean? are useful at reading time.

    • Re:Communication posted by Tyler Honeycutt on Apr 09, 2007

      Hi, I just joined the discussion and was really interested in the case of your son. I was just wondering...what is a minimerc? I am currently enrolled in a college AT classroom and have never heard of a minimerc system before reading this. I would be really interested to know how it works out for you and your son. Thanks!

  • Older students with no Functional AAC posted by Debbie on Apr 04, 2007

    How do you begin with a teenage student with fine motor issues? She began with a manual, no voice, PECS protocol with discrete trials using 1 real and 1 foil picture at age 10. Not very motivating or successful so attitude developed regarding potential and unwillingness to move to a higher tech system. She uses vocalizations with lots of inflection, head movement, reaching and general body language to communicate but as you can imagine can reach a high level of frustration. She remains very social but is seen as less appropriate due to self learned and reinforced non AAC methods.

    • Re:Older students with no Functional AAC posted by Amy M on Apr 04, 2007

      I don't know her level of functioning, but you may want to try something like a PODD communication book. I just saw these yesterday, and thought I might try making one, for a more portable form of communication, for times like recess, gym, and field trips, where having a very expensive communication device is not practical. Here is the instructions.

      http://www.lburkhart.com/Isaac_instructional_06.pdf

      Again, I am JUST a mom, so I don't know what usefulness this might be for you. I guess it would depend alot on whether or not you had Boardmaker, Writing with Symbols, or some program like that.

    • Re:Older students with no Functional AAC posted by Robin Hurd on Apr 04, 2007

      It sounds like a two-fold process needs to take place, if she is to switch to a higher tech system, or at the least, a more effective one.

      The first prong of the process needs to be developing an AAC system that allows her to say things she can't with her other methods, and develop some teaching strategies that ensure that every time she uses the new AAC system, instead of her other methods, she feels empowered and rewarded. I don't mean "you get a reward because you did a good job", but a reward that is automatic because she communicated something and the communication partner understood.

      The second prong of the process needs to be working with the staff and parents who are her communication partners, so that everyone understands how to make every interaction with the new AAC system empowering, how to prompt her, how to wait for her to use the new AAC system and not begin the guessing, etc. A specific, written plan is not too much here. Everyone needs to know how to support her communication in a consistent way.

      When planning for the first part of the process, an AAC system and teaching strategies, vocabulary selection becomes a big part of the decision making. Katya posted a list of the most used words by preschoolers, but this word list of beginning words is a good starting point for anyone who is working on building communication and language skills. When a student has some way of communicating, the tendency is to develop an AAC system that provides a new way to say all of the things the student is already communicating. This will no doubt be viewed as boring, and lead to more attitudes and rejection. Instead of focusing on providing new ways to say what she can already communicate (though that may be an eventual goal of a new AAC system) focus time and energy on learning broader and deeper communication. The fact that there is frustration is a sign that she has more to say than her current plan allows.

      • Re:Older students with no Functional AAC posted by Robin Hurd on Apr 05, 2007

        Here are a couple of suggestions on topics that can be used to get initial "buy -in" to a device for a teen girl. I include the target vocabulary, so you can see that basic, multi-use words can be used to learn language that will carry over into much more than these typical teen girl activities.

        Ideas for empowering interactions for a teen girl might be: painting her nails and having her tell you which nail and which color to paint using “this one” and “that one”. Doing nails is a great activity, becasue you can get 10 repetitions of the target phrase with just one coat of polish. If you add in using the target phrase to choose the nail color, you've added at least one more repetition.

        Obviously, you would get parental permission for the nail painting session!

        Getting a teen magazine is another idea. Have her talk about the people in the pictures using pronoun phrases and adjectives, “he is hot”, “she is bad” “I like/don’t like her clothes”,I want that shirt, etc. (How many of us did this kind of group magazine reading as teens?)

        You could do more “academic” things with this student, but to get an initial buy-in to a new system, especially from a teen, you need an element of age appropriate fun. You can provide this without sacrificing building language skills.

        Talking about pictures while targeting pronoun phrases can easily move from talking about a teen magazine to talking about pictures from a school subject and can also branch into writing projects (generated word by word on the AAC system) that provide a sense of accomplishment as the final project is viewed, as well as further practice with language.

        I love the great feeling of accomplishment that making a product gives a student. Writing a story on Powerpoint, putting it on a CD and making a label for it gives a great feeling of success when the student is able to take that CD home. All of the hard work seems a lot more worth it than if the story is printed on a sheet of typing paper (which most kids who use AAC can't handle on their own because of poor motor skills).

  • AAC and Cognitive Limitations posted by Katya on Apr 04, 2007

    Several postings have included questions about strategies to use if a person has cognitive limitations. I decided that I would start a new thread so readers can find information on this issue easily. Actually, I hope we see more perspectives and suggestions as people weigh in on the topic.

    I don’t see a big difference among AAC interventions for young children, older children or those with cognitive challenges. Especially, with access to core vocabulary. We all use the same words! Perhaps the biggest differences in intervention strategies would be related to personal interests and age-appropriateness. That being said, what do we know about vocabulary usage patterns of “older” beginning communicators or individuals with more significant cognitive disabilities?

    Here are some results from a 1958-59 study by Mein and O’Connor that is still timely and relevant. The study reports the oral vocabulary of adults living in institutions. The list is too large to include in its entirety, so I’ll just give a few words pulled from the alphabetic listing:

    A,
    About,
    After,
    Again,
    All,
    And,
    Another,

    Take,
    That,
    The,
    There,
    They,
    Thing,
    This,

    Was,
    Way,
    We,
    Went,
    What,
    When,
    Where

    The results show that, although not as robust as typical frequency lists, these adults still used a small core vocabulary for communication. I believe understanding the vocabulary usage of all people causes us to raise our expectations for vocabulary availability on AAC systems. Consequently, we must be careful NOT to put limitations on access to vocabulary, because the person might have cognitive limitations.


    Mein, R., & O’Connor, N. (1960). A study of the oral vocabularies of severely subnormal patients. Journal of Mental Deficiency Research, 4. 130-143.

    • Re:AAC and Cognitive Limitations posted by pwcassidy on Apr 06, 2007

      How do you begin with a teenage student with fine motor issues? She began with PECS protocol with discrete trials using 1 real and 1 foil picture at age 10. Not very motivating or successful. You hit the nail on the head when you said “not motivating”. We have to give them “voice” for what they are trying to tell us. I have one suggestion that I have used with a student who has fine motor issues. We have put lots of single message talking picture frames all over the place where her favorite things and activities are. She has very quickly learned to pull off (we are working on point) and bring these messages to others in the room. The picture frames have a symbol on them and a voiced message “ball, swing, snack, book, sing, up up, game, clapping game, etc. In the past she would stand near, or next to, something she wanted and if you didn’t see or understand why she was there she would respond in a self abusive way that something needed to happen (which worked by the way). We are now working on bringing these symbols to a central location in the room and eventually to her device. Because she struggles with access, she has difficulty with an 8 grid display. We are also providing her with an 8 grid core words overlay, to be used together with the symbols of her favorites. This device is supposed to be traveling with her at all times. (I am struggling with which 8 core words to use, but that is another discussion)

      • Re:AAC and Cognitive Limitations posted by Katya on Apr 07, 2007

        There are some very difficult and challenging problems with several complex issues regarding AAC intervention, and I'm hesitant to provide any suggestions not knowing the specifics. That wouldn't be professional. But I do feel I can provide some principles to consider.

        First, as soon as the vocabulary is larger than the number of keys on the array you run into problems. The smaller the number of keys the more restrictive the vocabulary. In courses and workshops, sometimes I use an example of an 8-location core vocabulary array that includes the words: I, you, want, more, not, eat, drink, go. During presentations I go around the room and ask people to generate a novel utterance using these words. The most creative utterance I can remember was from a special education teacher who said this 6-word utterance, "I drink more I go more." Well, these words might work for a time, but would soon get boring if that was all I had to say in every situation to every partner.

        One of my clients was a 5 year old boy that I reconfigured his 8 location AAC VOCA with core words rather that the 8 environmental nouns that were appropriate for making choices in class and at home. He was really excited with the way the "new" system was set up, but then got very ill and was hospitalized. It was 2 months before I saw him again, and his family indicated that he wasn't using the device anymore and perhaps we needed to go back to something more simple and maybe only 4-locations. My response was that he showed us he could put words together before and was probably bored after 2 months of the same symbols. That day I put him on a 45-location system. Guess what? He had no difficulty with symbol recognition and using the vocabulary to start interacting with some of the activities we had arranged in clinic.

        Well, that may be an appropriate example for a child with motor limitations, but can still use direct keyboard selection. Using a systematic, principled approach to solving access is paramount when access is significantly limiting the number of keys creating a very limited vocabulary.

        Perhaps others would provide some insights into how they have solved similar situations.

      • Re:AAC and Cognitive Limitations posted by Terry Gibson on Apr 08, 2007

        I hope your student's motor abilities can allow her to succeed like Katya'a client in using 45 buttons. I couldn't even begin to think how to limit a vocabulary to just eight words. Could her system be increased to 8 pages of 8 buttons, where each button on the top page is a link to a further page with 8 words on it? This would offer 64 words?

        Gail Van Tatenhove has several core vocabulary lists for download from her website, and an article that describes the functions of early words -Language Development and AAC Vocabulary - that might help you to decide which words would be most useful to start with:

        http://www.vantatenhove.com/showgroup.php3?id=36

        Perhaps you could make use of all the talking picture frames and replace the nouns with core words? Or draw large symbols / words on the wall, where they may be easier to point at, or draw them on the floor so she can just walk on the words?

        Don't rule out literacy and typing as an option once motor planning is addressed.

        There is a growing consensus of opinion that it is the motor problems and not the cognitive disability of people on the spectrum that prevent them from communicating, and that they could utilise a comprehensive vocabulary to communicate once motor problems are addressed.

        Joanne M. Cafiero, featured columnist for April/May at Closing the Gap:
        http://www.closingthegap.com/

        says in her article:

        Challenging our belief systems regarding people with autism and AAC: Making the least harmful assumptions

        "...in 1943, when Dr Leo Kanner first described individuals with ASD, he stated, “even though most of these children were looked upon, at one time or another as feebleminded, they are all unquestionably endowed with good cognitive potentialities.” (p.247)." and

        "...In a sample of children collected by Greenspan(1992), it was found that half of all children with ASD had severe motor planning dysfunction. This means that they could not show what they know. Adults with ASD report that they feel an actual “inertia” and are often unable to initiate an action. (Sullivan, 2002). AAC requires motor planning and practitioners must address this difficulty in both the assessment and intervention process."

        I've seen Facilitated Communication' being used to remedy this inertia, where the facilitator withdrew the client's hand from the keyboard between each keystroke but it was definitely the client who did the typing.

        I imagine it might be necessary during early typing / literacy lessons to place the client's fingers on the keys in the first place, but this is just my guess.

        People on the spectrum who have been helped to type through Facilitated Communication write their experiences in the 'Personal Stories' section of Breaking the Barriers website at:

        http://www.breaking-the-barriers.org/breaking-the-barriers/index.htm

        • Re:AAC and Cognitive Limitations posted by Sandra McClennen on Apr 08, 2007

          I am pleased to see the "Breaking the Barriers" site referenced. My experience is that facilitated communication often allows communication to people for whom no other approach has worked. Most of these people experience autism. In some cases, a person who began with facilitated communication has developed speech. [At the site: http://suedweb.syr.edu/thefci/
          go to Publications and Videos and look for “Inside the Edge”: A Journey to Using Speech Through Typing" written and narrated by Jamie Burke.] In more and more cases, people who began typing with support at the wrist (though they make all movement toward the keyboard when facilitation is done correctly) are now typing independently. [For example, at the same website, look for "Autism Is a World" written by Sue Rubin, who now types independently. "Every Step of the Way" documents how this journey proceeds with three people. There are other fascinating videos described, also.]

          At the website of the Autism National Committee (www.autcom.org), the Bookstore includes many books written by people with autism, some of whom communicate through typing and who document their journey from needing physical support to independent typing.

          Some of my clients who were thought for a few or many years to have great cognitive limitations are now doing grade level work. Because they are typing with support by a number of different school staff, and their personalities and particular ways of communicating remain constant, everyone understands that they are doing their own work in spite of support needs. When we failed to provide a communication system they could use, they could not show us how much they wanted to learn and how much they were able to learn.

        • Re:AAC and Cognitive Limitations posted by PWCASSIDY on Apr 08, 2007

          We are working on the motor issue, and I think it will come really soon however in the meantime it is most important that she does not communicate in her other mode (self abusive) and give her a "voice" that others understand. The other issue is how to bring her "voice" along with her. She does not prefer to carry it herself and getting others to bring it relies on others to bring it. Some do but some don't. But thanks for the suggestion about changing out the nouns on the talking picture frames, what she is really communicating is "give" "me" or "play" and instead of emphasizing the noun (fringe) word I need to emphasize the core.

          • Re:AAC and Cognitive Limitations posted by Terry Gibson on Apr 09, 2007

            Some good strong words for how she feels might help her to express things in words rather than by self harming.

            And it would be great if she could also say what it is that is most frustrating to her - perhaps she has a locked in ability to understand and express so much more than she currently has the tools or ability to use the tools to say.

            If she suffers from the 'inertia' often reported by those on the spectrum that is preventing her from pointing or pressing and releasing a button appropriately could she be helped to indicate that she understands much more, wants to say more, that her brain is fine but her hands won't do it?

            I taught my son to say things like 'I'm more than just angry, I'm really furious that...'

            He gets most frustrated when his repeated requests for help using his aid to chat with his friends at school are ignored and he ends up in tears and hitting himself at home about it. He doesn't complain at school, where he has learned to be passive and just accept it. He doesn't generalise his skills learned at home to the school setting and often turns his device off at school. I believe this is a common scenario when a user knows his communications won't be adequate and the support isn't there to make it any better.

            It's good that you are so keen to help your student and I'm sure she will be willing to bring her voice with her once a threshold has been reached where it is working for her effectively enough for her to see it as an essential resource that she can truly value.

            Meanwhile it is not a bad idea that carrying / bringing the voice is a shared responsibility as communication is a partnership and everyone has a shared responsibilty to it.


          • Re:AAC and Cognitive Limitations posted by Mariana on Apr 10, 2007

            We used to give the child a key to call for attention like clapping or touching the hand. The adult responds immediately and gives the AAC system.
            I think the main issue in AAC is selecting core vocabulary as everybody said here. If there's no picture and the child is already interacting with the adult (after getting his/her attention), the child can learn other communication strategies like saying no/yes with her head, pointing or looking at the object.
            Besides, if she knows that her own behavior is easier to get what she wants than a conventional communication system, I'm pretty sure that would win. Mariana

            • Re:AAC and Cognitive Limitations posted by Katya on Apr 12, 2007

              One of the topics I would like to cover during our discussion this month is intervention strategies for children with significant cognitive challenges. I propose that frequently a systematic and principled approach to assessing symbol representation and providing multiple, meaningful teaching experiences isn’t in place. If practitioners are not spending significant 1-on-1 time to identify the learning styles of children at the earliest stages of cognitive-linguistic development, we may not see progress with AAC intervention.

              I’ll try to make the point by jumping off the deep end again. :) Many times when I’m consulting with teams, I see that hours have been spent on completing “environmental inventories” or “vocabulary diaries” and building pages from scratch. However, almost no time has been spent with the child actually working on the device. Frequently, IEPs show that these children are scheduled for speech therapy services once a week in a group or classroom lesson. The responsibility for routine AAC intervention implementation is defaulted to others.

              While this may be appropriate for many children showing slow, steady progress in building communication competence, this is not enough for those children not showing progress. In my opinion, we can’t assume that the child is not capable of benefiting from AAC if we haven’t explored the reasons or provided for some intensive instruction. This usually doesn’t take any more time than the vocabulary selection, organization, and programming process by the way. We’re just diverting the same time and energy to working 1:1 with the child.

              The case study example I want to use is of a 4.9 year old boy with complex communication needs secondary to cerebral palsy and cognitive limitations. He was, actually wasn’t, using an 8-location static display digitized voice-output device with single-meaning pictures representing 8 pre-stored messages. He also had multiple voice-output single switches with symbols representing toys or other preschool classroom choices. Parents were getting ready for him to transition to public school, knew he hadn’t shown any progress in 2 years, and were wondering about the best placement decision.

              A three hour session was scheduled on a Saturday to work with Andy (not his real name). We programmed his device with the following vocabulary: TOP ROW: I, want, fast, more; BOTTOM ROW: Varoom sound (really cool); go, slow, stop. We spent the first hour in the hallway of the building working with these words to communicate during a routine with Andy’s wheelchair. We started with full hand-over-hand prompting and gradually decreasing the prompting hierarchy, to assess whether Andy was associating the symbol with the vocabulary and making intentional responses. The prompting hierarchy was based on Environmental Communication Teaching (ECT) (see references below). Once we had enough of the wheelchair routine, we used the same vocabulary with “playing the drums” (something he liked to do),” “cars/trucks,” “playing a CD (his favorite music),” and “musical chairs.” By the time we got to “musical chairs” Andy was making spontaneous selections, but we returned to the prompting hierarchy to model 2-word utterances or words/symbols not being using spontaneously.

              A word about data collection: Since the device didn’t have built-in LAM (Language activity monitor), we collected logged data using U-LAM. We couldn’t do this speeding up and down the hallway, of course. I had a graduate student monitoring the computer, so she could add a code for how the word was used and/or the prompting level. At the end of the activities, we asked the parents to identify the words/symbols they felt Andy had used spontaneously today. We had agreement that Andy was using: fast, more, varoom, go, stop. We also agreed that no spontaneous 2-word combinations were used.

              Andy left with these 8 words on the device. We created a 4-item eye gaze board and a flipchart for extended vocabulary or nouns such as WHEELCHAIR, DRUMS, VEHICLES, CD, MUSICAL CHAIRS, along with other toys, food, home/classroom choices. You may want to think about how the 8 words might be used and expanded on by the communication partners across situations, environments, and activities.

              Yes, this was three long hours on a Saturday, but well worth it for Andy, the family, the school team, and the graduate students. Not every child will have similar results. In many cases, a child may not demonstrate symbol representation or cause-effect and object permanence after this type of intensive time. However, if that is the case, a systematic approach still can be designed to build skills from the current level. Remember, this is not used as a pre-requisite for AAC.


              Reference

              Environmental Communication Teaching: ECT is a research-based communication intervention approach developed by Dr. George Karlan while at Purdue University with funding from a research grant from the Office of Special Education Programs, United States Department of Education. ECT uses incidental teaching episodes that are directed toward functional communication.

              Website for an ECT manual:
              http://www.aten.scps.k12.fl.us/training/Flyers/ECT%20Intro.pdf

              Website that explains the prompting hierarchy: http://www.region2library.org/DATA/Communication/AT-Prompt%20Hierarchy.pdf

              • Re:AAC and Cognitive Limitations posted by Pam Harris on Apr 14, 2007

                WOW! The information and resources shared in this online discussion are so helpful. Both Katya and Robin, each offering their perspective, are providing such balanced and comprehensive facilitation. Brava!

                Katya, to expand on your discussion of intervention strategies, I found the Environmental Communication Training resource interesting. The 6 page pdf link left me wanting more specific information. Most impressive was that a major component of ECT is a focus on the communication partner. In my experience, the ability of the communication partner can make it or break it for my son Josh. I have learned to actually turn my body around so the person can focus their attention on Josh. This seems to get the idea across. I used to just remain silent and stare at Josh but still many folks didn't get it and kept addressing their comments to me. Back to the ECT, I didn't get enough information regarding structural analysis and modification. Could you elaborate more on that aspect?

                For us (the Harris'), Aided language stimulation as described by Goossens', Crain and Elder along with least to most prompting as described by Light and Binger were our go-to intervention strategies.

                I see major differences between Karlan's and Light's prompt hierarchy. Specifically, use or no use of verbal prompting. Katya, do you know if use of verbal prompting within a least to most strategy offers a benefit? That is, is there any evidence that suggests one is more effective than the other?

                RESOURCES:
                http://convention.asha.org/2004/handouts/handout_184309.ppt#257,1,Interventions to Build Communicative Competence with Individuals Who Use AAC: From Research to Effective Practice Janice Light, Ph.D. Penn State University JCL4@psu.edu Short course presented at ASHA, Philadelphia, PA, November 2004

                Goossens', Carol, Crain, Sharon, and Elder, Pam. (1992). Engineering the Classroom Environment for Interactive Symbolic Communication - An Emphasis on the Developmental Period, 18 Months to Five Years. Southeast Augmentative Communication Conference 2430 11th Ave. North Birmingham, AL 35234

                • Re:AAC and Cognitive Limitations posted by Katya on Apr 15, 2007

                  Pam,

                  To be honest, I’ve never tried to track down Karlan’s publications summarizing the research study. Environmental Communication Teaching (ECT) was a 5-year field-initiated research grant from the Office of Speech Education (award no. H023C9005). A final report would have been required and submitted at the end of the funding, and could be requested under the Freedom of Information Act. Since the state of Pennsylvania participated in the grant, and my supervisor agreed to adopt ECT as part of our assistive technology program, I had access to our outcomes evaluation that was very positive.

                  Regarding your question about the prompting hierarchy, I feel that the detail provided in the ECT training manual is very important. The prompting hierarchy is very effective. The prompting steps allow adults to “script” out their comments/prompts for each item/event in an activity. From my experience each prompting level provides slightly more cueing for the child gradually leading to a full model prompt if necessary. In my opinion, verbal prompting is critical and it helps eliminate rhetorical speech by adults who start to apply more appropriate verbal prompting. The PAUSE is critical as well as the descriptive feedback. Learning and practicing the ECT prompting hierarchy takes practicing – especially the pause – but well worth it!

                  Regarding your question about more information on ECT's structure, I’m not sure where to find more materials. If you’re at a national AT conference, I know Susan McCloskey presents on ECT and ASD. I went down to the AAC Institute Library to get my 1994-95 ECT Classroom staff training handbook. The handbook would have been distributed to teams at the start of training. School districts needed to commit AAC classroom teams to 1 year of training: 5 full release days, video taping of AAC activities, and periodic days during the year for consultation by trainers in the classroom. The 5 days were spread out during the academic year with 2 days at the beginning of the fall, 1 in early winter, 1 in early spring and 1 at the end of the year. Teams left the first 2-day training with activities/scripts to implement based on incidental teaching episodes that would happen in the classroom. Although, the training requirement was reduced later to 3 days by our state AT program, the 5 day training model was maintained in my region.

                  Why? Because it takes this long for adult learning (or re-learning; changes in team members skills), and also the 5 days allow for working on increasing the expectations regarding the student’s achievement. The goal of ECT is to promote the use of communication as a means of maintaining familiar routines or activities. ECT includes procedures on the interrupted behavior chain procedure (Alwell, Hunt, Goetz, and Sailor, 1989). I feel that the goal of AAC is the most effective communication possible to maximize an individual’s potential and quality of life. Consequently, the procedures of ECT don’t go far enough in achieving interactive communication.

                  Initially, ECT was designed to help school teams realize the need to implement low-tech communication boards. Getting teams to discuss designing and implementing AAC communication boards didn’t happen until day 3. The teams in our region had students using voice output systems already in the classrooms. By day 3, teams need to be talking about core vocabulary and building spontaneous utterances. ECT data collection concentrates on recording behaviors and the levels of prompts. I feel that collecting and measuring language samples is critical to monitoring progress. Consequently, during the year teams learn a systematic approach to prompting and building communication competence along with seeing students who rely on AAC achieve success. The pre and post ECT tapes are quiet incredible!



                  Reference

                  Alwell, M., Hunt, P., Goetz, L. & Sailor, W. (1989). Teaching generalized communication behaviors within interrupted behavior chain contexts. Journal of the Association for Persons with Severe Handicaps

    • Re:AAC and Cognitive Limitations posted by Terry Gibson on Apr 06, 2007

      Like we wouldn't remove 'x' and 'q' from a keyboard just because a person wasn't ready to spell queue or xylophone. We don't know that they won't need to say or read these words tomorrow.

      I have several core vocabulary lists and I know the same few hundred highest frequency words appear at the top of them all but I'd love to have a copy of the complete Mein & O'Connor list.

      I'm finding it hard to persuade local professionals to use even the 300 most common words spoken by 3-4 year olds with our kids because they believe that these core words are 'too abstract' for our children's level of cognitive ability.

      Surely they must accept that the vocabulary of severely subnormal persons is then appropriate?

      Core vocabulary is very much the same as the Dolch Basic Sight Vocabulary (except that Dolch usually append 50 or 95 or so extra nouns to aid early reading). For 'normal' kids developing this sight vocabulary is compulsory schooling.

      Even if our kids don't learn and use all 300 or 500 core words in a hurry, they must have a right to access these same words that everyone else uses for most of what they say, write and read, and deserve the chance to try.




      • Re:AAC and Cognitive Limitations posted by sarah on Apr 07, 2007

        I would like to know how you're defining core vocabulary. Also, would it be possible to have access to one or more core vocabulary lists? Can these be posted or downloaded? Are there examples of how children use core words?

        • Re:AAC and Cognitive Limitations - defining vocabulary terms posted by Katya on Apr 07, 2007

          I'm sitting at a local bagel shop borrowing the wireless. My access to technology is rather limited "being home" this weekend. Despite the 3 inches of snow and white-out conditions this morning, isn't Spring wonderful! Let me attempt to answer at least part of this post.

          Core vocabulary is identified through word frequency lists. Core vocabulary is a term that reflects the most common words used in a language - in other words, high frequency of occurrence vocabulary. Core is generally those words that are used 80-85% of the time. Core words are consistent across all demographic groups, topics, situations, activities. Examples of core word categories are pronouns, indefinite pronouns, prepositions, articles, determiners, conjunctions, and many verbs (used with high frequency).

          Words that are used with low frequency or less than 15% of the time have been termed fringe or extended vocabulary. Fringe or extended vocabulary is specific to the topic, situation, activity, environment. Examples of fringe or extended vocabulary categories include nouns - lots of nouns, some verbs.

          What is important to remember, is that people don't decide what is core vocabulary - it's a phenomenon or characteristic of any language. To say that as adults we're going to decide what the "core" vocabulary is for a specific situation or activity is not how using language works.

          I will get a reference of vocabulary lists together when I'm back at work next week, as well as pull some clinical data on children learning vocabulary using an AAC system.

          Thank you for your patience.

        • Re:AAC and Cognitive Limitations posted by Terry Gibson on Apr 08, 2007

          Gail Van Tatenhove has several core vocabulary lists for download from her website, as well as an article that describes the functions of early words -Language Development and AAC Vocabulary - that might help you to decide which words would be most useful to start with:

          http://www.vantatenhove.com/showgroup.php3?id=36

      • Re:AAC and Cognitive Limitations posted by Mariana on Apr 09, 2007

        Since a long time I had access to the Dolch Kit and other high frequency vocabulary. It finished to be useless to me as it has a lot of non-grammatical words. My son was very functional and he preferred functional words, like subjects, actions, descriptives. We never could teach him the Dolch kit. He started to use it when he was more language functional with higher order structural sentences.
        He uses a diagramatical reasoning tool, like Inspiration soft for sentence structure.
        Mariana

  • Signing vocabulary to VOD posted by Lynne on Apr 04, 2007

    I have a hearing, non-vocal 5 year old who has been communicating at home & preschool using SEE (Signing Exact English). In the course of about 15 months, she has developed language according to all the typical stages & uses all appropriate language functions, adds past tense, plurals, articles, just as any typical 3-4 year old would speak - not perfect but moving through the developmental sequences. She probably has a signing vocab of 300+ words (and never "shuts up!"). As she moves into Kindergarten and onward, there is controversy about signing vs a voice output device. I'm thrilled that she's learned to understand (on target but better with total communication) and use language very effectively, but as people think about using a voice output device, how do we provide for the vocabulary and sentence structure that she possesses - she has a lot to say and it's self-generated - no pat stereotypic phrases for her. Did I mention that she reads and spells???

    How do we give her the vocabulary and syntactical structures she currently uses in an efficient mechanism that more people will understand?

    • Re:Signing vocabulary to VOD posted by Amy M on Apr 04, 2007

      If you figure this out, let me know! I am sort of in the same boat. My daughter is almost 8, is learning to use a communication device, but she is verbal, just not very understandable. She can speak in full sentences, beyond her age, and is able to understand language very well. It is teaching her to use the device, for clarification of words we can't understand, and in the future for notetaking, schoolwork, and reports. You do have to treat it as a second language, and how you would teach a spanish speaking child english, you have to do the same thing with your child.

      Personally, I would use Boardmaker, and print out a bunch of categorized cards, with the sign language and printed symbol on one side, and the printed PCS symbol on the other side. Make them business card size, and put them in a business card holder page, and put them in a lightweight folder. Alphabetize them, by category, and when she needs one, she can point to the correct card. I wouldn't worry too much about forming full sentences, at this point, with her second language. Verbs and nouns mostly, and most people would get the idea. Say, she was going to place an order at McD's. She could point to hamburger, no pickles, on 3 cards, and they would get the message. Sure she can say "I would like a hamburger without pickles please" in sign, but the person at the counter wouldn't understand that most likely.

      This is what I call Kendra's dictionary. We have a folder, comprised of the first 150 most used words. On each card, I have her device sequence, and the printed word. This way, she can practice CORE words, and see both sets of language, and the person she is speaking with, can read the word aloud for her, to make sure that is what she wants to say, and she can find it on her device. Those 150 words account for 70% of the spoken language. So, if she can point to them, chances are someone will understand her, if they can read, until she gets better at finding them on her device by herself.

    • Re:Signing vocabulary to VOD posted by Robin Hurd on Apr 05, 2007

      Wow! sounds like she has a lot going for her! It's great that she is putting together sentences, can read and spell.

      I am sure that the controversy about sign is that, although it is an effective method for her to communicate with people who know sign, her peers and teachers will need a translator, and this limits her ability to socialize with others who don't sign.

      You are right to be concerned that if voice output is used, it must support the great language skills she already is building using sign. So that rules out a system that contains mostly phrases or sentences. It also makes it imperative that a system contain not just nouns and verbs, but all of the little words that tie our thoughts together and help us make our sentences complete.

      When looking at a voice output system, look to see if there are verb tenses available to her, check to see how to find words like me, mine, yours, you, we, theirs, etc. Also check to see about directional words: over, under, beside, top, middle, bottom, etc. and words like this, that, here, there. Can she easily make a noun plural? Can she add an "ly" to a word to make an adverb? Can she access spelling and/or word prediction if she needs to for less common words? Spelling/word prediction is a very slow method of communicating, so I would want to see it as a part of the AAC system, not her only way of making words. Her peers will not be patient with long wait times for her communication, and she may then begin to communicate less fully in an effort to be faster.

      If these words are on the AAC system, stored in a way that makes sense and accessible without many motor movements, she will be able to get to the words she needs quickly once she learns the organizational system.

      As you probably have gathered, I would avoid a "blank" device, that has to be programmed from scratch. There are several AAC systems that come with an organizational strategy in place. This saves you lots of time in the initial programming, plus provides a format to help make sure that the words are organized in a way that they can be easily retrieved when needed. Check out all of the ways of organizing language on an AAC system, and then you can make an informed choice.

    • Re:Signing vocabulary to VOD posted by Katya on Apr 05, 2007

      Dear Lynne,

      I appreciate your questions and agree with Robin’s comments. However, your post shows the difficulty of limiting a discussion to "AAC and vocabulary." Very soon inter-related questions arise about the nature of language, such as grammar (syntax) and use (pragmatics). In your situation, the child has a rather extensive vocabulary along with rules of grammar (word order, tensing). The issue is not so much vocabulary selection and organization as it is how to represent and generate language. Right now language is being represented using “signs” and generated by “sign language.” In selecting an AAC voice output device, both language representation and language generation methods would change.

      The scope of how language is represented and generated using AAC systems is beyond the scope of this month’s discussion. Yet, I don’t think we can avoid mentioning the basics, because several questions already posted point toward those two major components of AAC. Once we start exploring those issues, we can’t help but start to consider what is commercially available. That’s not the purpose of this discussion. I believe the readers will have to be inquisitive and diligent exploring/investigating the full range of options. None-the-less, a basic framework to evaluate AAC symbols, language representation methods, and language application programs is available as a free self-study course at the AAC Institute at www.aacinstitute.org. At the home page scroll down to resources and click on self-study program.

      Identifying and selecting vocabulary is critical to building language skills. Just as critical for children using AAC is how vocabulary is organized. Beginning-to-large vocabulary sets (hundreds of words) using graphic symbols to represent words or messages may be organized and stored by an individual or team of people. This is a labor intensive (time and resources) on-going process, especially when vocabulary management seems to become an almost daily occurrence. Who does ALL the programming? Mom? SLP? Classroom aide?

      Large Vocabulary sets (thousands of words) using graphic symbols to represent words or messages may be organized and stored by one individual or group of individuals as a commercial product, e.g. AAC language application software program. When this is the case, the family and professionals have the responsibility of understanding, 1) how language is represented, the language representation methods that are available with the software, and 2) the rules or principles for learning and generating language. In addition, questions about performance and outcomes should be asked and forthcoming. Being able to talk with someone else using the program successfully is a reasonable expectation.

      Monitoring performance and collecting language samples for evidence-based assessments and to document progress is critical to knowing the success of intervention (Hill, 2006). Clinical data comparing performance differences among language application programs shows the importance of the decision-making process.


      Hill, K. (2006). AAC Assessment Outcomes for Individuals with Developmental Disabilities. In Proceedings at Thriving in challenging Times: The future of rehabilitation engineering and assistive technology the Annual RESNA 2006 Conference. Atlanta, GA. June 22-26, 2006.

    • Re:Signing vocabulary to VOD posted by Terry Gibson on Apr 07, 2007

      All high tech communication aids could facilitate self-generated sentences from a comprehensive vocabulary that is arranged by part of speech so that one's knowledge of English, grammar, syntactic structure actually aids the learning of the device, or for the developing language user, the device aids in teaching the language code, grammar and syntax.

      In my very limited experience this is not always the case. We were asked to try out two test sentences on each of four different devices with our son one day and we couldn't believe it when we found the words 'CAN' 'TRY' 'HAVE' 'BEEN' and 'SEEN' missing from one or another of these devices - a lot of words to be missing from just two sentences! And it is not a hardware problem.

      At a CM seminar on symbol sets and AAC softwares, Dr Janet Larcher recommended that whenever a new device is under consideration, ask:

      1. to meet a proficient user of the device (AAC Role Model) so that you can see it in action (all too often a product specialist will demonstrate a device by just showing you how to find category after category of noun)

      2. take along a few test sentences to check out the device's default vocabulary

      I would personally extend this last recommendation to taking along a complete core vocabulary list of 500 high frequency words. If they are all present, then it is probably true that the remainder of the vocabulary on the device will be the next most frequently occurring words in the English language, but a larger core vocabulary list would check this out.

      Take along a news item or some song lyrics or some literature and see if your Role Model can generate around 80% of the words without having to type them.

      The words should also be sensibly organised on the machine for fast access so you could almost 'touch-type' the buttons that reach them once you have learned your system.






  • Use of AAC for communication about curriculum vs. conversation posted by B. Poss on Apr 05, 2007

    As a professional working with students using a variety of AAC devices in school settings, I really understand the issues that some of the previous posts mentioned. The statement that one parent made that her child is using her AAC device to answer questions educationally, but not using it for conversation is one that is often an issue in the school setting. We have a dual problem of providing students with the means to demonstrate their knowledge about a subject and to access the general education curriculum and yet still provide them with the language training to be successful communication partners. Often, especially for students who are at the elementary school level or older, the focus tends to be on communicating curriculum information, rather than using comments and more socially based language. So much time and effort is spent programming devices with science, math, social studies, and reading/language arts vocabulary and teaching the students where to find it. Add in the time it takes for students with access issues to get to this school vocabulary and there are not many opportunities for just chatting with friends.

    As an AAC practitioner and SLP, when I introduce a device for students, I try to focus on "Core Vocabulary", even in the context of academics. Whether using preprogrammed phrases such as "Awesome, great!" and "No way!" or using the core vocabulary available on the main page sets of software programs such as Unity or Word Power, I look at teaching the AAC users, staff, and parents that there is a great deal of power in highly flexible language (like the concept that doggy means any 4 legged animal for a typically developing toddler)that an AAC communicator can use repeatedly in the context of almost any school or social activity. Does this make sense or did I ramble on too much?

    • Re:Use of AAC for communication about curriculum vs. conversation posted by Robin Hurd on Apr 05, 2007

      What you are saying about using core words absolutely makes sense!!

      I would like to share an example of a recent social studies unit my son Josh completed. Josh uses AAC and is in the regular third grade classroom in social studies. The unit was on heroes. a variety of real American heroes, Rosa Parks, Jonas Salk(inventer of the polio vaccine), Albert Einstein, Frederick Douglass... In addition to the real life heroes, the unit also covered Greek mythology and American tall tales.

      Josh's teacher and I decided to focus on the concept of "real" and "not real", and listed some phrases in words he already knows that we could target to explain about the people's lives. His teacher made a book with pictures of each person, and I made stickers using address labels which had the target words and the locations of them on the AAC system. As they studied each of the heroes, Josh put the stickers on the page and practiced telling his aide what they said. He brought his book home and told us about the people he studied. For the unit test, Josh had pictures of a selection of heroes from the unit, and his job was to describe them. He got 1 point for every bit of information he gave, with a target of at least 3 things for each character.

      Here are some examples of the target phrases that he used:

      Rosa Parks: real, no riding bus, people angry, she wants people happy
      Jonas Salk: real, man makes medicine, he wants to help people
      Cesar Chavez: real, help farmers, he wants to help(and Josh added to eat)
      Athena: not real, she gave a tree (to the city of Athens), they like tree
      Paul Bunyon: not real, he is big, works with tool

      You can see how many of these words he can use in a variety of ways, as well as how well he was able to describe the stories, even with limited words and limited language skills.

      Joshua really benefits from having some suggestions of what words can go together to say what he wants to say; for both he and Caleb (his identical twin with identical disabilities), having target words from the onset of the unit helps the boys to focus their minds on the possibilities they have with words they already know.

    • Re:Use of AAC for communication about curriculum vs. conversation posted by Diane C. on Apr 10, 2007

      This totally makes sense. I am a mother of a 14 year old girl with severe apraxia and cognitive delays who has been using a dynamic display device with Speaking Dynamically Pro and a somewhat customized set of boards (I do the programming) since Kindergarten. Early on her success was mostly in the classroom and for communicationg her basic needs. Our challenge was moving her into productive give and take conversations. So we looked at what motivates her and it is social commentary and her gift for empathy. We made a page where she had to build comments about characters in a story and how they felt (ie. the boy is sad). She would make a comment after someone in her reading group read (a great way to learn communication within the reading class). My daughter has been in a fully inclusive environment since Kindergarten. This taught her building sentences.
      Later when we hit another plateau with social communication we changed the computer voice to a recorded and dramatic voice for all of the emotions she might be feeling, then linked each emotion to a reason (ie. I feel proud--because--I did all my work.) If we look at the frequency of usage of each button (available in her current device, the Minimerc) she uses this page the most by far!
      Now we are on to longer conversations with common phrases on a variety of subjects. She navigates over 300 boards in her device. Did I mention that despite cognitive delays she has an excellent memory?!

      The pros of a customized device is tailoring it and keeping it motivating for the user. The cons are that I have logged hours in programming. The benefits are that my daughter never stops "talking!" She is a true teenager and has the vocabulary to prove it! "Mom, you are so annoying!"

      My biggest challenge is what to do at the pool, on the baseball field, in PE class, etc. Right now she uses a "Listen to Me" but that is limiting and we have one for each area.
      Love to hear some suggestions.
      Diane

      • Re:Use of AAC for communication about curriculum vs. conversation posted by Robin Hurd on Apr 10, 2007

        Very cool how you are using the frequency of use button to track what she uses the most! That has to help gear your programming and the teaching she receives toward the things that are interesting to her, so you can build skills on top of the things that she is already good at.

        Robin

  • one of lynne's questions:autism posted by Robin Hurd on Apr 06, 2007

    Lynne mentioned wanting to know about kids with Autistic spectrum disorders and AAC. More and more children with ASD who are non-verbal or partially verbal ("I can say some stuff on a good day to people I know well if I am not too stressed") are using voice output AAC systems. As the numbers of autistic children diagnosed rises, knowing how to meet the special needs of a child with Autism becomes even more important.

    Children with Autism not only may need AAC, they also have difficulty processing language-whether spoken or non verbal. They tend to be rigid in their thought patterns and have difficulties making transitions or handling unexpected changes in routines. They may also have sensory processing differences. A book may “smell too yucky” to stand to read it. A sound may be so loud that the child dives under furniture with ears covered, but no one else is bothered. Adding these sensory differences to a child who doesn’t have good ways of communicating, and behaviors inevitably result.

    When working with a student who uses AAC and has Autism, it is important that we not only teach where words are on the device, but that we build some language strategies. (This is important for other children, but even more so for a child with Autism.) One way to do this is to emphasize how words are related. I may be teaching a child some basic verbs: want, go and read, for example. Not only should I teach these words and their uses individually, but also that ALL of these words tell about doing something. “If I want to do something, I can do this (demonstrate on the AAC system, to find the words that tell me about doing something.”

    Language is made up of 2 things: chunks of sound (represented by letters) and chunks of meaning. Students with Autism may also look at language in one of 2 ways. They may see the chunks of meaning, but be clueless about the chunks of sound that we use to communicate that meaning, and “think in pictures” to the point that they may need to “translate into a second language” mentally to use words. They may also see language as chunks of sound, but have a hard time putting meaning with those sound chunks. Hyperlexia is an example of this. The goal, of course, is to put the two ways of looking at language together, so that the chunks of sound (words) and the mental image of the meaning of the word go together.

    Voice output AAC can help to make the connections between the idea of a word (represented by a picture or icon) and the chunks of sound that make up that word.

    We can also include in this discussion of Autism how language and AAC can help prevent those meltdowns and behaviors before they get out of hand.

    Does anyone have any input about a child with Autism using voice output AAC? It's great to share experiences and ideas.

    • Re:one of lynne's questions:autism posted by Terry Gibson on Apr 07, 2007

      I have no personal expertise, so can I just point you to some people who do:

      For anyone in the UK on 23 April there's the
      Communication Matters Study Day - Autism and AAC
      Institute of Child Health, London. Details and booking form from CM: http://www.communicationmatters.org.uk

      The presenters are Oliver Wendt, Helen Cockerill, Anne Gresswell, Rachel Moore, Jeremy Parr and Vicky Slonims.

      I've read a paper by Anne Gresswell that is a very good critique against the indiscriminate use of PECS as the only intervention with autistic children, where she describes how PECS were originally intended for use as a stepping-stone to more complex solutions, and how to move children on from PECS to voice output. I've emailed to ask Anne for a copy of her paper to post on the web. She has retired her post at ACE and passed on my request to a colleague.


      PRC's John Halloran and Mia Emmerson got some very positive results working with autistic children using VOCA's. 10 of the 13 children continue to use their VOCAs. Some started to speak and only needed VOCAs for a period of time.

      There's a link to some write ups with videos of Tyson and Joey on the Prentrom homepage:
      http://www.prentrom.com/

      Quote: "Joey is becoming more and more reliant on his Vantage with his expressive communication, which in turn decreases his frustration. Because of Joey's developmental delays, we never thought he would be able to communicate coherent sentences to us," says Joey's mother, Hazel Tabile. "Now he actually asks for 'kisses' and tells each member of the family, 'I love you.' As a parent, just hearing that from your son who doesn't talk is plain magic.


      Ralph Schlosser, when demonstrating how to pose a good question and search well known medical databases for the most recent and/or best evidence (sometimes the best is an old one), used as his case study a four years old boy with autism whose parents were concerned that a voice output device might hinder their child's natural speech development. He found no evidence that voice output devices hinder speech developing and some evidence that voice output promotes any inherent potential to speak that the child has. The results proved a hierarchy of effectiveness in AAC intervention methods, with voice output speech generating devices coming out on top, and also bear out the results of the PRC' project.

      At an Equality 2025 meeting in London last month I witnessed Facilitated Communication for the first time. A young lady and a young man typed their messages on Lightwriters, but needed their facilitators to pull their hands back from their keyboards between each keystroke.

      This is probably the access problem/solution that autistic people are referring to in their personal stories about their lives both before and after communication facilitation. Click ‘Personal Stories’ on Breaking the Barriers homepage at:

      http://www.breaking-the-barriers.org/breaking-the-barriers/index.htm.



      I was at a seminar last year where a doctor who has researched the use of Red, Green and Blue things (like glasses, lights in the room, colours for computer display) in a controlled study at a University, and which has been beta tested in one county, where some of the symptoms that can accompany autism, like falling over and bumping into things, dyslexia, not being able to let anyone within a certain distance without feeling pain, people's faces distorting or being part missing, headaches... all sorts of symptoms being instantly and totally eradicated with the right colour goggles, room lighting or computer display colour theme.

      It doesn't work for every symptom or for everybody, but the success rate for the symptoms just mentioned and for a large number of people lead this doctor to believe that his therapy should be the first intervention, before handing over a case to the more common interventions like an Ed Psych (or PECS?) I'm on the mailing list for more information when it is on general release.


      The Transporters is a world of imaginary toy vehicle characters who have emotional experiences and adventures. It aims to help children enhance their understanding of the causes of emotions and of emotional expressions.

      Read about it here:
      http://www.transporters.tv/

    • Re:one of lynne's questions:autism posted by Carol on Apr 07, 2007

      I have a non-verbal autistic son who used a voice output device a few years ago (he was 7 at the time). We used PECS and sign language before we got the device so much of what I programmed it to say was that same vocabulary. I also added questions, something we'd never successfully gotten him to ask with either sign language or PECS. To our amazement he used the questions!

      · While at Grandma's house for the third day in a row, he used the questions screen to ask "When do we go home?"

      He also used the questions screen at Grandma's house to reason with me about going to play upstairs. He kept trying to go upstairs to play but there were people still sleeping up there so I told him he'd have to stay downstairs and play. He went to the box and went into the "Time For" screen--he looked at it (without pressing any buttons) but when he saw what he was after wasn't there he went out into the question screen instead. He asked "What time is it?" Hmmm. I thought for a second--it wasn't breakfast time yet so I just answered "It's wake up time." He gave me a 'got ya' look and marched confidently upstairs. If it was time to wake up, then those sleepy heads needed to get up anyhow and that meant he could go up and play.

      Looking over the list of core words I realized that many of them are often used as questions, not statements. 'More' isn't just "I want more." but "Is there more?", "Can I have more?" or even "There's MORE?!" From what I've experienced there is a tendency to concentrate on desires or 'I want' vocabulary with AAC. But clearly, even for someone with cognitive difficulties and autism, building in the ability to ask questions is important.

      • Re:one of lynne's questions:autism posted by Robin Hurd on Apr 07, 2007

        What an awesome story!

        You write that your son USED a voice output device at the time, implying that he does not use it now. I assume that he developed speech. We'd all love to hear more about that!!

        Yes, it is so important that we make sure that children who use AAC have access to questions. Children learn so much when they are able to ask questions. Kids with Autism and/or anxiety disorders also need to be able to ask questions, because some of the things they need to know, to feel comfortable with what is happening around them, aren't necessarily things that the rest of us remember to tell them!

        My middle son is verbal, but on the spectrum, and his great need for a complete understanding of his schedule with plenty of time to process and prepare for transitions is something that can be easily forgotten. If he were not able to ask, "what are we going to eat for supper" (at 2 pm today!), or "what are we going to do tomorrow?" and "is that all?" (every evening at bedtime), he would have a lot tougher time having access to the information that can keep him comfortable and able to adapt to life as it comes -- and we as his parents would have a lot more meltdowns to deal with!

        No matter what the cognitive skills or disability labels of people who use AAC, having access to all of the ways we communicate with each other (not just a few words: food, drink, bathroom) is critical.

        • Re:one of lynne's questions:autism posted by Carol on Apr 07, 2007

          Yeah, sometimes just knowing he's been 'heard' can help prevent or stop a melt down. I say my son 'used' a device because after using it for a year, we moved and had to leave the device with the school district that owned it. We've just completed all the Medicaid red tape and are about to order him a new one. Being without his 'voice' has been difficult on all of us. We've had WAY more meltdowns since leaving the device behind. I can't wait to hear all the stuff he's got to say when we get the new device.

          • Re:one of lynne's questions:autism posted by guest on Apr 09, 2007


            Carol, that is awful, that he had to give up a device that was working well for him, and go through the red tape for another.

            Of course the dynamic display devices are incredibly expensive, but you could buy a Go-Talk (around $200) or other cheaper device and still have his basic questions and requests, and it will not be subject to school district nonsense.

            Because of motor skills issues, our son has problems accessing his dynamic display device (Chat Pc 2) but is learning. He has a much easier time with the Go-Talk, because it is larger, and it's so simple to use.

            I could not resist making this suggestion - people do need to know that there are easily obtainable, affordable alternatives or supplements to the expensive devices. The school also uses the Go-Talk when the regular device is sent for repairs.

            Lu

            • Re:one of lynne's questions:autism posted by patty on Apr 09, 2007

              Thanks for reminding people that there are less expensive alternatives.
              My son still has his old device, (has had a new /different one for a year and half now.) At first, I thought Oh! I can find a place to donate the old one to. It would be such a a gift to help someone find their voice. But a very wise SLP advised me to hang on to it. And she was right. It has helped when his new device has needed repairs and loaners never get to him quickly enough!! :) It has also helped us to see that he really has embraced his new device, because he tries to give back the old one to us.
              Says, no, no, no!
              It is such a sinking feeling when the device goes down, isn't it?? The "good" thing is, my son gets very upset....~ Patty

              • Re:one of lynne's questions:autism posted by Robin Hurd on Apr 09, 2007

                Carol,

                How awful to have had to leave the device behind and not get one right away after moving!

                When my guys have to send their AAC sytem in for repairs, they go into grieving. Even our substitute talking photo album doesn't help much. I can't imagine being without the device for a long time. A week or two seems like forever!

                It is great to see that the device makes such a difference, that it is sorely missed, but it's so hard not to be able to do much about the frustration levels when it is gone.

                Robin

      • Re:one of lynne's questions:autism posted by lt on Apr 10, 2007

        This makes me smile. I work closely with a 14 year old with severe autism. He's been doing PECS most of his life and was very proficient at ordering his food, telling us he wanted to ride in the car, etc. But that was it.
        I found a low tech device on ebay and he loved it. Then, it was lost...we have no idea what happened. He tore up all his PECS and still refuses to use them.
        We have been waiting two years on medicaid funding for a "big" device. Meanwhile, I was able to find a pocket pc and run RJ Cooper's Point to Pictures Mobile on it. This kid has amazed us. He's using it to report that he's sick, that he's angry, that he needs tylenol when he chipped his tooth. He never used his PECs to report any internal states like that, after years of trying.

        What got him "invested" in his device is that I put a few songs on it that he enjoyed. He is very much into music and that's how he really took ownership of his device.

        But now, I am a bit frustrated -- we're hitting the plateau.

        His device is very based on one or two messages at a time. I arrange it by levels -- first, he hits "food" then another choice page opens, and he hits "drinks" and then hits "I want coke." I currently don't have it programmed for him to make novel sentences and I'm not sure how to do that.

        It was recently brought to my attention that his device makes sense to me but not him. He was hanging out at the park and was agitated. This could mean
        -- he wanted to go home
        -- he wasn't feeling well
        -- he was too cold
        -- he wanted to swing but there were no swings
        -- he wanted to know how long we were staying and what we were doing next
        -- he needed the bathroom
        -- he wanted his little sister to pay attention to him
        He has a way to communicate each of these on his device, but some he would communicate by using the "places" levels, some the "feelings and needs", some the "questions" or "people." That was too scattered while he was agitated.

        I am in the process of restructuring his device not by what makes sense to me, but what he typically attempts to communicate in different situations.

        But still... I would love to take his device to the next level where he can reason and argue with me like what you are talking about. The above post makes me smile when it comes to using AAC to negotiate. I want him to argue with me someday, not with vocalizations or by actions, but by using his device.

        • Re:one of lynne's questions:autism posted by Robin Hurd on Apr 11, 2007

          What an astute comment: the device makes sense to me, but not to him". It's easy for a typically developing adult to set up a scheme for an AAC sytem or a computer, for that matter, that makes sense to us, but not to the person who actually is going to use it! My husband occasionally goes in and cleans up our home computer, and organizes everything alphabetically: when he does this, I can't find anything! I prefer it to store things in chronological order. No one is right or wrong here, just different.

          This is probably a no-brainer, but maybe he can help you to know what will help him the most. My son Caleb (age 9) who uses AAC, has some really great ideas about what will help him to learn, if I just take the time to listen. One day, he had me tell him what animals lived in different places on the world map (his geography lesson) and place stickers of those animals in the places where they lived. After that, he could answer questions about the various continents much better(even though the questions had nothing to do with the animals).

          As you are re-thinking this, you may want to think less about the external activities,and more about his internal state. Can there be one place that he can go to when he is agitiated, to tell others that he is agitated,and (hopefully) why? How about another place to find the kinds of things that make him feel calm and happy?

          Even for people who have speech along with autism, identifying feelings and communicating the cause of them can be very tough when upset, so part of his inability to do this is simply that it is such a difficult thing to master. Having one place to go to find a variety of options when agitated may make the task do-able. Things like: too bright, too loud, too stinky, too much movement, should probably be a part of this, if he has sensory issues. Another message that is extremely important to my verbal son with ASD is "what are we going to do next?" Notice how much of the way we express these is high frequency words.

          I would expect, even if you are able to move to a system where he puts words together to make meaning, that these types of things should remain available to him in pre-stored, easy to access messages, to make it as easy as possible to communicate about his agitation.

          • Re:one of lynne's questions:autism posted by Robin Hurd on Apr 15, 2007

            I wanted to continue the discussion of autism by adding that some of the ways we can support students who have autism and use AAC is by additional supports to organize their thoughts.

            Eventually, we want students with autism to set up some type of structure for organizing themeselves internally, but often, the students need to have structure that is outward, in order to cope with life and hopefully eventually internalize the structure.

            These support materials can take the form of picture schedules, social story books, calendars or aided language supports. Each of these has as its goal to help provide organization; they can also help provide language support.

            Often when we make these support materials, we focus on nouns--we label the objects. "store, bus, home" might be part of a shcedule for a trip to the store, with the items to buy listed, as well. With a little re-thinking, we can include other words that build the internal language structure beyond nouns and support using core words on the AAC system. "Go in, get food, push cart, front of store, go in bus, go home." These messages are still small enough to fit into a picture schedule, but provide a little more detail as well as support for using words together. We might still choose to include the name of each item to be purchased, but we have added much more language support by using words like "in, push, go, in front of".

            When we talk about aided language supports, we mean supports that have as their main goal increasing language skills and conveying what we as educators(or parents) are shooting for when we want our children to use their words. The teacher, parent or SLP can use the aided language support to show the child what the child can say in a given situation. When the goal is to learn more of the sentence building high frequecny words, an aided language support can be set up with these words. The adult can point to the words as they are used in an interaction. If the child needs a prompt, they can be directed to the aided language support to help narrow the search for the right words.

  • AAC Core Vocabulary List posted by Katya on Apr 07, 2007

    Several years ago, AAC Institute was developing software for measuring AAC communication performance. One of the summary measures identified was use of core vocabulary. Calculation of this summary measure required a list of core vocabulary words. At that time no generally accepted core vocabulary list existed. Existing frequency lists were reviewed as the basis for creating the General Core Vocabulary list used in the software.

    To learn more and to access the list, go to http://www.aacinstitute.org/Resources/ProductsandServices/PeRT/intro.html.Near the bottom, click on Core Vocabulary and the AAC Performance Report.

  • Vocabulary for scanners posted by Tess on Apr 07, 2007

    I am a special education teacher for students with severe and multiple impairments. All of my students are AAC users, all are scanners (some single switch, some two-switch step scanners). At this point all are still using linear scanning, but I hope that some will move to row column, or some other group scanning method.

    I am particularly concerned about vocabulary use because of the time and energy it takes for my students to get to the message they need, either too many locations on one page which takes too long, or the need to navigate through too many pages. In addition most of my students have cortical visual impairments, which again limits the number of items on one page if we want them to see them.

    Our main focus has been to help the students see the purpose and power of communication, trying to make things fun and have a reinforcing result. It is often hard to get my students inspired to use their devices. The things that have been most successful, in general, have been phrases like "can I see that?" and "my turn" that can be used in almost any setting, with almost any one.

    For this reason I have also been slow to get started in the process of having them put words together. I know this is the way to go and I am trying to incorporate it. But I am concerned that the students will lose interest or patience because of how long it takes to get to the different word combinations.

    I am really interested in getting thoughts from others on specific layouts that work well with beginning AAC users who access through scanning.

    • Re:Vocabulary for scanners posted by Terry Gibson on Apr 08, 2007

      Some of the children and one of the Role Models from the '1 Voice Communicating Together' group here in the UK kindly demonstrated their switching and scanning on camera for me to put the movies on our website. The clips include shots of their VOCA screens that show the various scanning methods being used.

      Nathan's overlay has 12 columns by 8 rows. His machine continuously and automatically scans his overlay divided into six blocks of 4 colums x 4 rows. He hits his switch to select a block, then he only has to wait for it to scan at most four columns and four rows within that block to reach a word, and he is very adept at word-by-word communication.

      All the children have special pages set up with maybe just 6 cells to scan to reach the pre-stored messages for the scripts to their magic trick, poems etc. for real time communication that is fun, motivating, empowering and entertaining.

      Natalie, the Role Model, demonstrates scanning the alphabet to spell, which is significantly slower than scanning for whole words, but it might always be necessary to spell a portion of one's communications.

      The movies are short and small dimensions but may take 30 seconds to a minute to load and display (longer with dial-up).

      You can view them at:
      http://homepage.mac.com/terryjohnmick/jafw/html/projects/scenario/tab_n_enter.htm




  • great posted by patty on Apr 08, 2007

    Well, I have cruised through some of the discussion and know that it will help me "empower" my son.
    I realize by reading that I have made some mistakes along the way, but that's okay. I am sure I confused the heck out of him, despite that he does learn and slowly, but surely becomes a better communicator.
    Just curious, if anyone has worked with or has a child with blindness that uses AAC?

  • A word about devices - components of AAC technology posted by Katya on Apr 09, 2007

    I’m going to suggest that people posting try to avoid or resist the temptation to ONLY identify AAC devices by name. Many people reading the discussion may not be familiar with all the devices and/or many of us will wonder how a device may be configured or customized for the person given all the possibilities. Rather, let’s try, within reason, to identify the basic components of the device even when you include the device name. This may sound rather "academic," but I think you'll see how that will help stay on the same page (oops :)) and avoid confusion, especially when so many configurations are available on the same AAC device.

    I’ve asked FCTD to put a file of a table that lists the components of dedicated AAC assistive technology (http://www.fctd.info/resources/newsletters/upload/Components_AAC-table.doc) first published in An Introduction to Rehabilitation Engineering by R. Cooper, H. Ohnabe, and D. Hobson. The table has been updated recently, and is the file I’m sharing with you.

    I’m going to use some examples of AAC systems mentioned in posts that I hope might be helpful in gaining an appreciation of how the vocabulary may be organized and accessed.

    Take for example the GoTalk. This is a 4 or 8 location static display with digitized voice output using single-meaning pictures. If this device is mentioned again, specifying the actual number of locations, the selection technique, and maybe the symbol types, e.g. photos, pictures, Imagine Symbols, etc. would be helpful.

    Now, let’s look at the ChatPC. This is a 16 location row-column grid-type touch screen using single-meaning pictures and alphabet-based methods with synthesized voice output. (By the way, the ChatPC does have a logging feature to monitor vocabulary use patterns.) Again, the selection technique needs to be clarified. Also, the standard configurations on the ChatPC are 1) symbol-base, 2) Velocity, and 3) VocabPC. Although all three configurations primarily support the single-meaning picture language representation method, if the person is using the symbol-base or Velocity configurations they have access to alphabet-based methods (spelling).

    AAC language application programs can be identified using a similar component table. (I did not make one available now.) AAC language application programs are primarily classified by the availability of the AAC language representation methods. When single-meaning pictures are the sole method being used by an individual, then identifying the symbol set may be of interest. Several technology features are available on devices to enhance the efficiency of using AAC software programs.

    Again, getting back to our discussion topic, AAC language application programs differ in vocabulary selection and organization, and the technology features available to access the stored vocabulary. Therefore, different performance outcomes may be achieved.

    • Re:A word about devices - components of AAC technology posted by Lynne on Apr 09, 2007

      I'd like people to address the vocabulary selection and organization features for dynamic display devices as opposed to those using semantic compaction. People have spoken about core vocabulary, but how does one organize that....agent-action-object across the screen, categories - people, places, food. What do people consider as they put the vocabulary into a framework for building sentences and making social comments/conversations? What makes someone choose a particular organization over another?

      • Re:A word about devices - components of AAC technology posted by Robin Hurd on Apr 09, 2007

        Dynamic display AAC sytems can come in many different ways. You can get a blank device and program it "from scratch" or you can get a dynamic display device that comes with a program of basic words and a strategy already in place. One of those strategies available is semantic compaction, which Lynne mentioned. For those who may not have seen it used this way, semantic compaction does come on dynamic display devices, too. It contains the basic core words organized using semantic compaction, plus a variety of page and activity row options already set up. Other strategies for storing vocabulary on a dynamic display device include Gateway, Word Power and Picture Word Power. With any of these software options, there will be special words that will need to be added to suit the individual, but the organization, categories and basic programming are already in place.

        The advantages of choosing one of these software options are that a framework for organizing words is already set up, plus, it saves time for whoever does the programming.

        What makes a person choose one system over another is based on a variety of concerns. What are the persons' strengths and skills? How important is motor planning to the person who will be using the AAC sytem? (Motor planning is important to everyone who uses AAC, but it is critical if the person has visual or access issues.) Can the person read/spell: some? not at all? fluently?

        You can try to make up your own system for a blank Dynamic display device. This may work, if you have a very beginning communicator, but what tends to happen to these systems is that, as the communicator's skills grow, the organizational strategy becomes so complex that it takes so much effort to get from the main page to the word, and the device is no longer effectively used.

        While I suggest using the existing software options, if you do choose to try to set up your own organizational strategy, think about where the person should be after using the device for a few years. What word groups do you want them to be able to use then? (prepositions and other location words, adverbs such as now, always, etc, possessive words like mine, yours). Plan your strategy at the beginning so the organization is already in place from the outset, not added on later as an afterthought.

        As you mentioned, people who do set up their own systems often organize them with a left to right orientation across the screen to support literacy. This may or may not be best, depending on how well the person can access their AAC system. You will want to take into consideration what will be the easiest to reach areas of the AAC system, and store the most commonly used words there. Katya has posted some of the most commonly used words in other places in the discussion. Check the resources sections for more information on research about high frequency words.

        As you can see from the things that have to be considered, making your own AAC system takes a lot of work. Ideally, an OT and an SLP would be working as a team on such a demanding and important project. Once the system is in use, it's important to make sure that it is serving as an effective communication tool for the person using it. An occasional language sample to compare to a beginning baseline sample and a peek now and then from an OT to make sure access is working are the minimum needed to assure that the AAC system (device, programming and intervention) is providing the outcomes that it should.


      • Re:A word about devices - components of AAC technology posted by Katya on Apr 09, 2007

        Dear Lynne,

        These are all great questions! In fact, you’ve had a lot of good questions that we’ve been trying to answer or hope someone answers one-by-one as the discussion continues.

        From your question, I’m going to base my response on using a high technology touch screen system with single meaning picture (symbols). Also, I’m going to assume that the number of keys on the array is more than 8, perhaps 20, 30, 40, 60 or more. You may want to let us know how many keys you are considering.

        Selecting a single meaning picture method means the following:
        1. Each word or message requires a picture
        2. Each new word or phrase requires a new picture
        3. A Variety of symbol sets are available to use
        4. Basic organizational issues are important – that’s your question!

        Here are the configuration types of touch screen displays you can choose to organize the vocabulary (based on the table on dedicated AAC technology features):
        1. single row (8 or less keys)
        2. row/column grid-type
        3. core/activity row
        4. visual scene (number of hot spots?)

        From the details of your question, I’m assuming that the vocabulary system you want to setup is not using a single row or visual scenes. I may be wrong. That leaves vocabulary organization for single-meaning pictures using row/column grid-type or core/activity row. For now, let’s leave out the core/activity row scheme, but NOT leave out visual scenes.

        I’m going to summarize the results from a study in the Journal of Speech, Language and Hearing Research. In this study (Drager, et. al. 2003), 30 typically developing children were asked to locate vocabulary items on AAC systems. Ten (10) children were assigned to each page arrangement scheme: activity-based grid, taxonomic grid and visual scene display.

        Each activity-based page (25 locations) was a grid based on an event like “eating cake” or “opening presents” and was accessed from a master page with four symbols.

        Each taxonomic page (25 locations) was a grid based on a broad category like “people” or “things” and was also accessed from a master page with four symbols.

        Each visual screen page showed a scene in a room with vocabulary “hot spots” and was accessed from a master page showing a house with four rooms.

        The results from the study show:
        1. Children generally could not find the correct page in grid-based page systems.
        2. Children did slightly better in the overall task with the VSD-based system, but still found less than ¼ of the words.
        3. The mean gain in vocabulary items found from the first to the last (fourth) session were .9 items for the taxonomic grid; 1.2 items for the activity grid, and 2.8 items for the VSD. However, 5 children scored 0 in every session and 14 children (47%) showed no improvement across all sessions.

        What are the most interesting results?

        Kids were tested on the same vocabulary for 4 sessions, but in the fifth session were tested on novel vocabulary. The children’s generalization was minimal (1 of 12 correct answers) with all 3 page-based conditions. HOWEVER, children found the most novel vocabulary on the taxonomic grid, the least on the VSD. The RULE-DRIVEN, de-contextualized nature of the taxonomic grid may account for greater generalization.

        Now, this was a lot to read, but I hope worth it.

        One answer to your question is that the organization of a grid-type display may get the best results when rule-driven & de-contextualized (not activity-based). It may be harder to maintain the rules in activity-based displays, because the nature of the activities are dynamic – always changing. It’s harder to maintain consistency, locations for vocabulary, etc.

        If we consider how we use language and vocabulary, we have difficulty “classifying” words beyond the basic grammatical categories (noun, verb, prepostion). Where do I store a word like pizza? Pizza is a very easy symbol to identify, but how do I put it in a food category? Italian food? Lunch? Dinner? Snack? "Well, we had pizza last night, and I want left-over cold pizza for breakfast." I'm not going to be satisfied until I get my pizza for breakfast! Do I go into a food page, than a snack page, and then find pizza when I’m talking about breakfast? Am I stuck on a breakfast-page with NO pizza? How does my memory work for retrieving words?

        No matter what systematic organization strategy you choose for vocabulary, you will always be categorizing words for someone else. The closer the word classification system resembles the rules of language, the more rule-driven (linguistic or language-based) the AAC system.

        With any row/column grid-based touch screen, once the vocabulary is larger than the number of keys on the array, you are facing the challenge of creating the rules for someone else to recall the location of vocabulary and the rules for grammar.

        Perhaps, looking at how some professionals selected and organized vocabulary for single-meaning picture language application programs would be helpful. Many programs are available on demo CD from companies or can be downloaded to explore how vocabulary has been selected and organized.

        I invite others to respond to Lynne’s questions. How are others organizing vocabulary based on single-meaning picture symbols? What factors go into your decisions? What results are you getting? You can look at the case study results I posted, and see that this 3 year old started with single-meaning pictures.


        Drager, K. D. R., Light, J. C., Speltz, J. C., Fallon, K. A., & Jeffires, L. Z. (2003). The Performance of Typically Developing 2 1/2-Year-Olds on Dynamic Display AAC Technologies With Different System Layouts and Language Organizations. Journal of Speech Language Hearing Research. 46: 298- 312.

      • Re:A word about devices - components of AAC technology - Pages and Grids posted by Terry Gibson on Apr 20, 2007

        Can I first describe the constaints in terms of number of cells to a page we are working to, and post separately on vocabulary arrangement?

        We are working on the final layout of a communication book so we can make a replica as a set of linked talking and writing grids on a PC (using Writing With Symbols). The book is A4 landscape to match the orientation of a computer screen. To maximize space and avoid too much page turning we use both sides, which I’ve just realised makes it portrait A3. We are going to re-do the pages A4 portrait so when the book is open it is landscape A3.

        The book is a reading and writing aid so we can only fit 20 cells to an A4 page and still have the words under each symbol in large font, and we want to Velcro a second set of symbol + word flashcards on top of each word that can easily be removed for sentence building, and hope that the taking of cards from the book and putting them back in their places helps to teach navigation of book, word types etc. The cards are easy to handle at this size.

        An A4 4x5 cells book provides A3 8x5 cells landscape per two-sided open page, 40 items in view. We’ll use coloured tabs down the edge of the pages to aid navigation between and within each group of words.

        The PC grids will have 8x5 cells for the words and symbols, with an extra column of buttons on the right in lieu of the book’s navigation tabs, and an extra row at the top for buttons to go to main grid, speak, delete, quickly access other predictably needed word group…

        The book is for building language skills and only contains 500 core words plus 95 additional nouns for early reading from Dolch. Whether we keep all 95 extra nouns in our core pages is under consideration as we want to use our materials in an experimental project to prove that a purely general core vocabulary provides around 80% of all the words our kids will want to say.

        We’ll make topic pages and materials for extra nouns and personal fringe words after project planning discussions and pre-project interviews with carers or on the fly.

      • Re:A word about devices - components of AAC technology - Pages and Grids posted by Terry Gibson on Apr 20, 2007

        Can I just describe the constraints we are working to in terms of number of cells to a page and post separately on vocabulary arrangement?

        We are working on the final layout of a communication book so we can make a replica as a set of linked talking and writing grids on a PC (using Writing With Symbols). The book is A4 landscape to match the orientation of a computer screen. To maximize space and avoid too much page turning we use both sides, which I’ve just realised makes it portrait A3. We are going to re-do the pages A4 portrait so when the book is open it is landscape A3.

        The book is a reading and writing aid so we can only fit 20 cells to an A4 page and still have the words under each symbol in large font, and we want to Velcro a second set of symbol + word flashcards on top of each word that can easily be removed for sentence building, and hope that the taking of cards from the book and putting them back in their places helps to teach navigation of book, word types etc. The cards are easy to handle at this size.

        An A4 4x5 cells book provides A3 8x5 cells landscape per two-sided open page, 40 items in view. We’ll use coloured tabs down the edge of the pages to aid navigation between and within each group of words.

        The PC grids will have 8x5 cells for the words and symbols, with an extra column of buttons on the right in lieu of the book’s navigation tabs, and an extra row at the top for buttons to go to main grid, speak, delete, quickly access other predictably needed word group…

        The book is for building language skills and only contains 500 core words plus 95 additional nouns for early reading from Dolch. Whether we keep all 95 extra nouns in our core pages is under consideration as we want to use our materials in an experimental project to prove that a purely general core vocabulary provides around 80% of all the words our kids will want to say.

        We’ll make topic pages and materials for extra nouns and personal fringe words after project planning discussions and pre-project interviews with carers or on the fly.

      • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Terry Gibson on Apr 20, 2007

        Sorry my last message posted twice.
        Our main system is semantic compaction – LLL 128 on a Pathfinder. We’re making a communication book and a matching set of talking / writing grids (dynamic system) for language and literacy practice, as an alternative communication aid if our machine goes in for repair.

        First we typed 500 core words alphabetically into Writing With Symbols 4 x 5 card template grids, using Widgit and PCS symbols.

        We used a Microsoft Word table with 500 core words in it and columns for word type and colour code as a reference, cut up the grids and stuck the word / symbol cards onto coloured pages per part of speech.

        Many parts of speech groups are naturally small, or they do not have many words that belong to them that are also in the 500 core words, so fitting them logically onto 20-cell pages has not been as problematic as we wondered if it might be. We’ve put the determiners and conjunctions together on one page. Question words on another. The prepositions take two sides. The 35 main pronoun variations take two sides. The pronoun abbreviation phrases (I’ll, he’s) one side. The most common indefinite pronouns fit on one side. One page is for word endings like –s, ed, ing, ly, er, est, ful, y.

        Initially we lumped all the adverbs and adjectives together (seven A4 sides) alphabetically, but on studying our pages once done we are so pleased to find that the time adverbs would fit on one page, the number adverbs on another and the remainder of the adverbs on another. The adjectives would divide nicely to the 20-cell pages in categories of colours, feelings, numbers, other. The nouns would also divide nicely into people, body, place, animal, and food etc. Adjective and noun pages will be rearranged before we print a final copy.

        As the vocabulary arrangement evolves we feel we are getting closer to many of the benefits of semantic compaction. A large proportion of the words require only two hits to reach them, the symbol on the contents page / main grid, plus the target symbol for a word on its page.

        Our fingers won’t be heading for a multi-meaning icon before our eyes have even seen a page, like it is with semantic compaction, because we don’t have the same icons in the same cells on every page, but for the word groups just mentioned learning the locations of the target symbols for such small logically related groups of words could become automatic, we hope.

        The verbs seem to be the group that most need further consideration to the arrangement of. There are around 145 verbs in the 500-core words list. 108 of them are root / present tense, the remaining 37 verbs being spread between past, irregular past, verb-ing, or verb-s tenses.

        It doesn’t seem practical to make separate pages for each verb tense with so few residents for any but the present tense pages, so we might have to keep this category alphabetical and think carefully how to label the buttons on the contents page. None of the following are very appealing ideas: Verbs 1, Verbs2… Verbs A-D, Verbs E-L… Green buttons with Ask-Drive, Eat-Light…

        Any ideas anyone?

        This is not a problem of either dynamic or semantic compaction. It is just a question of balance. Loads of present tense verbs are core words.

        There’s plenty of room on a 20-cell contents page to link directly to all major core pages, including linking directly to each adverb and adjective and verb page, as the adjective and verb pages only need one link per double page, so it will not be necessary to first go to a part of speech page and then to a ‘more of this category’ page. The noun sub-groups are our least priority, being person and context specific, so if we only had room for 20 cells on the contents page we would use one cell to link to a ‘more nouns’ or ‘topics’ contents page, which would only increase the file path to them by one hit.

        We can have a 40-cell contents page links to many noun groups and all sorts of personal pages and topics could be included on the main grid.


        • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by pwcassidy on Apr 26, 2007

          You said you are making anoher display "as an alternative communication aid if our machine goes in for repair". If you are using the Pathfinder 128 display, did you know Gail Van Tatenhove has posted a paper version of the Pathfinder on her website? (http://www.vantatenhove.com/) under the therapy materials and "free materials" section. She has directions on how to print and then use it.

          • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Terry Gibson on Apr 26, 2007

            Thank you for this. I've just had a look at Gail's site and I didn't find it. could you possibly give me the exact name on the link, or post the link to the page that this material can be downloaded from?

            • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Robin Hurd on Apr 27, 2007

              Terry, here is the link that you asked for.

              http://www.vantatenhove.com/showfolder.php3?id=18

              Be aware that Gail is an SLP from the USA, so her materials for the Pathfinder are using Unity, not LLL, the software version used in the UK. It might still be helpful to see it.

              For those who aren't aware, even though we speak the same language as people in the UK, the culture is slightly different, and the preferred version of the semantic compaction software in the UK is called LLL, not Unity like it is in the states. the pictures are slightly different, and some of the connections that are made with the pictures are also different.

              Making meaningful connections on AAC can be different, depending on a student's culture and native language, not to mention disability label and literacy skills.

              • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Terry Gibson on Apr 27, 2007

                Thanks Robin. It's great to be able to see your words are in the states, and a fantastic resource that I will be able to modify for Michael.

                Many, many times Michael's fingers hover over the icon for a word and he just doesn't know what the part of speech icon is - which with LLL you have to press before the word icon rather than after.

                I'm sure the LLL version of this manual communication board will help Michael to help anyone who works with him to find the right part of speech icon for a word, even if it is by '20 questions' or by process of elimination. His helpers should soon learn all they have to do is realise whether he is trying to say a verb, an adverb etc. - the context of the moment, the fact that there are so few potential parts of speech that would be relevant in each instance, should make this work.

                I made a words-in-cells resource for school, with just one word in each cell. It was A3 with one page for each part of speech, but no-one used it. Hope this one-page idea is more acceptable!

                Fingers crossed, Terry.



                • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Robin Hurd on Apr 27, 2007

                  Do you have nicknames for the parts of speech words? In the states, I have heard Herb the verb, the action man, the bridge words, the paintbrush words(adjectives), mother hubbard and her cupboard(nouns)...

                  At our house, I talk about the nicknames we use in the context of answering questions. If I ask a "where question, you will need a bridge word(preposition). (--in the box, under the bed, etc.) While that may be somewhat over simplified, it gets the boys to the type of word they want pretty well, and it is becomming automatic.

                  At least one speech therapist has taught this by having the child dress up as the character of the week, and then practice using that part of speech while in character. (the action man has a tool belt, grandma hubbard is an old lady, the determiner man has a magic wand to point with, etc.)

                  Little words that help make meaning clear can be difficult to get a mental picture of. (how can I make a picture of "now"?) Often these types of words that are necessary to communication but tough to show by picture are left out of AAC. When they are on an AAC system, it is important to understand that we will need to teach them directly to help form a mental image of what the word means, as well as to locate it on the AAC system.

                  • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Terry Gibson on Apr 29, 2007

                    Thanks Robin, yes we do a mixture of characterising the parts of speech icons like you are saying, or saying something about the type of the word we are looking for, or sometimes just name the type of word, orjust give the name of the icon needed, and we sometimes use the analogy of pages or folders even though our system has a static overlay.

                    We have a mother hubbard icon in LLL and she is the label for the word 'she' in the pronouns folder, the verb 'get', the adjective 'old', the pronoun 'she' in the asking phrases 'has she?, does she?, will she? etc., and the label for the group of phrases that start with the pronoun 'she'.

                    A Watch is our icon for the time adverbs (while, now, never, always, tonight.... ) and the icon for the number adverbs (again, another, other, both, pair, none, less, several, first...) is the Blocks with 123 ABC on them.

                    We talk about the time adverbs telling us something about 'When?' and the number adverbs telling us something about number -often answering 'How much?' 'How many?' 'Which?'.

                    If we are hesitating about where a time word is, (or the verb 'have') I might just hover my pointing finger over the area of the overlay where the Watch is while I see if Michael just needs time to remember, or give a hint by saying 'have you got the time?' or point to my wrist, or make the BSL sign for 'When?', or say 'it's in the time words folder / on the time page'.

                    The icon for 'Now' is a closed fist banging on a table so it's quite a good picture for the word!

                    We haven't really worked enough on the parts of speech and have built up quite a vocabulary just by learning the words. I'm looking forward to more characterisation and analogies and also very much to using Mad Libs that Amy and you recommend - just waiting for shipment to arrive!

                    I think the dressing up and role play is a great idea. Our friend's four-year-old will be getting a Minspeak aid sometime in the next few months and Michael and I want to help him learn it so we should have plenty of opportunity for fun learning sessions over the next few years.

                    Terry.



                    • Re:A word about devices - components of AAC technology - semantic and dynamic organisation posted by Robin Hurd on Apr 29, 2007

                      I like your "now" icon. We have the boy symbol. I tell my sons that's because boys always want things now, and they agree, so it works for us.

      • Re:A word about devices - components of AAC technology - agent-object-action posted by Terry Gibson on Apr 20, 2007

        To ‘speak’ write or read using our communication book or dynamic grids would mean selecting individual words from their pages and building sentences word by word.

        The computer grids could transport a user back to the main grid once a word is selected from those pages where it is not likely that the user would want to choose more than one word at a time.

        Pages from which a user might want to select more than one word could be set to remain open until the user hits the ‘go to main grid’ button.

        We have determiners and conjunctions on one A4 side in our book, facing the question words on another, which could all go on one 40-cell grid on the PC version so it would be a good idea for this page to remain open so a user could say things like: What’s that for? Who’s that? This and that. What if…? Because both of these, with this and that, or those with…

        Adding a pronoun or two and a verb or two is a simple visit to a yellow or green page… Oh no, not searching through 4 alphabetical pages for a verb. Or would it not be so bad?

        4 could be reduced to 3 pages if we went back to our original idea of putting the preverbs, as Gail Van Tatenhove calls them, on a page of their own. (In the book this would be before the pronouns to mark the fact that they are the only verbs that can go before a pronoun as well as after it).

        The preverbs are: have, haven’t, has, hasn’t, do, don’t, does, doesn’t, will, won’t, am, am not, are, aren’t, is, isn’t, would, wouldn’t, could, couldn’t, and must, may, can, should, might, shall, and their opposites.

        This would solve the label problem for one verb page on the main grid.

        Don’t know if it would cause any difficulty for a user to wonder why having, doing, done, being, and been, are in with the other verbs and not next to their relatives?

        We could reduce the remaining three verb pages to two by removing all but the present tense / root verbs and using our word endings page to modify a root if this is not too drastic. Two pages would be easy to search – half and alphabet each.

        Anyway, verb organisation headaches aside, it is easy to learn which page a word belongs to. The pages are either yellow, green, pink, blue, or orange and the main grid will have maybe 3 to 6 buttons of each colour on it.

        A second set of grids can be printed, cut up, laminated, and Velcro’d on top of each word in the communication book, to lift out and sentence build, or filed separately.

        • Re:A word about devices - components of AAC technology - agent-object-action posted by Robin Hurd on Apr 22, 2007

          It sounds as though you have undertaken a big project, Terry!

          As Terry is describing her dilemmas when trying to set up this system for computer and low tech supports in a way that makes sense and keeps the words readily accessible, she is demonstrating the pre-planning that needs to go into the organization of vocabulary on an AAC system.

          Once we get words on the AAC system, it really confuses the person using the system to make major changes in the organization of the words. So we need to make sure we get it organized from the start.

          We often think that people who are using AAC are looking at the symbols each time they need a word, so why does it matter if I move them around. While it may be true that people look at the symbols at first, motor planning quickly becomes a key part of accessing the vocabulary. For those who use AAC, who often have physical access or motor planning problems (apraxia) to begin with, messing with the organization of the AAC system once it is in use causes huge amounts of delay and frustration in getting to words, which can lead to abandoning the system altogether.

          The kind of pre-planning that Terry is doing is critical to success when organizing vocabulary for an AAC system, and it takes time.

          I'm going to lay out the steps Terry is going through in a numbered sequence.

          1. Chose what vocabulary will be on the final version of the AAC system. (You may choose not to have all of these operational at first, but you must know what your final product will be, in order to organize effectively.) Terry has chosen core vocabluary and dolch words lists to select the final vocabulary for her system.

          2. Choose how you want it to be laid out. Terry has selected her grid size and how many words will be on each page. She has chosen to have 1 main menu page, and wants to access the other pages directly from this one, without having multiple layers of pages, if at all possible.

          3. Choose how the words will be organized within the page. Terry is debating how to organize the verbs, because there are so many of them in her chosen vocabulary lists. A page of pre-verbs and a page of verbs? Alphabetical order or frequency of use? These are the questions that she is currently trying to solve as she organizes her words.

          As we look at what Terry is doing, we can see that this has been a multi-step process that she did not complete in a couple of hours, or even a couple of days.

          In order to come up with a system that is logical to the end user, provides sentence building words, and is organized in an accessible way, the designer of the system should begin to do the organizing and take frequent breaks to look at the big picture and make sure that the system is going to work well as a whole, finished system. Words can be added along the way, but the organization itself needs to work well.

          Too often, a system is designed with just the beginning vocabulary in mind. As the vocabulary grows, the number of pages and the complexity of getting to a given word grows. This increases the motor and focusing demands on a child, making the system more complicated to use and causing frustration and abandonment.

          Carefully walking through this process can make this less of a problem, but it is a big time investment. Choosing an AAC system that includes a language program already can greatly reduce the amount of time spent in programming and organizing the vocabulary. In an earlier post, I mentioned the programs that are available, but I want to re-direct your attention to this if you are considering designing your own system.

          • Re:A word about devices - components of AAC technology - agent-object-action posted by A. Davis on Apr 24, 2007

            Thanks very much for this explanation, Robin. I've tried hard to understand this discussion, sometimes reading a post 3 or 4 times. I've found Terry's posts very interesting, I really like the idea of someone participating so actively from England. But a lot of what she's written I haven't understood (same with others). This post really helped me better understand the process she's been sharing with us. While I haven't yet come across a family dealing with these AAC issues, I know that I will at some point (I'm a school principal in a small city.) This discussion has been invaluable in sensitizing me to what certain families are up against and how to better support them.

            • Re:A word about devices - components of AAC technology - agent-object-action posted by Robin Hurd on Apr 24, 2007

              If there are other things that you don't understand, please ask! AAC has its own set of words we talk about and it's easy to forget that not everyone who can benefit from this discussion is going to understand the same words.

              This discussion will be archived, so if and when you do have a student in your school who is not able to speak, you can come back to the discussion and re-read it.

          • Re:A word about devices - components of AAC technology - agent-object-action posted by Terry Gibson on Apr 25, 2007

            Thank you for clarifying our processes Robin. You’re so right about the time investment and complexity of the task of designing a system from scratch.

            We don’t really intend extending the core pages much beyond their original content, as this tool is primarily to focus on general core words, and to give friends who have no AAC an introduction to building phrases and sentences with core words.

            A five-year-old child has a vocabulary of over 2,000 words, which is way beyond the scope and reason for this resource and such a comprehensive vocabulary would contain many fringe words that would obscure the general core rather than highlight it.

            We’ve left space for a six or seven new verbs per (double-sided) page and will leave spaces on the adjective pages also.

            An individual user can as many topic and extra nouns pages as they wish added to their book without interfering with the core pages – we can link to a topics contents page and a nouns contents page from the main page.

            We hope to make a DVD with a group of children using these materials to say and write whatever they choose, and that if the children wish to be formally assessed for a communication aid as a result of their experiences, hope they can use their DVDs to support their applications.

            Our broader aim is to re-invent the wheel by measuring what % of everything the children say during our project exists in the 500-core words, to raise awareness of the value and essential nature of core words, and to raise expectations of and for our kids.

            Now for today’s headache:

            How to arrange the Adverbs and Adjectives pages and label their contents page buttons means considering the placement of words which belong in different parts of speech groups (Adverbs and Adjectives) but which have close relations in meaning (semantics?) e.g. the time adverbs: now, never, always, tomorrow, tonight and the time adjectives: before, after, early, later… and likewise the number adverbs: again, once, twice, much, and number adjectives: 1, 2, 3, many, more, first…

            Do we leave the adverbs and adjectives all together, with numbers, colours and time words interspersed alphabetically in one list, and label them Afraid-English, Enough-Lot in the same manner we did the verbs?

            Do we have one Time Words page (adverbs and adjectives together) and one Number Words page (adverbs and adjectives together)?

            Or do we have Time Adverbs, Time Adjectives, Number Adverbs, Numbers, Colours, Feelings, Other Adjectives…?

            The words fit quite easily to any of these arrangements. Linking and labelling is the only consideration.

            I’m happy for now with the look of six verbs buttons for Preverb, Ask-Draw, Drive-Count… so long as I remember this book is a dictionary, literacy aid, and AAC taster pack, which is not intended to be used as a substitute for a more sophisticated system.

  • core voca posted by Enter name here on Apr 09, 2007

    Hi
    What I am going to say may be rubbish but I becomeing aware that that core vocabulary might be is going against in my view the fundamental pracipe of aac that is in the words of steven hawing “the freedom to spaek is more important than the freedom of speach”. No one would bargain the words that he would use to the “most important” words to learn. Just think about this?

    • Re:core voca posted by Katya on Apr 09, 2007

      Thank you for your comments. We appreciate everyone's opinion! Yes, we may even need to liven up the discussion. So let me react to your post.

      First, I believe if we were to perform a vocabulary frequency analysis on one of Steven Hawking's books, even though the central theme may be astonomy, the percent of core vocabulary would make up 80-85% of the text.
      Although, I'm a speech-language pathologist (SLP) I need my core vocabulary to explain and discuss the terms unique to communication disorders. So if you taped one of my class lectures and made a transcript, I would use mostly core with a lot of single or double uses of fringe vocabulary. Knowing this, my fringe vocabulary is VERY important to me as an SLP. Steven Hawking's "most important" words may be related to astonomy, quantum physics, etc. Mine are related to augmentative and alternative communication.

      Second, in considering AAC interventions for children, learning to use language is crtical to educational success, if not overall quality of life. Core vocabulary allows children to start putting words together, make sentences, make more complex sentences, and learn to read. So we must consider access to core vocabulary or we are not holding the best interests of the child in mind.

      Just for fun, we might look at the Hawking's quote for core vocabulary. Quite a few words! But that's what makes the issue of vocabulary selection and organization, not to mention, AAC intervention so complex. We value and appreciate everyones insights!

      • Re:core voca posted by Mariana on Apr 09, 2007

        wow!! selecting vocabulary!
        I know it's different to teach language use in communicative situations to a child with motor involvement, but we got a lot of difficulties in decisions when selecting core vocabulary for my ASD son to learn academic skills. We live in Argentina and we can't get a system with vocabulary selection and prediction in Spanish. We did everything in low tech.
        I found out that once the child gets the structure, he is able to use it and remember the words, at least those high frequency words.
        I think in every disability the core is learning to communicate and use a language to it. Later, the same child guides you to help him. Mariana

    • Re:core voca posted by Robin Hurd on Apr 09, 2007

      The goal of AAC is the most effective communication possible for the person who uses AAC. When we keep this goal in mind, we provide vocabulary that allows the person who uses it to communcate what he or she wishes to say in as quick a method as possible.

      The 2 factors here: "what I wish to say" and "how fast I can say it" are dependent of the individual. Different individuals have different ways of accessing the AAC system, and they will have different "special" words that they will want to use on their AAC system.

      Even so, every individual needs to use the "little words" that help make their meaning clear.

      Children who have never spoken have an even greater need to be able to use and explore the "little words" that they will see when reading books, hear when others talk, and use when writing, because they haven't ever been able to use them.

      It's not that we are recommending that the "special words" that are important to a person who uses AAC be left off their AAC system, it's just that having access to ONLY those "special words" does not give the child who uses AAC the chance to develop the language skills they need to reach their full potential.

      As an example, my sons have "spinning wheel" on their AAC systems. Why? because we have a spinning wheel in our home; it's just another piece of furniture to them.

      However, many of the words that we have focused on teaching the boys have been the "little words" that help to make their meaning clear. "Now, stop, in, on and off" are probably the most powerful words they know and use, because they can make their point crystal clear with these words. "Stop. I want now Joshua foot off Pathfinder" communicates very clearly how Caleb feels about his brother's foot touching his AAC system! The only words in that sentence that are not core words are the name of the AAC system and the name of his brother.

      Too many children are given AAC systems full of nouns, and have very little power to communciate clearly to the people around them because of the vocabluary that has been chosen or left out.

      • Re:core voca posted by Marla Humphrey on Apr 10, 2007

        I am a para for a 9 year old girl who is non-verbal and uses an AAC device. I agree with the statement about giving people the ability to say what they wish in as little time as possible. However the child I work with also has motor difficulties causing slowed timing. She has 8 buttons on her device and links to further pages. I know she is very frustrated about getting out what she wants to say and her friends will not stay around long enough to listen so she does not like to use the device. Some things can take as many as 4 or 5 page sets to get to what she is wanting to say. She mostly uses the device to answer my questions about school work. My question would be if you put little words on and take up those spaces, wouldn't that be even more limiting than what we already do? I do most of the programing for her device and have tried to incorporate at least 2 button comments in some places to allow for some sentence structure. An example would be 1st button "I want a drink of", 2nd button "milk". This seems very limiting for her and I am wondering if anyone has any experience with getting a child to access their device when there are only preprogramed statements, maybe not really what she is wanting to say.

        • Re:core voca posted by Katya on Apr 11, 2007

          Dear Marla,

          This is another situation in which providing suggestions or strategies is very difficult without knowing more about the child’s abilities and skills. As soon as you mention “motor difficulties causing slowed timing” resulting in the recommendation of an 8-location display, a stream of questions flood my mind.

          First, I’m assuming that she is using single-meaning pictures (SMP) to access an 8-location touch screen device, but how many symbols does she know? This equates to how large is the expressive vocabulary she has to access on her system. This is not the same as how many symbols are available on the device. How large is the available vocabulary you’ve programmed on her pages? Also, I would be interested in knowing how many pages have been programmed? You can do a calculation for how many symbols/words she uses (knows) versus how many symbols/words are available on her pages. Looking at the frequency of core versus fringe vocabulary and the frequency of single-word access versus pre-programmed messages can offer insights into how the system supports the features of a natural language.

          Here are data from one of my clients. These data were collected from a 2.5 year old boy with developmental disabilities on trial for a SMP 8-location touch screen system. He was able to use direct keyboard selection using a keyguard without significant physical effort. The results show the number of pages and symbols identified and used spontaneously for functional communication after a 3 week trial. We collected LAM data, and the family confirmed vocabulary they observed used “correctly” at home. In other words, we verified use before giving credit. Note that a “go back symbol” was on 5 of the pages to return to the main page and navigate among the pages.

          Name of Page Words Used # Words on Page
          Want page 5 8
          Toy page 4 7
          Bubble page 7 7
          Fun page 3 7
          Read page 8 7
          Food page 4 7

          Total 6 pages 31 43

          This child had learned (was using functionally) over 70% of the available vocabulary/symbols on the 6 pages within 3 weeks. Note, he had learned to use an abstract symbol to navigate pages, too.

          Once we confirmed access to this size of successful symbol representation, we realized that we needed to increase the number of symbols on the array to provide access to more vocabulary to provide for a more rule-driven approach to build language skills. This child had no difficulty identifying picture-producer symbols, e.g. common nouns/objects. Using a keyguard, we were able to increase to 40+ locations using the single-meaning picture method organized by core and activity rows.

          Your challenge is to justify the need to increase the number of keys on the array based on data that show this child has an expressive vocabulary already larger than can be supported on an 8-location device. If this is the case, then the team needs to reconsider access.

          Not infrequently, direct keyboard selection is not the optimized approach. Individuals will make decisions that compromise the integrity of the vocabulary/language over being able to use direct keyboard selection. Sometimes, and I don’t know this case, team members may not be familiar with making decisions about alternative access or selection techniques. Again, I don’t know this case, so I’m not sure if you are struggling with managing vocabulary on 8 locations when the situation might be addressed through alternative access.

          I guess I’m saying that you need to answer whether the selection technique has been optimized before considering major changes in vocabulary selection, re-organization, and re-programming, because the child's abilities and skills require the 8-location limitation.

          To the readers: suggestions on how others may have solved building language skills and improving communication competence using SMP on 8-location pages would be helpful. Please, consider sharing the strategies you’re using and the results being achieved? I think knowing the process people are using to decide when to increase the vocabulary or move up to more keys on the display would be valued, too.

        • Re:core voca posted by Robin Hurd on Apr 11, 2007

          It sounds to me like she is doing an awful lot of navigating and less talking. One way to fix that is to provide an AAC system with more symbols available at one time, as Katya said.

          You mentioned programming in some 2 hit messages, such as "I want a drink of" and "milk". What if you simplified the first hit to "I want"? Then, it can not only work for drinks, but also for toys, books, games, food, friends, or the words "this" and "that" to get things she doesn't have words for on the device. It's amazing what you can get with "I want this". Remember high school foreign language class? :)

          What basic words like "this", "that" and "it", as well as some simple phrases like "I want, I can, I will, I don't like" can do for a child on a device with limited space available and limited motor skills is to provide multi-purpose words, so that you DON'T have to fill up limited space with lots and lots of specific names of things, but the student can still communicate.

  • Vocabulary use - case study outcomes posted by Katya on Apr 09, 2007

    I promised some clinical data on how children (with cognitive disabilities) learn and use vocabulary on AAC voice output systems. These data are from a preschool girl with cerebral palsy I saw in therapy starting when she was 3 years old (Hill, 2003). Her medical and educational records included the diagnoses of developmental disabilities with mild-moderate mental retardation and severe dysarthria secondary to cerebral palsy. She was using a 45 location single-meaning picture method on a touch screen display system with synthesized speech. She was able to direct select using a keyguard.

    Intervention could be described as a child-centered approach based on Mileu Therapy which included parent and Preschool staff training for carry-over of strategies across environments. Therapy-room materials that were good joint activities or motivated repeated (interactive) turn-taking included: tea party sets, baby dolls, doll house, bubbles, music. Mom was an integral part of each therapy session, either as an active participant in the routines or observing and providing comments about her daughter’s performance. The family’s schedule prevented weekly therapy sessions, but we tried to maintain twice a month sessions to monitor progress.

    For our discussion, you will be interested in seeing the results of her vocabulary use patterns and the words she was given credit for using “functionally” during play-therapy. Also, we crossed referenced words used in therapy with words identified by mom as being used consistently at home, etc. The combined vocabulary list after thirteen weeks totaled 63 words/symbols. We believe that she had “learned” or was using several more nouns/words using graphic symbols that were highly representative, but not verified across environments. The built-in language activity monitor was used for data collection, and therapy sessions were tape recorded to confirm performance (Or inter-rater reliability; remember these services were provided through a clinical training program.)

    Before I paste in the vocabulary lists, I would like to invite others to share some results about the order words are being learned, and how progress is being charted to keep track of vocabulary use patterns. What strategies are being used to support vocabulary learning and use?

    Here are these case study vocabulary outcomes listed in alphabet word-order by week:

    WEEK ONE
    baby
    blow
    bottle
    bubbles
    down
    feed
    food
    more
    pick
    pop
    up
    wake
    yeah

    WEEK TWO

    cup
    drink
    I
    louder
    music
    plate
    pour
    sing
    song
    stop
    tea
    teapot
    turn
    drink
    I
    turn
    stop
    cup
    tea
    teapot
    plate
    music
    louder
    song
    pour
    sing

    WEEK FOUR

    eat
    like
    my
    need
    play
    please
    sleep
    that
    this
    want
    you

    WEEK EIGHT

    apple
    banana
    bedroom
    come
    do
    end
    go
    it
    NAME
    not
    popcorn
    put
    NAME
    what
    yogurt

    WEEK TWELVE

    color
    feel
    get
    happy
    help
    pink
    purple
    say


    WEEK THIRTEEN

    bed
    make
    mommy
    read


    COMPLETE ALPHABETIC WORD ORDER LIST
    apple
    baby
    banana
    bed
    bedroom
    blow
    bottle
    bubbles
    color
    come
    cup
    do
    down
    drink
    eat
    end
    feed
    feel
    food
    get
    go
    happy
    help
    I
    it
    NAME
    like
    louder
    make
    mommy
    more
    music
    my
    need
    not
    pick
    pink
    plate
    play
    please
    pop
    popcorn
    pour
    purple
    put
    read
    NAME
    say
    sing
    sleep
    song
    stop
    tea
    teapot
    that
    this
    turn
    up
    wake
    want
    what
    yeah
    yogurt


    Hill, K. (2003). The use of AAC performance data to support evidence-based practice with a preschooler. In Proceedings of the 2003 RESNA Annual Conference [CD-ROM].

  • AAC in autism posted by Mariana on Apr 09, 2007

    I couldn't decide where to start with AAC with my nonverbal child. I stop by, and looked at those worst behaviors he had. He used to take out all the kitchen stuff until he could get something he wanted. I decided to start on manding those items I knew he liked. He was 5 years old when we began with AAC. After two weeks, he had a display in the refrigerator to use as PECS, and no more mess. In two weeks he had 30 mands options and he used all. We went on phase V.
    I run an educative center nowadays. We look for extremely bad behaviors and find their function in order to start AAC. We always find that agressive behaviors are connected to communication items. We have an experience with a severely autistic child who head bangs when not wanting to do something. We put a black and white line drawing picture saying "I don't want" and he changed his behavior in a week.
    My son grew all his language thanks to AAC. He is now speaking three word sentences (orally), asks Why and produces complex sentences in subordinates but by propositions. We started late, he is 13 now and goes to regular school with aids just in some classes.
    I'm pleased to participate in this discussion room. Mariana

    • Re:AAC in autism posted by Robin Hurd on Apr 10, 2007

      Mariana,

      We just can't say it enough: if there is a bad behavior, there is something the child needs to communicate, and can't. Give the child access to the words and teach them, and the behaviors lessen.

      Setting up a behavior plan that does not include communicating about the situation, does not take care of the root problem.

      I love your great examples. Both parents and teaching staff can benefit from these(I know there are lots of head-bangers out there!)

      We started very early with words to label emotions. My verbal but autistic son was learning them, so the twins who use AAC learned right along with him, and behaviors dramatically changed.

  • AAC and visual impairments posted by pattty on Apr 10, 2007

    My son is totally blind. He also has cognitive and physical disablities.
    As many of you can relate, I'm sure, when people see all the challenges my son has, then hear him speak using AAC...well it changes their perspective. Having a voice changes everything!

    I would love to connect with others who have a child using AAC that is also visually impaired or a professional that works with visually impaired AAC users.

    As you can imagine, learning a device is a titch :) more challenging if you can not see it. And so many of the tools to teach and support his learning are visual.
    He got his first device at about 6 yrs old. It was the old Alpha Talker. We started with an 8 location keyboard, but that didn't last long. He over time moved to a 32 location keyboard and had 24 themes. The Alpha was all voice recorded. There was no dynamic display.
    A keyguard for him is essential, the only way he can learn where vocab is is to memorize location. So, the keyguard is essential, but we also tactiley marked all the words..at first..we used all sorts of things...buttons, feathers, pieces of balloons, anything with a touchable, different feel to it. We eventually realized that we needed to only tactiley mark certain locations, they serve as sort of a map to him to find vocabulary.
    Also, counting helps him here. For example, "yes" might have a tactile marker, and two words over is "please".
    I will point out that covering up words with tactile markers poses a problem for us sighted people teaching him...because we can't see the words! Having some copies of the layout around helps a lot. We had a huge one made for his classroom at school.
    He's had a Pathfinder for about a year and 9 months. We used the same principles of tactiley marking vocab and usually add a tactile marker if he's learning a new word. We also marked all the vowels, and we used puffy paint to outline the keyboard where the alphabet is when he's in "spelling mode". The dynamic display would be useless to him, without the overlay the PRC made for him. It's made of plexiglass and has holes where words would be on the activity row. It fits right on the PF. So he has a way of finding choices and words on the display.
    A biggy is making sure we put language on as many non-vocab keys as possible. So for example, the clear display, says "clear" when he uses it. And when he toggles between spelling and speaking it says "spelling" or "talking". When he uses a period, it says period. (when he pushes it, not when the device repeats what he's said) He really needs the auditory cues to let him know where he's at. PRC also changed his software a little, but it made a HUGE difference. In activities, they changed some stuff. I don't want to get too device specific, but if somone wants to know, let me know.
    Pathfinder has auditory scanning available. We did try it with Ivar for awhile, but it was very confusing to him. For some people, it may help a lot.
    Again, I would love to connect with anyone else out there in a similar situation. I have found that it is not that common to be a blind AAC user and taking any and all help I can is welcome. ~ Patty

    • Re:AAC and visual impairments posted by guest on Apr 10, 2007

      My daughter is also visually impaired and also has CP so she does have motoric issues. We are in the process of finding what device would be best for her to use. We know it has to have auditory scanning, and she also step scans with two switches. She is beyond the tech talk devices....she has language but is not intelligible to most people unless you are very familiar with her or you know what context she is speaking in...even then so many things sound the same. School does not want to use anything with overlays....too time consuming, etc. I had her evaluated and we are really at a crossroads on do we go with a computer based device or a dedicated device. She does use the computer quite a bit with specialty software.
      I really do not know what to do. She talks all the time but it is so frustrating not to understand her or to see her dismissed or not understood at school and in the community!!!!

    • Re:AAC and visual impairments posted by Robin Hurd on Apr 10, 2007

      Patty,

      I am so glad you shared your experiences! So much of what we do to teach AAC is visual, and your son's team and you have had to adapt many things because he has no vision.

      I hope that others will share their experiences of what has worked for them.

    • Re:AAC and visual impairments posted by Katya on Apr 11, 2007

      Dear Patty,

      Thank you for sharing about your son.

      I want to say a few words about strategies to use with individuals with significant visual impairments who rely on AAC. Stating the obvious, visuals problems interfere with a person’s ability to benefit from visual displays thus requiring feature modifications to maintain access to the technology. If we look at features created to provide access to computers (computer display) for individuals who are blind, two main approaches are used commonly; screen enlargement and screen readers. In addition, access to print may be provided by Braille and access to spelling may be through Morse Code.

      Approaches to screen enlargement and screen readers have been applied to AAC assistive technology. Here are descriptions of the approaches.

      Screen enlargement is typically based on using the largest practical display size and reducing the number of keys available until the individual can recognize or identify the symbols. If a person can identify the symbols on the 8-location display, but not 12 or 15 locations and certainly not 30 or 40 locations, then 8 it is. However, we’ve seen the significant challenge to selecting, organizing and maintaining a rule-driven system to support interactive communication with only 8 locations on a display.

      When this method doesn’t get the desired results, then the “screen reader” approach can be applied to the AAC system. This is called “auditory scanning.” High technology AAC systems all work the same basic way, scanning each key by saying the label or name of the key, when the person hears the label/name for the desired word/phrase a switch is hit to select the item. The individual ususally wears an ear piece, so the communication partner isn't hearing both the label and the target. No matter how advanced the technology and the availability of features to customize the handling of the approach, it requires the person listening for a target and hitting a switch – VERY SLOW.

      The benefits of auditory scanning over enlarging the size of the symbols, is that now you can have more keys with more vocabulary. Yet, once you have vocabulary needs/demands above the number of available keys on the array, you run into those nasty organizational issues again. According to Beukelman and Mirenda (pg. 90, 2003), “when multilevel displays are available in electronic auditory scanners, the person must be able to remember the categorical topic scheme used for organization. For example, if messages are organized by main topic (e.g. food, drinks, places, people), the person must remember that COKE is a message under DRINK… However, if vocabulary increases and you have to add two levels, this categorical scheme can become even more complex, and COKE might be a message under SOFT DRINKS, which is a subcategory of DRINKS.”

      Auditory scanning increases the cognitive load by the memory demands and the necessity to retain the organizational scheme for the vocabulary that was imposed by the person doing the programming.

      Unfortunately, I haven’t been able to find any published performance data on people using auditory scanning. I am aware of some data that’s been collected clinically. I’ll keep looking, because I’ve used this method and I've seen this method being used very effectively!

      What’s left for teams to consider is Braille and Morse Code; both of which require literacy (spelling and reading) skills. Right now, I’m going to hold off discussing either of these approaches, because I feel we should consider vocabulary selection and organization for the two most widely used approaches: 1) graphic symbols that can be visually identified, and 2) auditory scanning.

      Thank you in advance for contributing your insights into this important issue.


      Beukelman, D. R. & Mirenda, P. (2003). Augmentative and alternative communication: Supporting children and adults with complex communication needs (third edition). Baltimore: Paul H. Brookes Publishing Co.

      • Re:AAC and visual impairments posted by patty on Apr 12, 2007

        For my son, auditory scanning was not effective because it confused him. Screen enlargment wouldn't help, because he is totally blind. Every child is so different. Ivar does have multiple disabilities, not just blindness. The good thing is that his fine motor skills are good enough to physically select choices on his device using his hands and fingers. So many factors affect his ability and willingness to learn.
        Ivar had a device with 32 locations, but also had 24 themes within those locations. So, he did have to memorize a lot. He was successful in learning and using those themes and accessing on his own. This was the old device.
        The new device has 128 locations on the static part and endless on the dynamic display. Lots of memorizing to do for him. He has a Pathfinder. I know this discussion isn't device specific, but you knowing what device I am talking about might help. (I know Robin is VERY familiar!)
        It can be overwhelming deciding what to teach him and keeping the organization, as you mentioned, consistent. That organization piece is critical to a blind person.
        I have found keeping choices to the minimum more effective, not to overload him. For example, if he says I- eat- (then choices come up for eat) there are 7 choices. His top 7. I could program way more in, but then he'd be scrolling through, having a hard time remembering where he's at and that's just frustrating.
        He has a Pathfinder and has made progress. He uses single hit, and the language is simple, but gets his point across.
        yes, no, thank you, please, like, do, want, new,more,eat, go, get,sit,give, help, take, wash,hear, hot He uses all these with other vocab attached. In other words, he might say I-like- you. I -want -new- story. I -want- hot- popcorn.
        Help! ~ Patty

        • Re:AAC and visual impairments posted by patty on Apr 12, 2007

          Ivar also is a good speller, so if all else fails and I haven't programmed in a word that he's trying to say, he will spell it or attempt to phonemically. He can toggle between talking and spelling on his own and does so all the time.
          So, keeping choices to a minimum and hoping I've chosen the right ones is okay usually, because he will revert to spelling if he can't find the word. Not ideal usually...spelling slows him down, but with his challenges, this is okay???!!

          • Re:AAC and visual impairments posted by Katya on Apr 12, 2007

            Patty,

            Thanks for sharing so much about Ivar. Since you mentioned that he is able to direct select on a 128 location device (which meaning a relatively small key-size for those that don't know) is he learning Braille? If not, has Braille been discussed as a possibility in the future?

            Also, are any readers on the discussion working with someone with visual impairments using AAC that is learning or uses Braille? What other tactile symbol methods are people using to represent vocabulary for children with visual impairments? Please, consider contributing to this thread of the discussion. Almost no published evidence exists, and VERY LITTLE is published in the AAC literature about this topic.

            • Re:AAC and visual impairments posted by patty on Apr 13, 2007

              Yes, Ivar does know some braille. It's something that's worked on at school. Up until now, I always thought functional braille, not using it to read. Not sure if I am right, but now I am thinking we need to address learning braille differently.
              I have asked his VI teacher to become more involved with teaching him vocabulary. If he can read braille..even a simple word and tell us with his device what it is...he's READING!

              If there is someone out there, near us, that would ever want to observe Ivar or work with him....to research and help other blind AAC users...I would be open to that. It is different.
              ~ Patty

              • Re:AAC and visual impairments posted by Katya on Apr 13, 2007

                Patty,

                Is there any possibility that Ivar can use Braille to select keys? Since the Pathfinder has a static overlay, it might be possible to add Braille as key labels. I'm wondering about an integrated system combining auditory scanning and Braille. Haven't completely thought this through yet. I know our topic is vocabulary, but we're looking at how technology might be used to enhance access to vocabulary.

                Has anyone ever suggested Morse Code as an indirect spelling method? Morse Code can be an effective method for individuals who are blind and need AAC. The first client I set-up with 2-switch Morse Code was blind and in 6th or 7th grade.

                Katya

                • Re:AAC and visual impairments posted by patty on Apr 14, 2007

                  It would be possible to intergrate Braille. Maybe. He needs to learn it better. The spaces are very small also. We did intially put Braille on the alphabet, but soon realized he needed some tactile things to help him learn the alphabet layout on the device. I am not convinced auditory scanning would be a good thing for him. I mentioned that we tried it and it was confusing to him. But perhaps we should try again.
                  Morse code? I am not sure how that would help him. I guess I don't understand how that would be used. He already spells well.
                  One of our goals is Ivar learning more core vocabulary. So, I suggested to the Vision Impaired teacher who is responsible for teaching him Braille; to integrate those Braille lessons with learning more core vocab.
                  My ultimate goal being that he becomes more proficient with his device.
                  So, if he practiced reading specific Braille words that came from the core vocab on his device then he could transfer that to learning the location and use of the core vocab on his device. Does that make sense?
                  For example if her words of the week were new and get. He reads them in Braille, finds them on his device, then also practices use of those words and ideally those same words would be words used throughout his school day/ week. Lots of planning and preparing and making sure everyone is on the same page. (Multiple disabilities means multiple staff in his case)But seems very doable.
                  Does that make sense? Am I missing something? ~ Patty

                  • Re:AAC and visual impairments posted by Robin Hurd on Apr 14, 2007

                    That makes a lot of sense. The words that he will first lern in Braille should be the basic words that build sentences and/or are easy to decode. It should not be hard to go through his AAC system and pull out the words that you want him to learn, both on his AAC system and in braille. Looking at the lists of high frequency words that have been posted on this discussion might yield plenty of words to start with.

                    He can practice reading the words in Braille, finding them on his AAC system, spelling them in Braille (does he need adaptations to do this?) or on his AAC sytem, and even chunking the word in to parts of sound (/c/ plus "an" equals "can"). He can also branch out into reading Braille for other words that have the same word ending(pan, man...) and words that are similar but with a different word ending (man to make, for example).

      • Re:AAC and visual impairments posted by Cathy on Apr 15, 2007

        Dear Katya,
        My 7 year old daughter is visually impaired and physically impaired as well as cognitively, however she is constantly blowing us away and we (family) as well as the professionals in her life are realizing she has much more going on. She is very verbal, but not very intelligible. I understand her pretty much for the most part when and those that are close to her when you know the context of what she is talking about. She does not spell or read yet. We are trying to get her to learn using Edmark. She is not a Braille candidate. She uses two switches and does step scanning. She has an amazing memory!!!! Her hearing is very keen also. She is also very musical (I am watching her now in her gait trainer just singing and dancing away). She memorizes tunes and words to every song she hears.
        Anyway, because of her motoric and vision issues using a system that she has to locate with her hand and vision to activate is out of the question. School has her with the tech talk 8 but they do not use it for communicating. She has too much language for it...and the staff has been honest in saying they do not have time for overlays. She has recently had an assessment done. We are all stumped on which way to go. She uses the computer for fun and educational needs. She uses much of the Laureate Software and Intellitools Classroom Suite. Would it be best to put her on a computer based system like Dynavox or the Mercury or a dedicated device like Tango. Unfortunately during the assessment they did not have any of the devices properly setup for auditory scanning and for scanning.....
        What would you suggest?
        She is in a self-contained ESE class right now. I would like to see her do some mainstreaming soon. She would have to have a portable computer and AAC device. Her independent AT and Vision consultants believe this for her. I just seem to have to make it happen and find what is best for her and prove it to the school.
        They also said that Classroom Suite wasn't right for her so I downloaded a trial, got switches, and she figured it out in a week (step scanning and doing activities that support that.)
        Thank you,

        Cathy

        • Re:AAC and visual impairments posted by guest on Apr 16, 2007

          Dear Cathy,

          Thank you for the details. Of course, it's difficult to provide specific recommendations for your daughter. However, I can review some of the principles I would follow regarding evaluating an AAC system. Before I do that, I would like to have a better understanding about the team's and your impression of your daughter's language skills. Although your daughter is 7 years old, what do you think her auditory comprehension skills are like? Does she understand the words and sentences similar to her 7 year old peers? If not, how would you identify her auditory comprehension skills? Do you think she has a receptive vocabulary over a few thousand words? Then, what is her current expressive language like? Can you provide an example of how she puts words together?

          Also, from your message, I get the impression that we have a 2-track approach to identifying and implementing assistive technology. First, you're concerned about identifying the AAC interventions that will build communication competence. Second, you're implementing computer-based software for curriculum objectives, e.g. Edmark, Laureate and Intellitools. A wide-range of educational objectives can be targeted using these programs. I'm wondering about what learning priorities have been identified using these programs. Any particular entry or grade-level on the programs? Are you working on activities within a specific curriculum, e.g. pre-kindergarten,kindergarten, 1st grade?

          I appreciate your providing more information, because that will help in bringing more appropriate evidence and principles to the discussion.

          Katya

          • Re:AAC and visual impairments posted by cathy on Apr 18, 2007

            Katya,Thank you for your response.
            My daughter's auditory comprehension skills are much better than her expressive skills. She understands everything said to her if she has had experience with it. She uses please, thank you, yes, no, etc. appropriately. She will put sentences together like "I want to play computer please" or "Turn the light on/off,(open,close door, etc.) please" She will tell me what video and title she wants to watch. She will shorten a lot of things because she know I know what she wants like "I eat" if I say how do you ask, then she will say "I want some potatoes please (or whatever)".

            When she wants to be held she will say "I hold you momma." The other day in the tub she was splashing and said "Momma....ocean (while doing a big splash with her leg.) She really says so much. She is very strong willed (not to mention bossy) and does get very frustrated when she is not understood or when you don't do what she wants. When she is playing on the computer like with one of the Laureate programs (she does Nouns&Sounds, First Words, Verbs, Categories) she will tell me if she wants black background or scenery and if she wants sound off or on. One of my biggest challenges with her though when communicating is keeping her focused and understanding the two way conversation. Someone may come up to her and ask her something but she will focus on saying what color shirt they have on. Or just staying focused on the conversation. She loves to be asked things though to challenge her. She loves to get things right...She could be asked all day long what did you eat for...what color is grass, sun, barney, etc...what is your brother's name...what did you do today at school....who did you work with...This can go on and on.

            As far as using the computer and software I can't say exactly what are her learning priorites or if there is any specific curriculum. The staff does not seem very knowledgable about it....I pushed for AT and software and getting her to scan. She has it, can do it, now what? She does struggle with the math concept of how many of something there is (one-to-one correspondence I guess you call it). She can rote count till the cows come home but won't tell you there are 3 crayons in front of her. Okay they may not be fair because of her vision, but for example if they ring a bell 3 times, she will count along 1,2,3, but not listen and say 3. Same thing with trying to teach her to read she will identify the letters instead of looking at the whole word.

            She is self-contained ESE in a varying exceptionalities class and is in the 1st grade (on paper). Her class is from K-2nd grade. Mostly she is still working on the K-level. My daughter is the only one visually impaired and orthopedically impaired. Frankly they are not used to a child like mine being there because they usually put them into a center school but I refused.

            I hope I answered your questions....please if I didn't... perhaps re-phrase it to me. I really would like your input and direction here.
            Thanks,
            Cathy

  • Kathy Manriquez posted by Enter name here on Apr 10, 2007

    In our home, school, community, social group,etc. we use the Chat PC from Saltillo. It is a Palm pilot with a voice output. My son uses it to communicate his immediate needs. There are picture icons that speak either the word or phrase,whichever I format into the device.
    Uploading onto the device is fairly easy. If I want to upload new information or make a new page I can do it on my computer while my son is at school. When he comes home I can upload it onto his device.
    The device weighs about 3-4lbs. It speaks with the high quality DEC talk.
    We use the device as a tool to develop Independent skills. In Occupational Therapy I ask that the therapist use it so that my son con develop his organizational skill and purposeful movement. For example, If he chooses to go onto the platform swing than loses focus he can be redirected "remember you wanted to get onto the platform swing, let's do that now".
    I also have a keyboad page on the homepage.
    My son types with an Alphasmart NEO. He has been typing for 3 years now.
    He has an aide who works with him in school. He is in the 4th grade and is fully included. His level of support to type is at the shoulder. He is now emerging in his independence with typing.
    At home his sister works on communication with her brother with a dry erase board for simple yes/no questions and multiple choice for choice making.
    The most difficult challenge we have now is working through emotion and some of the hormonal changes that he is experiencing.
    The communication devices have really come a long way. I really wish that all the devices could have the AT&T voice output. My son says "It is hard enough to fit in with his peers, but when you sound like an alien what do you expect".
    I look forward to progress in technology for the sake of our kids.
    Thank you for your time.

  • Supporting adult AAC users with lesson plans for improving literacy and language development! posted by msmcalpine on Apr 10, 2007

    What suggestions can you give an AAC user who is not literate to learn to compose their own thoughts with an aug com device? It is our goal to create lessons within the aug com device for the AAC user to help them become more literate and gain access to spontaneous communication. The end user has never had access to individual words "only" preprogrammed messages. The AAC user's receptive skills are excellent; but their expressive skills are not even at a toddler level due to the fact that they have never had access to individual words. We need to give Adult AAC users the dignity to gain access to a proper education with electronic lessons within their aug com devices to improve their literacy and language development.

    They will succeed if given the opportunity to do it their way!

    We need to change our regulations to allow for reinbursement for speech language pathologist services to do follow along after the speech evaluation and the AAC device has been delivered to the AAC user and their family. In Nebraska there is no way to bill for SLP follow along services. Many AAC users and their families are struggling after receiving these high tech tools. Low tech does not work for many adults with multiple disabilities. These AAC devices are miracles allowing the end user to communicate successfully and live independent lives. These adults are smart and eager to learn.


    Your thoughts,
    Mary McAlpine
    NE Parent Advocate
    Omaha, NE





    • Re:Supporting adult AAC users with lesson plans for improving literacy and language development! posted by Robin Hurd on Apr 10, 2007

      The great thing about using high frequency words to compose your own thoughts, is that that those words are the ones that you will see most often once you begin reading.

      With the kind of expressive vocabulary that you mention, I would suggest that you begin by building the expressive skills. Picking some phrases that a child who is learning to speak might use, and using them in the context of adult activities is a good way to start. Finding out the usefulness of putting words together is the first step.

      Once you have some knowledge of how to put words together, you can begin to have the person do some writing, generating it word by word and choosing a picture as support. (ex:"my family" and a picture or, "I want more", with a picture of a pizza or a favorite tv show) This mimics the way children write as early writers. Having a "product" in the form of a written work, should be almost as much incentive as it is for a child, because everyone can see your progress!

      Once this foundation of expressive language is in place, then you have the foundation to begin phonics teaching.

      Have you looked at Benetech's route 66 program? It is designed for adults to build literacy skills. Perhaps this will be helpful.

      http://www.benetech.org/literacy/route66.shtml

  • another of Lynne's questions: quick mesages versus word by word posted by Robin Hurd on Apr 12, 2007

    In several of the posts, we have touched a little bit on this topic, but I thought we should open a new thread to address this in more detail.

    One of the toughest things about AAC is that it is a slower communication method than speech. The speed varies with the individual, but even for someone who is familiar with his or her AAC system and has good motor skills, it's slow. Add to this a person who is just a beginner at the AAC system and language, and speed becomes a big concern.

    In our fast paced, verbal world, we value the sound byte, the quick wit, the fast exchange of information. In our schools, we value the quick return of the conversation back to the teacher. Even children who have no disabilities do comparatively little sentence building in classroom interactions. So when we plan for a student who uses AAC, we look for quick communications.

    However, we all know that children must learn at some time to put words together. Without ever aquiring this skill, writing and reading comprehension, not to mention communication skills, will be impaired.

    So, when we plan for a child who is using AAC, we MUST, like it or not, plan for time to practice sentence building skills as part of the use of the AAC system.

    When I think of this, I think of the children who have a stuttering problem. They, too, communicate much more slowly than their peers. However, we tend to be more understanding of their need to be given time to build their sentences, as well as a better understanding of what will happen if we don't allow them time to develop their skills.

    So, when is the best time to build in practice putting words together? Just like the student who stutters, students who are learning AAC are probably NOT going to be at their best when 25 pairs of eyes are looking at them during sharing time!

    One good time to practice combining words is during writing time. When other students in kindergarten or first grade are drawing pictures/writing stories, children who use AAC can be doing the same thing, using their technology. Normally developing children at these stages start with a picture, and so can a child who is pencil impaired, using clip art and the computer. The child can then write about the picture word by word, with the AAC system. The great thing about writing is that there is no pressure of many people looking at you, and it is also perfectly acceptable to go back and edit your work afterwards, so you don't have to be perfect the first time.

    Having said that, let's not get obcessive about editing and perfection too soon. The goal is practice, not perfection; communication, not frustration.

    Another great time to work on sentence building is when reading a book. I like to pick a phrase or two that can can be repeated throughout the book. A couple of days ago, we read a book about a boy who is looking for his cat. The cat is hiding on each of the pages, and the reader has to try to find it. Our target phrase was,"I know!" (as in, "do you know where the cat is?") Before anyone could touch my book, they had to tell me something. --a new take on "you must raise your hand, or I can't call on you". Since we used that same phrase on each page, the boys got a lot of practice doing it, but they also had a great time!

    As a third suggestion, one of the things I have done for the boys and their school team is to type up target sentences for what they are studying in school. It's very hard to know when you have achieved success, if you don't know what it will look like. When a comprehension questions is asked about a science or social studies unit, I want the staff, as well as my boys, to have an idea what kinds of things they can say with the words they know. Next week, Joshua starts a unit on conservation. The target phrase for recycling is "use again" or "make new things". For renewable resources, the target phrase is "can get more". Planning this out ahead of time helps the classsroom teacher know what words Josh can use, so she can say those words as part of her definition. It helps the aide and the resource teacher, who assist and adapt the materials, to know what answers to expect and prompt for, and it helps Joshua, to mentally narrow down his options of what words go together to get the idea accross. As I said, these are targets, to get everyone aiming in the right direction. They are not a "right or wrong, cut in stone" kind of an idea, but a support to use as needed to make the job easier. Sometimes, Josh or Caleb will add to or change the phrase, to make it their own, while still reflecting a knowledge of the material.

    While there is a need for quick response types of messages to help those who use AAC communicate predictable things without fatique or to make their message clear in spite of stressful situations, it is important to their long term language and literacy development to have plenty of chances to practice putting words together, and to have all of the supports they need to be able to do so.

    Anyone else's experiences with structuring supports so that time is available for working with words would be great! It's touch to reach a good balance between all of the things that need to be done in school.

    • Re:another of Lynne's questions: quick mesages versus word by word posted by Amy M on Apr 12, 2007

      Add in the time it takes to do TYPICAL school day stuff, and it is all hard to get in in a 5.5 hour day. Kendra never gets the few free minutes her classmates get, in the morning, or when the teacher just gives them something to do, like coloring, to keep them busy for a few minutes, or before a special class or activity. She is ALWAYS doing a worksheet, or finishing up a test.

      We have spent this whole year, concentrating on identifying the parts of speech (very helpful on her 84 location dynamic sequenced PRC Vantage), and the colors associated with just VERBS (green)and NOUNS (orange). Her device is color coded, by parts of speech. No one else in first grade knows what part of speech THAT or THIS is, but Kendra knows it is a POINTY WORD (can be pointed to word, she knows it is LITTLE WIZARD, which is a determiner), or how many words are prepositions, which is a BRIDGE and CLOUD (prepositions are words you can do to or with a cloud or bridge, such as on a bridge, over a bridge, through a cloud).

      I found this was a very first place to start, with this device. If she recognizes the parts of speech, she will learn to find the correct sequences much faster, because she will know the first hit.

      Another big thing has been to make sure she knows how to categorize items. Another thing that helps with the device. Then, we make sure she has a tangible object, to associate with the device icon for that category. Example, APPLE for food and eating, she gets an apple, with an explanation. These are all necessary, to teach her, BEFORE she actually learns how to use the device much, in a sequenced way.

  • Very basic question posted by Guest on Apr 13, 2007

    I apologize for asking a question that may not fit this discussion, but I've been following the discussion with great interest. My neighbor's son uses a talking picture board to communicate. Because of his physical disabilities, he goes very slowly and it's always been painful for me to watch him struggle to touch each picture in turn. I've noticed that most people (including his family) jump in and "finish his sentence" as soon as they think they understand what he's going for. I understand the temptation to do that, but I've always remembered what a friend who has a bad stuttering problem told me, that is, that the only respectful thing to do was to be patient and let him finish his sentence. So I've always tried to let Zach finish his thought, no matter how long it takes and how hard he seems to have to work at it, but have always wondered whether I was doing the right thing. There must be huge frustration for these kids and I don't want to add to it. Thanks for your help.
    Ginny

    • Re:Very basic question posted by Katya on Apr 14, 2007

      Your question isn’t that basic and simple, and shouldn’t be given a simplistic response such as “don’t fix it, if it’s working” or “the child is successful, do worry about it.” Yet, this family has worked out an efficient way for functional communication and expression of needs/wants, and is making the best decision they can. So, my response to your question is more of my general philosophy and recommendation I give families and team members.

      Most individuals who rely on AAC use multiple methods for communication, with many “invented” methods used within the family that are very effective and efficient. However, these methods are not exclusive. The most competent augmented communicators use language as effectively as any one using natural speech. Consequently, children using AAC shouldn’t rely solely on partner assisted or completion of messages in order to build fluency.

      Without having the opportunity to manipulate words and construct complete utterances, fluent use of language is not being demonstrated and might even be questioned that it can be achieved. Other considerations about over-reliance on partner assistance are issues related to lowered expectations from others and learned helplessness when communication frequently is completed by communication partners. Again, families frequently develop strategies that speed-up communication to make it through busy daily routines. However, the most intimate interpersonal communication requires individuals to have the opportunity to choose their own words and express their own thoughts.

      At PEC (the Pittsburgh Employment Conference for Augmented Communicators) several years ago, Rick Creech, an augmented communicator, suggested that communication partners ask a person whether it is okay to complete their sentences before they are finished. You just don't start finishing what you think the person is going to say. This shows respect for the person, and lets them make the choice. Similar politeness can be extended to children using AAC. Also, for children, individuals should ask permission to “touch the AAC device” before automatically hitting keys to model locating vocabulary.

      Again, proficiency of access is an underlying factor in your comments. The intent of our discussion is not about the selection and training of alternative access methods. However, when access is so inefficient that people question the ability to benefit or use AAC independently, perhaps alternative access methods need to be considered.

      If team members have minimal AAC pre-service or in-service training, team members have even less training on access. DeCoste (Glennen & DeCoste, 1997) suggests that professionals need to work with approximately 40-60 (?) cases before having the skills to evaluate someone’s access skills. Many individuals may be using very slow and laborious direct keyboard selection, just because it is possible without ever having explored other techniques such as optical head pointing or scanning. We have to do a better job at this!

      A case study illustrating lowered partner expectations because communication was so slow that sentence completion was the norm and partners felt uncomfortable having the wait is found in A Case Study Model for Augmentative and Alternative Communication Outcomes in the Third edition of the Assistive Technology Outcomes and Benefit Journal. Articles from the journal can download from the web site at: http://www.atia.org/atob/ATOBWeb/ATOBV3N1/index.htm.


      References

      Glennen, S. L. & DeCoste, D. C. (1997). Handbook of augmentative and alternative communication. San Diego: Singular Publishing Group, Inc.

      PDF file of Chapter 2: Assessment for Special Access from Glennen and DeCoste (1997). http://callcentre.education.ed.ac.uk/downloads/sat_book/SAT_chapter_02.pdf

      PEC web sites:

      Paper presented by Susan Balandin at PEC on vocabulary in the work place. http://mcn.ed.psu.edu/emp/Publications/PEC/BalandinS_PEC98.html

      http://www.sciconics.com/shout/index.html

      http://www.cpcoak.org/PEC.htm

    • Re:Very basic question posted by Robin Hurd on Apr 14, 2007

      Ginny,

      This is a great question! The etiquette of how to interact with a person who uses a communication method other than speech is something that no one ever taught us when we were growing up, but it's a big part of supporting a person who has a speech disability.

      You are right, automatically jumping in and finishing the thought is not a respectful thing to do, nor does it help him to build confidence or skills putting words together that he needs for reading, writing, and communicating to people who aren't familiar with him.

      Generally, good manners requires that you wait until you see that the person is finished with their thought before responding. If you didn't understand something, don't be afraid to ask. (Some of the voices can be tough to understand.) Occasionally, someone who uses AAC and has severe access problems will ask their close friends and family to guess what they mean, but most of the adults who I have asked about this prefer to finish their own thoughts.

      It is also good manners to look at the person who is talking, and not watch their AAC system. The exception to this is, of course, someone who is using a low tech board with no voice output, and you must look at the board in order to understand their communication. When someone is using one of these communication boards, saying the word out loud after each can be helpul to you and to the person communicating, to make sure the message is understood. A family friend uses a low tech spelling board, and he spells so fast that I can't always keep up with him! Saying each word helps him know that I got it. Occasionally, I have to ask him to spell more slowly, because I can't keep up.--better to do this than to miss what he has to say.

      For many people who use AAC, there are several ways to communicate, and they may be combined. Some speech may be combined with the use of the communication device, and gestures or signs may also be used. When my kids really, really want something, they combine the sign for please, a word approximation of it, and the word on their AAC system! When a person is using some speech, some gestures, and the AAC system, close attention to everything that is going on may be required to understand the full message.

      I am working with the Leadership and AAC committee of ISSAC, and one of the barriers to people who use AAC being involved in leadership roles is this whole question of etiquette. Others simply aren't comfortable with how to communicate with someone who uses AAC. During the first phase of our project, we came up with some AAC etiquette tips, which still need to be looked at by people who use AAC in a variety of countries, to make sure it reflects the values of people who use AAC across cultures. What I have shared here is a part of what was expressed in phase 1 of that project.

      • Re:Very basic question posted by Ginny on Apr 16, 2007

        Thank you both for your long and informative answers. I hadn't realized how much I cared about this question until I found myself crying while reading your answers. It's so good to know that I haven't necessarily done wrong and may even have taken an approach that helps him. I'm not sure I'll ever know how Zach feels about my approach to letting him struggle to the end of his thought, but when he gets older and has more vocabulary (what I guess is considered expressive vocabulary...so many of these terms are new to me) I'll have the confidence to ask him.
        Thank you again,
        Ginny

        • Re:Very basic question posted by Katya on Apr 16, 2007

          Ginny,

          I hope Robin replies as a parent, because my role as a professional is easier. I really have to applaud families for sticking to their dreams for their child. Far too many times, families are doing battle. I'm not sure where you live, but I hope that you and your family can make it to PEC one day. (Not to mention the AACI Symposium. :) ) Many of the stories shared at PEC by the presenters using AAC include comments about how their parents believed in their potential. These are individuals once placed in full-time special education classes, and now presenting at a major AAC conference! Some have college degrees, and probably not the expectation of some professionals at school entry. They thank their parents for their accomplishments, and are grateful for all the work it took.

          Of the 20 adults using AAC that I interviewed during my initial research, almost all indicated that after leaving school they selected and trained themselves on the AAC system they found worked. Their motivation to do better came from their families. As I continue collecting outcomes data, I find this scenario still to be true. To use the words of a dad whose school-aged son was evaluated here recently, "I can't wait to have a real conversation with my son."

          Thanks for continuing to participate in the discussion.

          • Re:Very basic question posted by Robin Hurd on Apr 17, 2007

            Ginny and other parents,

            Being a parent is tough, being the parents of a child with a disability who can't communicate effectively is really, really tough! It's too easy for us to labor under guilt, whichever choice we make. Parents who, like you, Ginny, expect their kids to do as much as they can themselves, can give ourselves guilt trips because we may be frustrating our kids. Others who respond immediately to help their child get what they need quickly and without frustration can feel guilty because they aren't pushing their kids all the time. I can sometimes feel quilty both ways, because I push the boys for complete thoughts using AAC instead of invented sign, but then accept invented sign when they arrive off the bus from school, are travelling in the car, or in other settings when the AAC system isn't able to be handy.

            But guilt doesn't help our kids grow.

            The most important thing as parents is that we continue to believe that our kids will develop their skills,and continue to expect them to move to the next level and provide chances for them to practice doing this. Sometimes, growing involves a certain amount of frustration. I often see really great communication shortly after a lot of frustration because the "dumb grownups" aren't figuring things out! Once the boys decide the grownups are clueless, they push themselves and are able to tell us much more than they thought they could.

            If you have never had the chance to meet an adult who communicates using AAC, I highly recommend that you attend a conference such at PEC(Pittsburgh Employment Conference) or one of the large assistive technology conferences and make it a point to visit with people who use AAC.

            For my husband, especially, the first time we attended the PEC conference was the first time he was able to really catch a vision for what our sons could become, even without the ability to speak. He spent the first evening in the lobby, meeting people who use AAC, and came back to the room changed.

  • ABA posted by SQ on Apr 16, 2007

    Hi, I am new to this website but was referred to it by one of my daughter's therapists. She is 10 years old, diagnosed with Autism, non-verbal and has some self injurious behaviors. She is a social little girl who enjoys being around people, particularly other children.
    Anwyay, we are beginning (did it years ago) to do ABA with her. Can any of you share your experiences with this?
    Thanks.

    • Re:ABA posted by Katya on Apr 16, 2007

      Dear SQ,

      Thank you for your posting. Would you please let the readers know what you mean by ABA? Could you describe your procedures and what goals you want to accomplish? I'm very interested to know more about how AAC is being used to build language/communication. More information certainly would help us understand the treatment better so we can share our experiences.

      Look forward to hearing more about your daughter.

      Katya

  • Midway Point in Discussion posted by Katya on Apr 17, 2007

    Wow, this month is going fast! We’ve already passed the midway point of our time together. Indeed, a lot of information and ideas have been shared. However, we haven’t exhausted the topic on AAC and vocabulary! We haven’t even come close.

    I believe we have consensus on a major vocabulary principle so critical to communication competence – high frequency of occurrence vocabulary. The foundation of selecting and organizing vocabulary for AAC intervention is related to core and extended vocabulary. Core words, or high frequency vocabulary, are critical! In reviewing the discussion comments, I feel we reached the conclusion that designing AAC interventions to support core vocabulary (those words that are the SAME across activities, topics, situations, environments, and partners) makes life easier.

    Taking a closer look at some of the threads, we’ve only started to explore: 1) early words, 2) vocabulary and cognitive impairment, 3) vocabulary and children with autism, 4) vocabulary and children with visual impairments, 5)communication and the curriculum, and 5)device components... to name a few.

    I realize that we may not have answered all the questions posed in these threads. If you feel your question has gone unanswered, please consider drawing that to our attention.

    Several of the threads are begging for the next entry; please consider contributing a posting to the content. If we agree on high frequency vocabulary, what ideas or evidence can be shared on vocabulary organization?

    To stimulate some further thought on what to contribute or about potential topics to create, I’m recommending that you visit the AAC Institute web site at www.aacinstitute.org. Consider reading the AAC Rules of Commitment, a link under the Goal of AAC. These ten (10) rules were first published as part of a three-part series in Exceptional Parent (October – December, 1999). Also, visit the Parents Corner and look over the archive for Robin’s monthly column. Please, don’t hesitate to contribute to our discussion on vocabulary if anything motivates you!

    In the meantime, I’m going to add four (4) new discussion threads over this week. So, keep coming back!

    A big thanks to all of you contributing and staying with us this month.

    Katya


    References

    Hill, K., & Romich, B. (1999). Choosing and using augmentative communication systems. Part III: Assessment, intervention and resources. Exceptional Parent. December. pp 45-49.

    Hill, K., & Romich, B. (1999). Choosing and using augmentative communication systems. Part II: AAC success stories: Making the rules of commitment work. Exceptional Parent. November. pp 60-67.

    Hill, K., & Romich, B. (1999). Choosing and using augmentative communication systems. Part I: The goal, the team and AAC rules of commitment. Exceptional Parent. October. pp 76-80.

  • teaching vocabulary/assessing learning posted by Robin Hurd on Apr 17, 2007

    One of Lynne’s questions at the beginning of this discussion was how to teach the vocabulary once it has been selected. For those who work in the schools, inherent in this is the question, “How do I document learning?”

    Teaching approaches that focus on using the target vocabulary words of phrases in natural settings provide the child the chance to practice using words in the very settings where we want to see them used. This prevents the problem of lack of generalization: the child can say the words when asked during a drill and practice routine, but has no clue how to use them within a natural setting. Mileu teaching, which Katya mentioned in one of her posts, is one of the techniques that is useful. Mileu teaching, or errorless teaching, provides a natural context for learning, with a pause, a series of prompts as necessary, culminating in hand over hand assistance if needed so that the child performs the target task successfully, with whatever level of prompting necessary. The goal of this kind of teaching is to practice the target communciation correctly. The teaching shoudl not be confused with assessing if the child "knows stuff"; it is simply teaching.

    When a child is school age, errorless teaching strategies can be used to teach vocabulary and language skills in a setting in which they will be used and a prompt free or limited prompt approach can be used to assess the knowledge of content for curriculum areas. (The same way most students are tested on science or social studies concepts).

    The reason why teaching vocabulary to children who use AAC must happen within natural settings, and cannot just be flash card drill, is that the children who use AAC must learn more than where the word is on the AAC system. They must also learn what the word means, and how it can be used in everyday life. As an example, if my sons are to learn the word “turn”, it is tempting to put it on a flash card. It’s a common word that is easily decodable, and they could demonstrate that they could read the word from a flash card and find it on their AAC system. The problem is that reading it from a flash card in isolation from a sentence that helps to supply meaning and finding it on the AAC system does not teach them all that they need to learn about “turn”. In addition to being able to read it and find it on their AAC system, my sons need to know that “turn” can be used in the phrase ”my turn” or “turn around” or “turn up, down or off”. In each of these settings, it will have a slightly different meaning.

    Now to the question of how to document learning. If we are not going to use flash cards, but learn words in meaningful settings, our documentation will be slightly different. We can judge learning by the reduced number of prompts required to get the target word or phrase. We can judge learning by seeing the target word or phrase used independently in different settings. We can document word recognition (as in the example of the word “turn”) within the context of a story. Changing the vocabulary used and the way we teach it may result in changing the way we assess and the way we write IEP goals.


    • Re:teaching vocabulary/assessing learning posted by Sarah on Apr 18, 2007

      I'd like to just ask some questions related to this thread. Would you mind giving some examples of IEP goals and/or objectives that you feel are appropriate? Also, how would you measure or demonstrate that the goal and objectives were achieved? I think it's easy to show that a student in the classroom is able to identify the color words, money, weather, or other symbols so these seem like good IEP goals for an annual meeting.

      If it's not too much trouble, could you please provide some other vocabulary list references? I asked about this earlier.

      Thank you for your consideration.

      • Re:teaching vocabulary/assessing learning posted by Amy M on Apr 18, 2007

        For some great lists, and yes, I love Gail Van Tatenhove, here is the lists I use, along with the Dolch lists. With each, if you delve further into links, you might find stuff for more specific age ranges.

        http://www.prentrom.com/profiles/lelandandtommy/StarterVocab.pdf

        http://www.vantatenhove.com/showfolder.php3?id=37

        for a check list of CORE words
        http://www.vantatenhove.com/files/VocabList.pdf

        http://www.vantatenhove.com/files/NLDAAC.pdf We use the list on page 6, the first 50 words, adding on to, and adding to get to 300.

        • Re:teaching vocabulary/assessing learning - word types? posted by Terry Gibson on Apr 19, 2007

          We use all of these great lists too Amy, and I'm so glad you posted the link to Gail's StarterVocab.pdf. We've got it already but Gail doesn't seem to host it on her site anymore and we wanted to be able to point others to it.

          Gail names each word type for the 250 words on her VocabList.pdf and we used this to colour-code our word wall words and flashcards.

          For the rest of our 500-600 words we attributed word types according to their Minspeak category on our Pathfinder, or looked them up on www.dictionary.com but it was a long process and so many words can be more than one word type depending on the context they are used in.

          We need to decide which word type to attribute to each word before we decide final layout for our communication book and make a matching set of 'Send Grids' in Writing With Symbols (Grids for writing and speaking).

          Does anyone know of a longer wordlist that gives the type of word for at least the 500 highest frequency words?

          • Re:teaching vocabulary/assessing learning - word types? posted by Amy M on Apr 19, 2007

            Here's the list I used to use, before someone turned me onto Gail. http://www.duboislc.org/EducationWatch/First100Words.html It will take you clear up to 1000. Doesn't give you word type, but at least it is a list of the words. I will keep searching for one with parts of speech!

            Here is what we do for a PERSONAL Dictionary. I print them all in color, but don't color code them, YET. I put the icon sequence, for each of Gail's 150 words, and print them in a table, 2 columns, auto fit high. then I cut them apart, and stick them into a business card holder page. Then we buy those transparent pocket/dividers thigns, and cut them up into different size pieces. We just hold them over the words, color coded to the parts of speech. To make it easier for the kdis to hold, you can glue popsicle sticks to one side or the bottom, and stick tri fold clips on them for easy pick up. I leave a blank space or two, in the pockets, after ever letter of the alphabet, so if I add words, i don't need to re-alphabetize the WHOLE thing. So, if we are saying DREW, her brother, and it is a noun, it gets orange, or if we say drew as past tense of DRAW, we can put a green colored transparent card over it over it. Besides, it gets the words in there, and we can always color code them when we need them.

            Email me, and let me know of some good things to do with WWS. I just got it, and can't quite figure it out yet. amy_wayne59@SPAMBOTyahoo.com (Remove SPAMBOT, that is to avoid getting on some automatic junk mail lists)

            As far as how to introduce vocabulary to them? We like to use the Super Fund Decks 100 and 200 MORE SITE WORDS decks. There is two sets in each, one color coded, and one black set. I stuck the icons on each of the color coded ones. But you can practice identifying the parts of speech, if you use the black set. Also, I just bought a MEGA MAD LIBS book (hundreds of pages). These things are great for kids to learn their parts of speech.

            Another thing, we have the most problem with right now, is motivation to even use the device. SO, we are working on independence, and using it, at the same time. Next year, she must tell someone, using the device, what needs set up or what she wants, BEFORE someone automatically does it for her.

            • Re:teaching vocabulary/assessing learning - word types? posted by Terry Gibson on Apr 20, 2007

              Thanks for all this info Amy. I hope we do find a bigger list of word types sometime soon.

              I've bought a few Mad Libs books on eBay today and ordered both sets of Site Words cards. The cards will come in real handy as extra copies of each word for building longer sentences (I'm thinking of when we video the kids creating their scripts for a DVD).

              I'll be making any future business card sized flashcards on a rightly sized templates - ours were the right size until I laminated them. Think I'll trim them so they will fit in business card holders like yours, and take them out of their parts of speech groups and put the whole lot A to Z so that we have one resource that is completely alphabetical.

              They aren't really colour-coded except that I spent ages sticking little coloured squares in the top corners of each white card - I have so much time to spare I can afford to go the long way round!

              The only things we have used Writing With Symbols for so far have been writing with symbols so that Michael can then reproduce on his Pathfinder - bits of coursework, crib sheets for school plays, things he wants to say to his friends - and for making a 1,100 word LLL dictionary that we just typed out without limiting the words to a few to each page. It was only really ever used by his English teacher for reading simple scheme books and it's not a teaching resource - it didn't help Michael's teachers notice how Minspeak works. Michael still carries it every day as he finds it easier to look some words up in a dictionary than to use word prediction.

              We can save our flashcard set and communication book pages as web pages and put them on the web to share ideas with other LLL / Widgit / PCS symbol users. We can share the files themselves with other users. I wonder if the files could be shared between Unity and LLL users? Wouldn't it be marvelous if we could share files and have either the LLL or Unity symbols jump into place according to which symbol set we had in our own wordlist?

              You'd be just the right person to give me some feedback on vocabulary arrangement decisions!

              I've explored all the templates and environments that come with WWS but can't find a set of communication pages with the core words so we will have to start from scratch or modify a blank set to match the size and number of cells we want to use.

              I don't think WWS Send Grids can be saved as web pages like their print grids and written documents can, and if they could I don't think the links and speaking part would work - maybe we should be using Clicker or buying a copy of Boardmaker? Can Boardmaker files be saved as web pages?

              I've had a couple of goes at linking a few grids together (and forgotton how to do it 'til I get down to it again). It seems easy enough and I should know this bit pretty well soon.

              It took me quite a few goes to learn how to make the icons for new words not already in the default LLL wordlist get assigned to the words, using WWS Resource Manager - it had to be done a bit different to how it is written in the instructions and it took two calls to Widgit, a visit to our County SEN Advisory teacher, and two calls to PRI before someone at PRI managed to talk me through it!

              Do you have the Unity wordlist for WWS? Wonder if the other wordlists are standard in UK and USA?


      • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 18, 2007

        Sarah,

        You are right, it is easy to document labeling tasks like numbers, money, colors, weather. However, Individualized Education Plans are designed to build the educational skills the child needs. When we design IEP’s, we need to consider the skills that are the building blocks of learning: language skills.

        For an IEP goal in math, instead of identifying numbers or money, how about starting with identifying same and different? This is a language skill that is a pre-cursor to visual discrimination, the skill that allows a child to tell the difference between a 6 and 9, a 2 and 5.

        We also want to build skills that will develop reading comprehension strategies. IEP goals for reading might include: The student will retell, describe or make predictions about a story using at least 2 word utterances, with reduced levels of prompting. A writing goal might be: Given twice weekly opportunities for self-selected writing, the student will describe a picture using word by word generation, producing 2 utterances of at least 3 words each, with reduced level of prompting.

        In order to teach to these IEP goals, the teacher will 1) choose target phrases to be modeled, taught and posted on the word wall, and 2) collect data on the number and types of prompts required to perform the activities at the beginning of intervention and as the intervention progresses.

        Here is another vocabulary list: http://aac.unl.edu/vbstudy.html University of Nebraska, Lincoln, has done several studies on vocabulary. This is the site that contains several of these lists.

        • Re:teaching vocabulary/assessing learning posted by Terry Gibson on Apr 19, 2007

          Robin you're an Angel. We've never managed to get anything useful written into an IEP yet, and all our research and learning and expert opinion collecting has ended up giving us too much information to choose from.

          I'll try to have these very reading and writing goals and teacher strategies written into Michael's IEP, and as school has now to use Tracy Kovach's Continuum of Learning I will try to get them to allow me to introduce them to the idea of verbal, physical and visual prompting/ cueing, at maximun, moderate and minimum levels, so they can learn the most suitable type of cueing for Michael, maybe teach new vocab initially with maximum prompting, and reduce the prompting over time while they measure and record his progress.

          For his language skills goals we could target areas he failed at in his 'Test for Reception of Grammar' assessment last December - if I can get the set of pictures that match the sentences on the assessment sheet SLT gave me and use it as teaching material, Michael won't be the only one who learns what 'reversible passive', 'post modified subject', and 'reversible passive' are!

          • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 20, 2007


            Using the assessment from December to guide future IEP planning is exactly the right idea! What good is it to assess kids, and find out what they don't know or can't do yet, if we don't use that info to make a plan to improve that area of learning for the child?

            Coming up with a written prompting strategy, and a checklist to document its use, is a great way to help implement it consistently with all of the various teachers, SLP's and aide staff that work with the student who uses AAC. When we write goals that include reduced levels or prompting as an assessment strategy, having a plan for when and how to prompt, as well as a checklist to keep track of the prompting, is critical. The checklist can go on a clipboard hanging on the wheelchair, be kept at the student's desk, or have each staff person keep a copy of the checklist handy when working with the child.

            SLP's may find that part of their consult time with the other staff needs to focus on teaching how to use the prompting strategy and waiting time to get the maximum out of the child. SLP training differs from teacher and aide staff training, and this is one of the training differences. Having a written explanation of the prompting plan is a great support, but it may need to be taught initially.

            • Re:teaching vocabulary/assessing learning posted by Terry Gibson on Apr 20, 2007

              How I wish SLT and teachers could have been at Tracy Kovach's training day. I will extract just the nuts and bolts definitions of modeling prompting from Tracy's very comprehensive workbook and present that - on paper or slide handouts might be all I'm allowed to do - but we can use the programme ourselves and compare our results with those of SLT and staff to monitor their progress as well as Michael's. Maybe they should video themselves working with Michael and let me see it.

              I'm sure SLT will have learned a lot about modeling and prompting at Carol Goossens and Pam Elder's training sessions in February, and Michael's class tutor was at Pam's session too a first!

              The focus was activity based where even the level four pages had only the same 36 core words on each one, and I was hoping all day that there was more to come.

              Pam's answer to a question from the audience still haunts me:

              "What happens if one child just wants to turn to another child and have a chat?'
              "Oh, we try to keep them within the activity. Most of these children don't have conversations"

              I supported the lady who asked the question by asking was the goal of AAC not to provide access to a comprehensive core vocabulary in single words and to facilitate spontaneous conversation?

              Pam replied that she does have conversation groups but that those clients have a high level of ability to start with and don't have language problems.

              I was really sad we didn't see any videos of clients conversing on their communication aids. I really hoped that this was going to be the day that Michael's SLT and teacher learned the value of core language, and thought this best part was being saved 'til last.

              We're calling our group AAC Beta Crew - Beta stands for Beyond the Activity, and Crew stands for Chatting, Reading and Writing.

              • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 22, 2007

                What a haunting comment: "Most of these children don't have conversations".

                The goal of this whole month of discussions has been to talk about setting up an AAC system so that children without speech, with language delays and possibly cognitive delays as well, can begin to "have conversations" about the things that matter to them!

                And conversations can happen, even before all of the nuances of verb tense, pronoun use, etc. are figured out. Our regularly developing 2 and 3 year olds do it, and so can children who use AAC.

                I want to contrast your story, Terry, with one of my own. In March, our family attended a conference for people who use AAC. Most of the participants were adults, but there were 5 children who use AAC (including my 2). No one else had the same AAC system except my boys, who both use identical AAC systems. Josh and Caleb invited other kids to have dinner with us, asked them to swim (they played tag in the pool) and made good friends. One of the girls told me after swimming, "I like your boys". On Saturday evening Josh, who had fallen in love with the girl, asked her to marry him, and she said yes! (so quickly in fact, that the grown-ups were still processing this conversation by the time it was over!)

                Children who use AAC CAN have conversations just like their speaking peers do, but only if we give them access to the kind of vocabulary that gives them chances to put their own thoughts together in their own way.

                The potential is there; we simply need to provide access to vocabulary and freedom to use it.

                • Re:teaching vocabulary/assessing learning/measuring performance posted by guest on Apr 23, 2007

                  I can’t let this month go by without discussing monitoring and measuring vocabulary learning and use. I was going to introduce this as a new thread, but Robin beat me to it. As I’m going through the previous comments about teaching vocabulary and documenting learning, I see several suggestions about documenting the levels of prompting strategies and keeping vocabulary inventories. However, I believe we have several other important measures that are helpful in understanding how a child may be learning and acquiring vocabulary using AAC interventions.

                  Contemporary practice indicates that spoken language intervention strategies are appropriate and beneficial for children using AAC. Therefore, using the same methods for measuring progress is appropriate. Developmental milestones can be used as indicators for monitoring AAC vocabulary use patterns. Personally, I’m not as concerned about the ease of learning symbols, as I am about using vocabulary during interactive communication. Learning to identify a symbol does not equate to being able to use the vocabulary that symbol represents for intentional communication.

                  That being said, what measures are SLPs collecting to document learning or monitoring vocabulary use? Previously, I gave you some case study examples of clinical data showing vocabulary frequencies during a treatment period. The specific measures that SLPs typically report based on language samples include:
                  1. Total number of different words (TDW)
                  2. Number of word roots (NWR)
                  3. Frequency order vocabulary usage lists
                  4. Alphabetic order vocabulary usage lists
                  5. Frequency or % of core versus fringe vocabulary

                  Another measure that SLPs report to document the results of language intervention is the mean length of utterance either by words (MLU-w) or by morphemes (MLU-m). MLU is calculated by averaging the number of words in each sentence (utterance) of a language sample.

                  Remember the vocabulary list of the three-year-old girl showing the words she was using over the first 13 weeks of therapy? Below are the data we collected showing how she was starting to use words to generate sentences. Language samples from therapy were analyzed and included in progress report summaries. These data usually are shown in a table.

                  Month 1
                  MLU-w = 1.83
                  TDW = 35

                  Month 2
                  MLU-w = 2.31
                  TDW = 65

                  Month 8
                  MLU-w = 3.13
                  TDW = 47

                  Month 12
                  MLU-w = 3.39
                  TDW = 64

                  Reporting these measures allow us to track or compare performance with such milestones as Brown’s Stage. Brown’s Stages were discussion in a post on Early Words – a professional perspective on April 02.

                  Looking at the rapid learning of vocabulary or symbols, you might conclude the challenge in keeping up with adding new words if you were selecting and organizing the vocabulary yourself. You might conclude that the resources to keep pace with this rate of learning might not be available. Consequently, a child has access to vocabulary that is no longer meeting their needs or interest. If we are not monitoring and reporting AAC device activity routinely, we don’t have accurate information to make decisions about the effectiveness of the AAC intervention.

                  Katya Hill

                  • Re:teaching vocabulary/assessing learning/measuring performance posted by Robin Hurd on Apr 24, 2007

                    Both of my example IEP goals, a math and a reading goal, were designed to work on language skills, but both used a lessening of prompting to show progress. Let's look a couple more IEP goals, specifically for speech interventions, that use some of the other ways of progress monitoring available to document success.

                    Why look at IEP goals? My sister had a profesor who said "Assessment drives intervention". This professor insisted that if we want to change the way we teach, we must look first at the way we test students. So, following this lead, we'll look at how we assess IEP goals first, and then how we would teach those goals we have written.

                    goal 1: The student will increase his/her mean length of utterance(MLU) from 1.8 MLU to at least 2.8MLU during spontaneous communication. (insert your own baseline and target goals)

                    The reason for this goal is to show an improvement in the ability to put together words. Mean Length of Utterance is the average number of words a person uses in a communication message(or utterance). We don't use the term sentence here, because it might only be a phrase or a string of words. An increase in MLU shows us that the child is progressing toward becoming a fluent communicator. Progress with this will affect literacy as well as communication outcomes. (as I get better at putting together my thoughts, I will get better at understanding when others put together thoughts and better at putting my thoughts in writing)

                    An SLP who is working on this goal in Therapy time will be focusing on having the child put words together to build thoughts. Describing pictures, telling about a field trip, re-telling a story, predicting what will happen next in a book are all ways that this could be taught. The child must have access to words that can be used to build sentences on the AAC system, as well, so the fucos of programming the AAC system will be on high frequency words.

                    For those who have nightmares about doing the math on an IEP goal like this, the AAC Institute has an automated performace reporting tool that will do this for you. It's as good as magic; you enter the sentences, click a button, and get a report in seconds.

                    Goal 2: the student will increase his/her use of high frequency sentence building words during spontaneous communication from(insert baseline data here) to (insert goal here.) Achievement of the goal will be documented by language sampling comparison of baseline data with periodic samplings throughout the year.

                    In order to teach this IEP goal, the SLP first will select a group of high frequency words to target. These might be the same sight words that are being taught in reading class, or they might be words that are not currently appearing in the student's baseline language sample, but are often used in sentences. Notice that we did not set this goal up to demonstrate success on flash cards, but in the context of communication. So, while the SLP may choose to use flash cards and word walls as part of her teaching strategy, she cannot document this IEP goal based solely off of the use of the words in isolation. Real vocabulary growth occurs when a student begins to use new words in sentences, not simply when asked to produce or define the word in isolation, so this goal has been structured to show this.

                    The SLP will structure her interventions to allow plenty of time for communicating the child's thoughts, modelling the use of the target high frequency words with her speech and on the AAC system. The same ideas that were used for the first IEP goal would be useful here: re-telling a story, talking aobut a field trip, describing pictures, etc., so the SLP can be working on two goals at the same time.

                    In order to document this goal, the SLP will do periodic language sampling and look at the total munber of diferent words used. The SLP should see and increase in the number of high frequency words being used in communication, especially those that have been the focus of the interventions.

                    Once again, this language sampling does not have to be done the old fashioned way, using a tape recorder and math. Automated reporting can make this very easy to do.

                    I hope that taking the possible ways of documenting progress and putting them with IEP goals has helped to explain when and why certain types of documentation is useful.

                    Robin

                • Re:teaching vocabulary/assessing learning posted by Amy M on Apr 24, 2007

                  And now Robin, you must prepare to have a daughter in law ;) Bet you thought you would have more time for that one!

                  Anyway, spontaneous speech is my second main goal for using her device (first one being to use whole words to type out school work, instead of individual letters). All through integrated preschool, that would not take any time to get to know the device, I was told Kendra's weakest area was spontaneous conversations with the rest of the kids. This irritated me, but I understood their point of view, and had no clue how to teach Kendra to use the device. Yes, you understand her, if you know you are talking about dolphins, but even then, you have to be 5 steps in front of her.

                  An example. This morning, her homework was to write a brief story about sleeping in a sleeping bag at the beach. We got WWS 2000 all set up, got the Unity wordlist loaded in, got a good topic sentence. Then, she was trying to explain to me what they did next at the beach, and I just couldn't figure out the one word, and she just kept repeating it, for half an hour. I couldn't get her to give me another word, she wanted THAT word. I handed her the device, asked her what it started with, she said she didn't know. I asked if she could find it. She said no, she had no clue. How nice it would have been, and a lot less frustrating on BOTH of our parts, if I could have handed her the device, and she saw the picture of WOOD, and she found the noun for WOOD (she had to dry out her wet sleeping bag with a fire so she could sleep on it). Would have taken mere seconds. But, instead it took an hour and a half to do the 5 sentence story.

                  My question is, how do you teach a child that speaks and talks, where all these core words are, for access to that ONE word, she can't say? I know the answer. PRACTICE. The words are all there, but until someone besides me, in a lot of different situations, shows her where they are, she will never be able to just go up to someone and say "I need WOOD for my fire." Well, actually she now could, because I showed her where WOOD was, LOL Verbally, to a stranger, it would sound like "I NEE OUL FO MY FIER".

                  This summer, I plan on using MAD LIBS (for parts of speech recognition), and maybe a scene type thing on Boardmaker, to have her explain all the different things she can do or see on a page!

                  • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 24, 2007

                    Amy brings up a good question aobut teaching children to access vocabulary: how can we help kids find a word they need, but don't know where it is?

                    The options for finding a word are to look through various categories to see if you can find it, or to use spelling and word prediction (if available on the AAC system). However, in order to find the word using spelling and word prediction, the student needs to be able to sound out the word, at least getting the first letter right.

                    For kids who use AAC (and who can't speak, or can't speak clearly) deciding what letter a word starts with can be tricky. The child can't make the sounds accurately with their mouth and often can't hear the subtle differences between sounds, because of their more limited exposure to the sounds.

                    My son Caleb and I had a conversation one night, where he told me that he could spell his name with a "G" or a "C", and it would sound the same. Even after listening to his AAC system say it both ways, he still could not hear the difference between those 2 consonants.

                    Amy's daughter cannot say the "W" sound, and was having a terrible time telling her mom what word she needed, because she also could not accurately hear what letter she needed to start the word, either.

                    Sometimes when we want to help kids gain better access to their AAC systems, we need to work on skills that seem to have little to do with the AAC device. In this case, in order to help Amy's daughter to better be able to figure out what a word she wants starts with, Amy or the staff at her daughter's school might choose to work on hearing those subtle differences in sounds. Earobics is a computer program designed to help with this, for example.

                    Even if a child can't say a certain sound, she can learn to listen for it and distinguish it from other sounds. This skill not only helps a child to be able to guess what a word might start with, in order to use spelling and word prediction to find it on a device, it helps a child "guess" what a new word should sound like when she reads it in a book.

                    • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 24, 2007

                      I wanted to post again, to talk about a separate part of Amy's question: how can she teach her daughter her AAC system, when she relies partly on speech and partly on the AAC system?

                      Children who use AAC most often have other ways of communicating besides their AAC system. They may sign, use gestures, and may even have some speech that they rely on at certain times or with familiar people (like mom).

                      The more speech a child has, the tougher it can be to encourage communication using AAC, even though the speech may be impossible to understand.

                      The child wants to speak, and we want them to, but it is more important to be understood. The AAC system is necessary for them to be able to communicate with strangers, or even at times, with their parents.

                      Someone told me that I should ignore the boys' sign language, in order to get them to use their AAC systems when they first started on them. It may work fine for school staff to do this, but when mom began to ignore the very thing that had been our only effective communication, all I achieved was to cause intense frustration! I learned that acknowledging the sign, while reminding the boys that other people could not understand it unless they used AAC seemed to work better.

                      I really like to use the computer, with the AAC system hooked up as an alternative keyboard, to encourage using the AAC system only. The computer does not understand sign language, and can't hear what we speak, only what we say using AAC. Writing on the computer can be so motivating. You can print it and hang it on the wall, e-mail it to someone, or even do it on a powerpoint and put it on your own CD!

                      Sometimes in the summer all 4 of my sons work together to write a silly story using Kid Pics software. One of the twins is in charge of the adapted mouse, the other is in charge of the words using his AAC system, and the older two are only allowed to give ideas and suggestions. This is a great way to have fun while one of the boys works on his AAC skills, and the other his mouse access skills. It is totally for fun, with no editing and no right or wrong, just sharing and writing ideas and working together.

                      We also like doing mad libs. You can assign the child who uses AAC the parts of speech that you want most to focus on: describing words, action words, etc.

                      We also do an adapted version of charades, where one of the boys tells his partner what to act out and how to do it, using AAC. Occasionally, a whole team of people will be assembled to act out a story, and the boy in charge uses AAC to tell the others what to do. This works great, until the 14 year old brother refuses to be the bad sister (wicked stepsister) for the story of cinderella! :) As you can imagine, this is a very motivating way to use AAC, especially when picking on your older brother.

                      Robin Hurd

                      • Re:teaching vocabulary/assessing learning posted by Amy M on Apr 27, 2007

                        Thanks for the ideas Robin. We will be starting Earobics at school next year, perhaps as one of Kendra's center times during the week, and probably during one of her speech therapy times.

                        We will be using Madlibs this summer. Also, I am trying to motivate her to use WORDS to type out sentences. I feel a little thwarted with this, because when she has s sentence to do at school, the aide has her TYPE it out, rather than look up the 5 or 6 words for the sentence. But hopefully I can give her enough practice this summer, that it will no longer seem foreign to her, to reach for the Vantage and TALK.

                        We were able to, for the first time all year, get her through a whole spelling test today, without her becoming really frustrated with the device. She practiced all of her words, spelling them on her SPELL page, several times each, all week long. I just had an idea. The aide put a dot on a paper, for each time she spelled out each word. Why not use those small reward stickers, each time? Think I will be heading to EXCEL, and doing a template for her spelling words, and some columns, Or maybe graph paper might be easier. I can decorate one piece, all fancy and colorful, and copy it on the color copier.

                        The other day, I just straight out asked her if she wanted or liked to use her device, and she told me NO. A little later, she was upset with me, because I couldn't get a word, and I asked her if it wouldn't be nice if she could tell me what she wanted? She said yes. I told her to try to find it on her device. Never got past that, but hopefully I am building some bridges, to get her to see that using the device will save her time, frustration, and will give her a whole level of speech that she can't currently say, verbally.

                        • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 27, 2007

                          Madlibs are a lot of fun! It is also fun to be the one in charge of running the game time, more so if you are a younger child like my boys. :) Perhaps allowing her to be master of ceremonies during the game, as long as she uses her AAC system to do it, will help her to want to use it.

                          A child who has some speech can struggle with the desire to use AAC, even if their speech is not understood by others. They know speaking is faster than AAC, and they desperately want it to work for them! Kids that can't speak a word don't have this struggle, because they don't have that option.

                          Setting a time for "talker time" or whatever you want to call it, where she has your attention at the same time each day, but needs to talk to you uisng her AAC system, might be a good thing for her. Don't expect her to come up with a topic, though; have some ideas ready to talk about--magazine pictures, some of the those nasty cheap toys designed to feel goey and slimy or a fun story might start some good conversations. Or, you could plan a picnic or trip to the park. This is great on several levels if the child is one of those that needs to know the details ahead of time. Not only will they know the schedule, they get to plan it!

                          Sometimes, I ask the boys if I can use their AAC system, and start talking to them on it. Very often, they will push my hand out of the way and begin to use the device that they were, moments earlier, trying very hard not to use!

    • Re:teaching vocabulary/assessing learning posted by Robin Hurd on Apr 20, 2007

      Another way to teach the vocabulary once it has been selected is to teach the relationships of the word to each other. We can teach words and their opposites together, so that relationship begins to become firm in a student's mind.

      We can teach the question words along with the words that might be used to answer them. For example, when my boys hear a "where" question, they are trained to think of the words stored under the bridge symbol-bridge words to them, prepositions to us. Where is the toy? IN the toybox, UNDER the couch, BEHIND the book.

      We can teach words that have the same function in a sentence and (hopefully) have a similar motor pattern on the AAC system. If we are teaching the pronoun "I", we may choose to get it introduced, and then add another pronoun, "you", using it in the same way as we did the first pronoun. There are so many great ways to work on pronouns. You can do this looking at a collection of photos from school or home. "Who is in the picture? Am I? Are you? Is he?" You can do it when reading a book. "Who sees the cat?" "Does she? Do you?"

      If children begin to mentally group words into categories based on how they are used in sentences, they will have a great mental storage system to help them mentally choose the right group of words, and eventually the exact word they need for what they want to say. Building the mental framework to support communication is as much a part of learning to use AAC as finding the word on the AAC system. This mental framework of language stays with children for the rest of their lives, whether they become able to speak eventually, or remain an AAC user.

      • Re:teaching vocabulary/assessing learning posted by Terry Gibson on Apr 20, 2007

        Great ideas for using the pronouns with to be, using pictures. I keep waiting until we are in a group, planning to do role play stuff, and forget how useful a picture can be for creating that group!

  • Strategies to build vocabulary skills posted by Katya on Apr 18, 2007

    The intent of this post is to encourage sharing strategies that people have found successful in building vocabulary and language skills to support interactive communication. Many ideas and resources related to intervention strategies and techniques have been woven into the threads so far. However, I’d like to create this thread as a point of reference for adding new information and references around this important topic.

    Here are some strategies we’ve mentioned, could expand on, and/or could add:
    >Behavior Chain Interruption
    >Environmental Communication Teaching (ECT)
    >Incidental Teaching Episodes
    >Milieu Therapy
    >Parent-focused training

    Please, consider sharing what you are doing to build vocabulary use and how you’re monitoring progress.

    • Re:Strategies to build vocabulary skills posted by Robin Hurd on Apr 19, 2007

      One of the strategies that we use with our sons is to pick a new word or phrase, and then inundate them with it! Right now, for example, the boys are working on the word "make" and its various verb forms. When we are cooking, they can tell me "I am making cake". At school, Caleb is studying assembly lines in social studies, so one of the target phrases is "they are making..." When we are reading books, I will be asking questions designed to get "make" in the answer. A favorite book is "warthogs in the kitchen". In this story, the warthogs make cupcakes, make a mess, may make their mama angry...

      By focusing on the word so directly and using it in so many different ways, we can quickly build automaticity and get it fully ingrained into their usable vocabulary. It takes several weeks of using the word over and over again to get its use automatic, but you would be amazed how many ways we can support a single word, when we choose it and target it throughout the day!

      • Re:Strategies to build vocabulary skills posted by Katya on Apr 22, 2007

        I would like discussion participants to consider the importance of applying spoken language intervention strategies with children using AAC. Many times the focus diverts to the use of technology and operational skills, rather than focusing on building linguistic competence using AAC interventions. As children enter the educational system, the immediate concern may be on how AAC interventions can be used to accomplish curriculum objectives. The language skills needed to be successful with these curriculum objectives may get lost. I once had a school administrator say to me during an IEP that the school didn’t need to be concerned with “language”, they only needed to be concerned with meeting the educational objectives.

        If this is a prevailing mindset, then applying the availability of the broad range of language intervention strategies with children using AAC may not seem obvious. Contemporary evidence indicates that spoken language intervention approaches are effective as AAC interventions. So what strategies are you using to promote naturalistic communicative experiences at home, at school, in the community? Here are some approaches you may want to explore for details.

        1) Implementation in the natural environment (Calculator , 1988)
        2) Parents taught to implement intervention strategies (Kaiser, 1993)
        3) System for Augmenting Language (*Romski & Sevcik, 1996)

        Access to a single-word vocabulary that supports building linguistic competence is critical to applying spoken language interventions approaches with children using AAC. Another way to look at this issue is that when spoken language interventions approaches ARE applied with children using AAC, then the availability of a single word vocabulary with consistent access to core words becomes essential.

        References

        Calculator, S. (1988). Promoting the acquisition and generalization of conversation skill by individuals with severe disabilities. Augmentative and Alternative Communication, 4, 94-103.

        Kaiser, A. (1993). Parent-implemented language intervention: An environmental systems perspective. In S.F. Warren & J. Reichle (Series Eds.) & A.P. Kaiser & D.B. Gray (Vol. Eds.), Communication and language intervention series: Vol. 2. Enhancing children’s communication: Research foundations for intervention (pp. 63-84).

        Romski, M.A., & Sevcik, R.A. (1996). Breaking the speech barrier: Language development through augmented means. Baltimore: Paul H. Brookes Publishing Co.

        *This is one my most borrowed book by students. I’ve gone through 3 copies.

        • Re:Strategies to build vocabulary skills posted by Terry Gibson on Apr 26, 2007

          Michael collects coats, tops and trousers that he has charmed and pestered off the backs of friends, family, even people he hardly knows. He’s done this since he was very young and his bedroom would be stuffed to the ceiling if he didn’t dispose of a cherished item every now and then.

          His bed is one foot out from the wall, the gap packed with a tidy array of Grandad’s and aunties’ and uncles’ and nephews’ and friends clothes, tiny to large, along with other items of interest, like angels and (old broken) Christmas lights.

          Every now and then Michael ritually cuts up an item and usually keeps the pieces for some time, maybe arranged on his pillow, before disposing with an item. We’ve kept enough pieces of some of his favourites, especially from earlier years, to make a patchwork quilt one day.

          Michael knows all the fringe vocabulary he needs to talk about clothes and clothes parts in may different contexts so it is an easy subject to ‘inundate’ a conversation with target groups of core words.

          We faked an argument a few months ago when he initiated it with: “Please, can I cut it up?” I was cutting up word wall words at the time and I got Michael to speak my side of the conversation as well as his, so on my behalf he had to say: “No. Never, Not ever. I want you to keep it forever.”

          It was a long chat with where I got him to explain exactly what he wanted to do and why, so I won’t go into it all, but it contained repeated sentences like:

          “You do what you want to do. Let me do what I want to do so we will both be happy. I want to cut it up now.”
          (On my behalf) “No, never, not ever. I want you to keep it forever.”
          “Every time I ask ‘Can I cut it up now?’ you say ‘No. Never, Not ever. I want you to keep it forever’ “
          “Why won’t you let me do what I want?”
          “Why do you always say no?”
          “You won’t let me do what I want I’m really angry”.
          “Let me do what I want. I let you do what you want”
          Every time I ask you say “No. Never, Not ever. I want you to keep it forever.”

          After a session like this we generalise the vocabulary learned into other situations by recounting our argument to friends and family members over the next few days, and using the words practiced in different ways.

          • Re:Strategies to build vocabulary skills posted by Robin Hurd on Apr 26, 2007

            What a great example of using high frequency words, plus practicing how to use your words to explain your wants and feelings in an argument. Hopefully that carries over to him actually using his words when the time comes and he gets upset!! (smile)

            Role playing like this can be a great way to teach how vocabulary can be used, as well as to explore what might happen in a given situation, so the child can prepare for it. Especially kids with Autism and anxiety can really benefit from doing this type of role playing as they learn to use their words.

            • Re:Strategies to build vocabulary skills - age appropriateness posted by Katya on Apr 27, 2007

              Some excellent examples to make vocabulary meaningful and show how natural language strategies and/or incidental learning can be easily fit into the day - even at school!

              I just want to make a point about considering the age-appropriateness of activities for individuals with developmental disabilities. So many times children are seen in our clinic that are entering the teen-years still receiving elementary level graphic worksheets or being rewarded with children's activities. We need to discuss how to appropriately transition to more age-appropriate interests. Many times, the student is ready, but hasn't been given the opportunity.

              Age-appropriateness does NOT change the dynamics of core and extended vocabulary. It may change the availability of more appropriate interjections, however. For example, use of the word "sweet" to indicate something is liked very much. Yes, language is dynamic and teens have to create new word uses.

              Below are some activities that my graduate students have found of high interest (and age-appropriate) for teens using AAC to work on language and communication skills. Note, this does not mean that we are applying an activity-based approach to intervention. We are still using natural language strategies to generate communication occurring within these activities.

              Making jewelry
              Putting scrapbooks together
              Starting a collection
              Making personalized door knob signs (warnings for family on door)
              Personalizing picture frames
              Seasonal arts and crafts, e.g. decorations, wreaths
              Manicures

              Again, the communication partners need to be trained on how to change their communication to avoid asking yes/no questions or making choices that require the student to use fringe vocabulary. Rather communication partners need to ask open-ended questions that will elicit core vocabulary, “What should we do next?” “Where should we put this?” “How should we do that?” “Tell me about….?”

              Incorporating these activities into intervention does not mean that we are creating displays that contain the various objects (nouns) used to complete these activities. We are identifying the core vocabulary that can be used to describe or confirm the actions or steps to participate in an activity such as “making a necklace for mom.” The expectation is that during the time we may be “making the necklace” we may have frequent topic shifts to chat about what is going to happen at night, TV show preferences, going shopping, etc. along with talking about the task at hand.

              Here are data showing the differences in language patterns using an activity-based approach and a language-based approach (Hill, 2007):

              Frequency of core vocabulary
              Activity-based approach = 20%
              Language-based approach = 78%

              Frequency of spontaneous novel utterances (SNUG) as opposed to pre-programmed utterances
              Activity-based approach = 10% (SNUG)
              Language-based approach = 90% (SNUG)

              Hill, K. (2007). Augmentative and alternative communication (AAC) evidence-based intervention. Presentation at i-CREATe (International Convention for Rehabilitation Engineering and Assistive Technology) 2007. Singapore (April 23-26, 2007).





  • comment about vocab choice/learn from mistakes posted by patty on Apr 22, 2007

    I just want to make a comment about choosing vocabulary, or maybe it's called which system.

    When my son got his first device, Unity was the vocabulary. It seemed daunting. and didn't make sense. We chose to "wing it". Built our own/his own vocabulary. (And the story is more complicated than this...I'll skip the details.)

    But, now years later, when he moved on to a better/more sophisticated device, we chose to teach him Unity and use the device pretty much how it is set up (with his unique needs in mind).

    Now, I think I should have taught him Unity from the beginning. It would have made the transition easier on both of us. And I think he would be a better communicator. We didn't give him the opportunity to learn language in a natural way. We designed pre-programmed sentences, etc. He is learning Unity and is learning to communicate better and more naturally, but we did waste some years, I think.

    So, my comment is, be very thoughtful of your choices. It is daunting for parents. Parents are learning a new language also and need to be ready and willing to embrace it.
    ~ Patty

    • Re:comment about vocab choice/learn from mistakes posted by Robin Hurd on Apr 22, 2007

      Hindsight is always 20/20! If we only knew then what we know now, many of us would have done things differently with our kids. Yet in spite of that, our children continue to make progress, and we learn ways to better support them. :)

      Thanks, Patty, for the reminder to be very careful when making AAC choices. The more complex a child's access issues, the more difficult a transition can be.

      To piggy back on this, look at Terry's posts about what she is designing, and my follow up about the steps she is taking to organize things long before this system is used by anyone.

      Something very important is in the balance any time we make decisions about a child's vocabulary and the way it is stored: the ability to communicate! Careful decision making is a must.

  • Pre-stored messages versus Single-words posted by Katya on Apr 22, 2007

    I promised to add some new threads to our discussion that I felt were important enough to highlight before we reach the finish of our time together. The approach of using pre-stored messages has been mentioned in various postings. I feel we should have some principles to making decisions about pre-stored or pre-programmed messages as an AAC intervention. The use of this approach influences and impacts on vocabulary selection and use.

    First, two methods of utterance generation are possible in designing an aided AAC system; either pre-programmed sentences or spontaneous novel utterance generation (SNUG). AAC systems can be exclusive in using either method or use both.

    We have considerable agreement throughout the threads on the importance of providing access to high frequency vocabulary for having SNUG-able systems to build language skills. Yet, we see that most of us are using pre-programmed sentences to varying degrees. How do we make decisions to support either or both methods?

    Let’s look at pre-stored messages. Pre-stored messages may be used for the following reasons:
    1. Perception of communication competence and fluency by partners. (Bedosian, 1992)
    2. Increased communication rate based on “spoken” message; partners are not “waiting” for utterance construction.
    3. Technology supports an “unrestricted number of messages including those related to small talk, scripts, and stories that earlier systems could not manage.” (Beukelman & Mirenda, 1998)

    Carolyn Musselwhite (and others) has developed clinical support materials for scripting messages using voice output AAC systems. These pre-stored scripts allow children to have an opportunity to experience fluency and multiple turn-taking in conversation with a partner. The partner can say almost anything in response to the message, and the next pre-stored message will still be appropriate for the conversational topic. Scripts can be written to provide a child using AAC to experience various social communication acts, e.g. greetings/making introductions; telling a joke; relating information; etc.

    Pre-programmed sentences give the perception of ease of use, especially for individuals with cognitive-linguistics disabilities. Consequently, pre-stored messages may be over recommended, since use of this approach may take the burden off of working on or with a single-word vocabulary. Clinical evidence provides data for decision making regarding use of AAC methods of utterance generation. I’ll save the research data for another post. In the meantime, please feel free to ask questions or share how you’re making decisions about utterance generation methods and when you’re deciding to use either method.

    • Re:Pre-stored messages versus Single-words posted by patty on Apr 23, 2007


      In my son's case, we want him to SNUG and are working on that. His vocab is set up that way. BUT, there are some pre-programmed sentences. Jokes are one, some personal information, like address, phone number, etc. (Except while I am writing this, I realize he could tell me info about himself without a pre-programmed sentence.)
      I think sometimes we (parents, teachers, etc.) want those pre-programmed sentences because it's quicker and easier, but doesn't allow for freedom of speech. ( How can we possibly know what is always in this child's head?-whay he really wants to say?)
      I think it's so individual. And in my son's case, there is a mix, but not too many pre-programmed sentences.
      What about spelling? I know it really slows things down when communicating, but in his case, it really helps him when he can't find the right words. And also helps me know what he understands.

      • Re:Pre-stored messages versus Single-words posted by Katya on Apr 26, 2007

        Patty,

        Thanks for sharing. I believe your son’s use of the methods to generate utterances with a voice output system is fairly typical. We use pre-stored messages to gain attention, relate routine information, script narratives (stories, etc). Providing opportunities for more fluent communication is reinforcing, too. Yet, single words are needed to develop linguistic competence.

        I’m in Singapore presenting at a conference with Jennifer Lowe, Executive Director of SHOUT and an augmented communicator. On Tuesday (Monday for you), we were interviewed by the media and were provided beforehand some possible questions to prepare for the interview. Jen had pre-programmed some basic information about herself and her position, etc. Not one of the questions expected to be asked was posed to Jen. During the actual interview Jen was given much more interesting questions to answer about herself, and I was asked questions Jen thought she was going to be asked. Consequently, only 1 answer (maybe 2 – her example to show the difference in message generation methods) contained pre-stored sentences.

        Today, our session included the collection and analysis of a language sample using LAM (language activity monitor) tools. The language sample was based on attendees asking Jen questions. The analyzed results showed a frequency of 2% for pre-programmed messages (1 message about Jen’s educational background). My research database indicates that pre-stored messages are used at a frequency of 2% in conversations by adults who use AAC and self-identify as competent communicators.

        The bottom-line is that we need to be carefully monitoring the use of pre-stored messages as we build communication competence in children. We have times when the frequency increases above the norm, but overall the goal is to approach the performance of the most effective communicators. Jen, and many others, are the role models!

    • Re:Pre-stored messages versus Single-words posted by Terry Gibson on Apr 28, 2007


      I wish we knew it was essential to teach single core words when we started teaching Michael his AAC, but we didn’t even know what the core words were then. We used to store all sorts of pre-programmed messages in his Delta Talker and we even thought this was the right way to meet the aim to say things quickly and easily. Now others who we haven’t managed to convince yet ask for pre-stored messages – that is if they ask for anything at all.

      We stick to the default core words on Michael’s Pathfinder as much as possible, and words that Michael wants to be stored. He does like pre-stored messages for things he wants to be able to say on the spot to people but we make sure he knows how to say the same things using individual words.

      We could have enforced Michael’s learning the part of speech location for words as separate items more if we hadn’t introduced hime to the common co-location phrases that are part of the Minspeak package (the pronouns combined with have, do, will, am, are, is, would, could…) until he had mastered his single words. Using phrases reduces the number of opportunities to learn where single words are stored by part of speech.

      Also, in a sentence containing a verb-pronoun-verb string like ‘do you want’, which two words do you generate as the phrase – ‘do you’ or ‘you want’? What if the string was ‘do you want to go to school?’ Michael might try to say ‘to school’ by hitting ‘to + school’

      I can totally see your point in recommending “NO pre-stored messages until a child is confident and competent at communicating a range of two- and three-word utterances using single core words, because without this core, language cannot be generative.” (Katya Hill, AAC Results You Can Count On Study Day, UK, September 2006), because

      “Young children begin to speak using individual words and word combinations, not full sentences. As language develops, children apply the rules governing the sequencing of language's basic units – iwords and morphemes.“

      (Achieving Success in AAC: Assessment and Intervention
      Katya Hill, Ph.D., CCC-SLP, Executive Director, AAC Institute
      http://www.aacinstitute.org/Resources/Press/AssessmentModelpaper/aacsucc.html)

      Children who use AAC need the same opportunity as speaking people to use single words.

      Regarding communication rate and AAC, Robin and the parents on the AAC Parents Group have posted some very useful comments:

      We need to understand that a voice output speech-generating device (SGD) is NEVER going to produce communication at the same rate as natural speech.

      It is better to base our expectations of communication rate on comparisons of typing and writing to communicate versus an SGD, rather than on natural speech versus an SGD. Verbal people communicate at a rate of around 200 words per minute, which far exceeds the speed of the best touch-typist.

      Think of the SGD as a pen or computer keyboard - many SGD's can hook up to a PC for word processing. On the Pathfinder and similar devices 95% of words are generated with two keystrokes, which is FAR FASTER than typing words L-E-T-T-E-R---b-y---L-E-T-T-E-R, the average word being 6 letters long when you include the space. The Pathfinder automatically generates a space at the end of each word.

      AAC users often have motor skills issues that prevent them from typing fast or even accessing the SGD with their hands at all. Delayed language development issues may be due to late and /or ineffective intervention and teaching. We shouldn’t underestimate a child's potential to learn just because current ability doesn't match that of naturally speaking children of the same age.

      Terry

  • Incredible parents! posted by Guest on Apr 23, 2007

    I'm taking an AT course as part of my GenEd major and our entire class has been following this discussion. Privately we admit to one another that we don't understand half of it. A lot of the AAC shorthand is "Greek" to us and most of us don't have time to read all the references. But we're learning a lot and I didn't want the discussion to end without saying how blown away we are at reading what you parents are doing for your kids! You guys are really incredible and your kids are so lucky to have you! I know that sounds a little cornball, but what with everything that's happened this week around VA Tech, I guess I've been thinking a lot about parents and kids. Anyway I just wanted to say that. And thanks to the moderators and everybody for all the info. Our prof is printing it all for future classes.

    • Re:Incredible parents! posted by Amy M on Apr 23, 2007

      Thanks! It is nice to hear once in a while. Most of us were not given the choice, and some of us no training. I taught myself, and memorized the manual, for 2 years before I ever had any training to use the device. Ever heard practice makes perfect? And the bit about learning from your mistakes? The hardest thing I needed to learn, is to leave it alone if it is Unity. I think there has been about a month since I have added anything new to it. It is fine just like it is.

    • Re:Incredible parents! posted by Robin Hurd on Apr 23, 2007

      Thank you so much for your nice comments! We parents have really worked hard to learn what we need to know to support our children. Most, if not all of us, did not begin the journey to AAC with prior knowledge or training; we learned about this in order to help our kids.

      As a professional, if you ever run into one of us (figuratively speaking)in your work, please don't feel intimidated. If you don't understand us, please ask questions. We are usually happy to share what we have learned, and certainly want to save anyone else from repeating our mistakes. As part of learning about our children's disabilities, we have probably spent hours and hours when we could not sleep at night on-line gathering information to help us through the grieving process and to gain some hope for the future of our kids. We know that you would do the same thing if it were your child who could not speak.

      At the AAC Institute, there is a Parent's Corner area, where monthly articles are posted on topics of interest to parents who are learning about AAC. Many of these articles are also helpful to professionals who are not familiar with the "lingo" of AAC yet, because I try to write them so that anyone can understand. Some of these are stories of real life with a child who uses AAC, as well. Feel free to use these as a professional resource for parents or teachers you may work with.

  • How much fringe is too much posted by Christine H. on Apr 23, 2007

    Hi, I have been following these discussions on and off for the past few weeks and it has been so educational.

    I have a question that may be somewhat redundant to other threads, but I would love some insight on how much fringe, curriculum based vocabulary is appropriate to put on a child's device and how much is too much. I have a client I have been working with that has used direct selection (slow, but steady) semantic compaction on a device with both static and dynamic displays since he was almost 3. He is currently fully included in 4th grade and his teachers are constantly requesting that fringe vocabulary be added into his device. I know Gail VanTatenhove often has kids use the strategy of describing the target word using core vocab (e.g. "dirty bug makes you sick" for Bacteria), however this child is a slow communicator so he often will spell some target vocab. or just not participate in class. This results in the teacher feeling that he is not motivated to learn or that he doesn't understand because he's not demonstrating what he knows using the vocabulary she expects. What is a good way to approach this challenge?

    Thanks for any help.

    • Re:How much fringe is too much posted by Robin Hurd on Apr 23, 2007

      This is a question that all of us puzzle over.

      In my mind, when I am looking at my sons' AAC systems and the school curriculum, the first question I want to ask is, "how often will these words be used?" Sometimes, the words are not likely to be used again any time soon, even if the subject is studied next year, and other times, the words are likely to be used occasionally throughout the year.

      An example of words that are not likely to be used would be the term, "human feature". This was used in the 3rd grade social studies text, to describe things that are on a map and are man-made. Every adult I talked to, including some that teach geography, gave me a blank stare when I asked about that term. Needless to say, we came up with a way around adding it to the device. We used "people made it" as our description, but even storing the word "man-made" would be an option that is much more likely to be used again than "human feature", and would provide quick access for a slow communicator.

      An example of words that are likely to be used more often, and would be good candidates to be on an AAC sytem include the parts of a plant (stem, leaves, flower, seed) or the various Biomes (desert, rain forest, pond, ocean, forest).

      Whenever adding these types of words to an AAC system, care must be taken so that the communication device doesn't become a "tell me what you know" device. By this I mean that the main portion of an AAC system should be about learning to use words, and we must not take away any of the potential for that, in order to have curriculum words on the system.

      We also need to make sure that the teaching of vocabulary that is lower frequency words used only in one subject area during one unit does not take precedence over teaching words that are the building blocks of written and oral communication and language skills.

      In the case of a child who is slow to access the AAC system and struggles with time limits if too many words are used to "get around" having curriculum words on the device, a plan at the beginning of the unit can help. Figure out which of the curriculum words can be easily described with a few words, and which would be hard to get around. Sort out how many words that are new to the student will be used. (Teaching too many new words plus new concepts all at once can be very tough on everyone involved.) A blend of describing the curriculum words and adding some important words to the device can be used effectively. Planning out ahead of time what vocabulary will be taught and making sure that everyone who works with the child (parents, aides, regular ed teachers, SLP) knows what the target words are, can make a huge difference in consistent support throughout the unit.

      Teachers can also learn to ask different questions. Instead of "what is the name of..." Teachers can say, "tell me about..." or "tell me one thing about..." In the example about bacteria, when asked to tell about it or name one thing, the student can say, "makes sick", "need medicine", "wash hands" or a host of other short answers to communicate an idea about bacteria and participate in class.

      • Re:How much fringe is too much posted by Katya on Apr 26, 2007

        You have a great question, that deserves a much closer look at for individuals struggling with access and individuals using low-technology communication boards. Although research indicates that in natural or daily communication fringe vocabulary is used only at a frequency of 15%-20%, providing a much higher fringe frequency seems appropriate under some circumstances.

        We shouldn't throw out the principles of how a natural language works in order to make it easy to design AAC displays, BUT we need to consider the demands on the individual also. I see 2 issues intertwined in your question. The first issues is access. If physical access is so physically demanding, could another selection technique be identified. Obviously, I can't answer that question. However, experience tells me that many students could have been evaluated for an alternative access method that would have been more effective sooner.

        I'm mentioning this, because I'm at a conference in Singapore presenting with Jennifer Lowe, Executive Director of SHOUT and an augmented communicator. Jennifer has discussed the issue of access during our presentations. She told how she was required to use direct selection for years, even though inside she knew it was impossible. Jen uses optical headpointing to access her DeltaTalker now. Her story about access is very telling, and should make professionals think about how we're making decisions about access.

        The second issue has to deal with how we pose questions to individuals using AAC and the expectations we have for an answer. When our expectations for a correct response are based on the use of fringe vocabulary or a complete sentence, then access to core and fringe vocabulary may become imbalanced. Robin really discussed this in her reply. How can we reconsider how we are posing questions to elicit core vocabulary as an appropriate response?

        Initially, this may take bit more time. It's easy to rattle off a list of fringe words related to the topic to organize on a display. It's more difficult to start to think about re-phrasing our questions to encourage a response based on core words. However, in the long term, this becomes easier, and the student becomes more fluent using core vocabulary.

        In the end, the team needs to look over the AAC system as a whole and determine whether the student is making gains in fluent language use. In some environments, the frequency of fringe may be higher. However, across environments, topics, and activities, the frequency of fringe is approaching 15-20%.


  • if you have any questions on anything, please ask posted by Robin Hurd on Apr 24, 2007

    Whew! We are entering the last week of our discussion, and we have talked about a lot of things related to vocabulary and AAC.

    Before we finish up this discussion, I want to make sure that we have answered your questions, and that you understood everything that was discussed here.

    If you have any questions or if anything was just plain tough to understand, please let us know. If it didn't make sense to you, there are probably others who need things clarified, as well.

    We want this to be as helpful to you as possible. Please don't hesitate to ask for clarification on anything that might be confusing.

    Robin Hurd

    • Re:if you have any questions on anything, please ask posted by Terry Gibson on Apr 24, 2007

      I was away Sunday 'til midnight Monday for CM Study Day. Tonight I'm preparing for a visit from our Regional Facilitator for Inclusion, who is interested in what we have written her about core vocabulary. I'm speaking with our MP Tony Blair's Agent Thursday about improving practice in three local departments. Michael's next Annual Review meeting is Monday. Wish I had nearly enough time to prepare and do justice to all of this.

      I'm really grateful for all the valuable information and advice you and Katya and everyone here has shared. So much of it will help to guide a better future for our kids.

      Hope I get to ask and post a few more times between now and discussion end. Terry





      • Re:if you have any questions on anything, please ask posted by Robin Hurd on Apr 24, 2007

        Remember that you can always get the archives after the discussion, when you may have more time to look at everything.

    • Re:if you have any questions on anything, please ask posted by patty on Apr 25, 2007

      I have learned alot from this discussion. I am grateful that I can access the archives....so much to take in and then apply!

      I have some tools to help Ivar and also help the school staff. I think it can be very overwhelming to them.

      Here's an example of how you've helped.
      Ivar has sentences to practice each week for homework. The class goes out into the community a few times a week. They take the local bus and go to the grocery store and library. Language to practice..I go bus. I go store. I buy food. (I actually for the first time changed a core word....I was daring and no one to consult, so I went for it. I changed "fat" to "buy". "Fat" is not a word that I think Ivar will use much, but "buy" is.)

      The bus is called the BTA. Sentence came home to practice..The BTA is 25 cents. Well, Ivar would have all these steps to memorize to accomplish that. So, I suggested this instead. I go bus. It is 25 cents. Much easier for him to learn, builds on words he's using, etc.

      For Ivar, a lot because of his blindness, we can not and should not change vocabulary and add things without thought and planning.
      So, thanks so much!
      ~ Patty

    • Re:if you have any questions on anything, please ask posted by patty on Apr 25, 2007

      Is there a "cheat" sheet for words used in reference to augmentative communication? It would be very helpful to me. Any ideas?
      Some of the lingo, I get confused about....here I have a child who's been using a device for years and I feel kind of silly asking, but....! Patty

  • Patty's question: define some terms posted by Robin Hurd on Apr 25, 2007

    Here is a beginning of some terms that may need to be defined. Please feel free to add to this or ask about other terms that I forgot to add to the list that you'd like to know about.

    AAC—communication other than speech, often used to mean voice output communication devices
    Cognitive limitations, mental retardation, cognitive disability—limitations of the person’s intellectual ability.
    Core vocabulary-high frequency words that research has shown are the most frequently used in written and oral communication. The term has been around for a long time, and has been used outside of the field of AAC as well. For instance, basal readers of the 1940’s used this research as their basis.
    VOCA-voice output communication aid
    High tech-computer based voice output communication systems
    Low tech- paper,lamination and Velcro based communication aids
    PECS-Picture Exchange Communication System—a structured way of teaching a child to communicate using low tech picture symbols
    PCS- a “brand” of symbols, often used for PECS, and used with boardmaker software from Mayer Johsnson
    Semantic compaction, unity, minspeak, LLL—all related to a patented system used to store vocabulary on AAC systems.
    Intervention: therapy plans, what we do to help the child learn to communicate
    Continuum of Learning—an assessment tool that assesses a variety of language and communication skills across a wide range of environments, from initial eye contact and intent to communicate, up to fluent communication. Designed by Tracy Kovach, not yet published.

    • Re:Patty's question: define some terms posted by Robin Hurd on Apr 26, 2007

      Here is another term that was mentioned in the discussion, and should be defined: FITZGERALD KEY. The fitzgerald key was originally designed to help deaf children organize language syntactically. Syntax means the rules that govern how sentences are formed. The fitzgerald key organized words in the order in which they were likely to be used in a sentence, and also color coded the words according to their part of speech.

      It has since been used to support hearing people who use ACC, to build knowledge of the rules of how sentences are formed. Often, the Fitzgerald key is simply considered to be color coding, however, it is also an organizational structure.

      See:
      http://www.deafed.net/PublishedDocs/sub/960920x.htm
      for more information on its original use.

      • Re:Patty's question: define some terms posted by Robin Hurd on Apr 27, 2007

        Yet another term that we have used that we may not have defined: fringe, or fringe vocabulary.

        No, we aren't talking about that fancy stuff on your couch pillows!

        Fringe, as it relates to vocabulary words, refers to those words that make up about 20% of what we say, but are not used often. Generally these are nouns but can also be some unusual verbs, adverbs or adjectives.(backpack, germinate and slimy are fringe words.)

        Like the stuff on your couch pillows, these are the words that "dress up" our speech. Often, these are the words that vocabulary building programs for regular education students focus on, and these are most certainly the words that get highlighted as vocabulary words in science and social studies texts.

        So why don't we seem to want people to teach kids who use AAC fringe words? Beck, McKeown and Kucan(see reference below) as they talk about increasing vocabulary(with regular ed. students) show a 3 tiered hierarchy of words. The largest tier, the foundation for the other 2, is the group of words we call high frequency words, or core vocabulary. The middle tier contains fringe words that are all usable in a multitude of settings but not used as often. The top tier contains domain specific words. These words may be useful during a certain unit in science class, for example, but are not useful outside of that particular setting.

        Since the bottom tier, the high frequecy words, forms the foundation for the other 2 tiers, it must be in place first. Otherwise, the "fringe" words we add don't have the other words they need to let them do their job in communication.

        With children who use AAC and have never had the chance to learn the basics through speech, we stress the focus on high frequency words because they are used so often in text and conversation, can serve many purposes, and are the foundation for fluent communication. we would(hopefully) also do this for a child who was an English Language Learner. (I don't want to get too focused on teaching you the word "germinate" if you don't know and can't yet use the words " It comes up" with meaning.)

        Fringe words, though they are needed and useful, cannot by themselves allow for independent communication and writing skills to develop. A lack of understanding what high frequency words mean(what is "UP" or "behind") can limit comrehension in the child, as well. By focusing on these words first, and building a solid foundation for sentence building, we are readying the child for success in the future.

        Beck, I.l. McKeown, M. G., Kucan, l. (2002) Bringing Words to Life, Gilford Press, NY, NY

      • Re:Patty's question: define some terms posted by Katya on Apr 27, 2007

        I’d like to expand on Robin’s post regarding the FITZGERALD KEY. Robin correctly indicated that the Fitzgerald Key was developed for individuals who are deaf or have significant hearing impairments to support the development of grammar skills, specifically correct word order. Research has shown that the average reading/written language grade level achieved by individuals with significant hearing impairment is 4th-5th grade. Consequently, the Fitzgerald Key is just one visual representation strategy to teaching word order. We must be careful not to assume that the Fitzgerald Key provides for an adequate representation of the morphology (e.g. forms of pronouns, verb tenses) and syntax (grammar) of a language or will promote these skills in children who use AAC. No research has been done in this area.*

        Some AAC displays reference the Fitzgerald Key as a model. When you look at the display, you may notice the color coding to indicate words are organized by grammatical categories, e.g. pronouns, verbs, “little words,” noun categories. Evaluation of AAC displays must go one more step in looking at access to the rules of grammar (rules of how language is generated). Although I might be able to construct a Noun Phrase + Verb Phrase + Noun Phrase sentence moving from left to right on the display, how are morphemes provided to change this sentence into the past or future tense? How can a noun be pluralized?

        When I was first employed as an SLP in the public schools my caseload consisted exclusively of children with complex communication needs. This included 3 classrooms for the hearing impaired. Although the Fitzgerald key was a common intervention strategy, by no means was it the sole intervention. In addition, the Key was not effective in the remediation of the frequent spoken and written grammar problems observed with these students.

        In AAC we have to be very careful in assuming that the use of the Fitzgerald Key will support the acquisition of appropriate morphology and syntax with children who rely on AAC. Access and use of the linguistic structures of a language have to be modeled and taught. Consideration of access to morphology has to go into the early design of an AAC vocabulary system, because use of pronouns, plurals, possessives, verb tensing occurs at the earliest stages of language development. In addition, how morphemes are accessed should be consistent (doesn’t change) so individuals can become automatic in using the correct pronoun, verb tense and prepositions when constructing a sentence.

        The focus of our discussion has been VOCABULARY. Yet, the discussion must go beyond the selection of core and extended vocabulary to making decisions about vocabulary organization that supports the rules of a language. Therefore, we need to be critical in evaluating how the organization (display organization and access to words and morphemes) supports a spoken lexicon in order to be the most efficient possible.

        *As you may have gathered by now I’m in Singapore, meaning that I don’t have ready access to reference more studies to support my views regarding vocabulary organization. However, here are a few references that I pulled from my power point presentations.

        References

        Bedrosian, J.L. (1997). Language acquisition in young AAC system users: Issues and directions in future research. Augmentative and Alternative Communication, 13, 179-185.

        Blockberger, S. (1995). AAC intervention and early conceptual and lexical development. Journal of speech-Language Pathology and audiology, 19, 221-232.

        Bruno, J. (1989). Customizing a Minspeak system for a preliterate child: A case example. Augmentative and Alternative Communication, 5, 89-100.

        • Re:Patty's question: define some terms posted by Lynne on Apr 29, 2007

          Katya brings up another important point that has been troubling me, that is how do we teach/provide access on an AAC device to a variety of morphological structures? In other words, how is a person able to add plurals or past tense, put in prepositional phrases,etc. I've been using color coding and left to right organization for subject + verb, etc, but my student is still limited in being able to give a message that indicates pronouns and verb tense. The discussion thus far seems to reference devices that use Semantic Compaction such as on the Vanguard, etc. How do you include all of this information when the student is using a dynamic display, such as a Dynamyte or Series 4 - whether its set up with a 4x5 5x5 grid or greater? Where is there room for all of the Core vocabulary and yet provide easy access?

          • Re:Patty's question: define some terms posted by Robin Hurd on Apr 29, 2007

            Lynne,

            I am not as familiar with the dynavox devices,since my kids use something else, and I am a parent not an AT specialist, but I'll give this question a try, since Katya may be on an airplane right now, and may not get back with us in time.

            On some of the available software programs for dynamic display, the child first selects the root word, and then can go for the verb tense on the screen that comes up after the root word is selected (sort of the way word prediction can work).

            If I were to try to program this myself, in the screen that came up after I selected the verb, I would put a macro that would delete the word I had just said, and replace it with the verb tense I had chosen. So if I had said "run" and I wanted "ran", I would choose run first, then see "ran" on the screen and select it. Doing so would delete "run" and give me the verb tense "ran", so when I spoke the utterance, it would have the proper verb tense.

            People often add plurals by putting an "S" at the end after choosing the initial word. You would want to have that "s" stored somewhere easily accesible, not on the spelling page, so people could get to it easily. And, what you store there needs to delete the space at the end of the word so the "s" becomes a part of the word that preceeds it. You might save a spot for an "s" on every noun page you designed. This doesn't help with unusual plurals, where you might take off the "y" and add "ies", for example, but it would work most of the time.

            As you can see from Terry's puzzlings over her project, figuring out how to store everything and still have easy access is tough. Go back in the archives and look at how Terry is explaining what she is doing. Some of it may help you out with this question.

            Many people have spent a lot of time puzzling over how to store langauge. Don't be afraid to look into the available software. There is only so much time in a day; and the most important way to spend that time is NOT programming, but teaching language and enjoying those amazing moments of discovery. Dynavox has the Gateway software, which provides a framework of words. There is also word power or picture word power (not sure if they work on a dynamyte or DV-4). Look into these programs and see if they can meet the needs of your clients for verb tenses, plurals, possessives and all of the little niceties that build toward fluent, complete communication. And let the companies know what exactly you wish they had on an AAC system, if they don't meet your needs. Our input can make good changes in what is available.


          • Re:Patty's question: define some terms posted by Terry Gibson on Apr 30, 2007

            We are using an open book which gives us 40 cells to a grid, but I’d just like to post again without mentioning both 40-cell and 20-cell grids in one post, for Lynne and anyone else who is working with only 20 or 25 cells to a grid.

            Our 4 x 5 pages book has around 30 – 34 pages in it, which we feel are well worth adding to any system lacking a core, considering they contain the treasure that the 500 core words truly are.

            Eight of the pages are early-reading nouns and not core vocabulary.

            Our wordlist is a combined list from several sources that also contains words collected from famous language samples, but because a language sample is from a real conversation it can contain some words that are not universal core words.

            I would be the last person to suggest reducing the number or core words a child has fast access to, but you might like to adhere more strictly than we have to a pure core list from principled research – but as Robin so rightly advises, consideration must be give to allowing expansion of the system, and perhaps all the 500 known high frequency words should be given space.

            We feel it is best that all the groups of core words should be linked to from the main page to provide fast access to them.

            There is room on a 4 x 5 contents page for all the following buttons and a few more:

            Main Grid label (which would be the link back to the main grid from any page)
            Greetings / Interjections
            Determiners / Conjunctions (fit on one page)
            Prepositions (most common on one page, link to second page)
            Pronouns
            Indefinite pronouns
            Pronoun abbreviations
            Verb
            Adverb
            Adjective
            Noun
            About Me
            Topics
            Activities

            And six more buttons

            About Me, Topics and Activities could be one link ‘Pages’ that links to a submenu for all three or whichever categories are chosen, if it was desired to save space on the contents grid for more core pages.

            Noun would link to a submenu of categories of noun.

            Adverbs and adjectives together need around 7 4x5 pages and as they easily categorise into ‘Time’ ‘Number’ ‘Feelings’ ‘Colour’ ‘Other Adverbs’ ‘Other Adjectives’. We would make space for at least ‘Time’ ‘Number’ and ‘Other’ on the main grid. ‘Other’ (maybe labelled ‘Describe’ or ‘Adjective’) would lead to a page containing the first ‘Other’ adverbs / adjectives and links to the further pages.

            Core verbs (on our list) need 8 4x5 pages so the ‘Verb’ button could lead to a page containing the first few verbs, buttons to the 7 other verbs pages, and the go back to main grid button, but it might be possible to link to all verbs pages from a main grid with some thought, maybe fewer verbs, maybe ‘Pages’ instead of ‘About Me’, ‘Topics’ and ‘Activities’.

            These are all just ideas and I wish you the best of luck. I would advise speaking with a Minspeak user and checking out Gail Van Tatenhove’s wordlists for any help with categorising words.

            I really having been part of this discussion and thank you all for everything you have shared.

            Terry

    • Re:Patty's question: define some terms posted by Raisa on Apr 27, 2007

      Thank you so much for this! I wish we had it at the beginning of the discussion. A couple of other SpecEd teachers and I have been reading this every day. The young one:-) would sometimes go off and Google a term we didn't understand and come back and report what she found. But as you can imagine we don't have much free time, so mostly we got the gist and moved on. Our school doesn't have the money to send us to conferences to learn this stuff, so this has been invaluable. Thanks!!
      Raisa Goneeva

      • Re:Patty's question: define some terms posted by Robin Hurd on Apr 27, 2007

        Raisa,

        If there are other terms I have missed explaining, please ask. It is important to know what the terms mean, or the discussion can be tough to follow.

        Special educators have very different training than Speech Language Pathologists, and each field tends to have it's own terms, so don't ever feel afraid of asking for clarification. Kids who use AAC need the strengths of each of these fields to succeed in school despite their languge and/or physical challenges.

        By the way, this is how parents sometimes feel at IEP meetings! :) The terms that teachers know and use everyday when doing IEP paperwork don't always mean much to the parents, or worse yet, may mean something totally different to the parents than to the teaching staff.
        Taking a break to explain the terms is never a waste of time.

        Robin

  • Early Words posted by pwcassidy on Apr 26, 2007

    This goes to show the importance of regular ongoing discussion by team members regarding expectations of vocabulary and communicative behavior. I have never been a big believer in "please" and "thank you" as very early words. I have worked with students who learned "No thank you" and as one unit and couldn't say the "No" without the "thank you". But I also realize the "accepting nature" of others when those words are used.

    • Re:Early Words posted by Robin Hurd on Apr 26, 2007

      Yes, the team needs to work together and be respectful of each other. Especially if the parents are very concerned about learning politeness, the team needs to respect their wishes and (at least sometimes) require the polite words to be used. Army-like vigilance is not needed, but an acknowledgement that the child just behaved politely and you like to see that goes a long way toward keeping expectations similar in the different settings.

      Finding vocabulary to communicate that there was a problem and you want to correct it can also be a helpful idea to fix communication breakdowns, apologize for athetiod movements that hurt another person, etc. Each team should choose target vocabulary for this(sorry, excuse me, etc) so consistent expectations for fixing problems yourself can be decided on.

  • Thanks FCTD, Robin and Katya posted by KC on Apr 27, 2007

    Thanks for another information-packed online discussion. This was one of the best! Sorry that I couldn't add anything to this one, but I really liked learning about a whole new world. I've printed out all the posts and organized them in a binder by topic, so if a parent comes to our center with a child who uses AAC, I'e now got a guide I can share. Thanks again!
    Kathy

    • Re:Thanks FCTD, Robin and Katya posted by Robin Hurd on Apr 28, 2007

      You are so welcome.

      I like the binder idea. There was so much in this discussion, that is is hard to glean all of the good stuff out of it in one reading. Plus, as the students who use AAC in your caseload change, some of what has been discussed may suddenly apply when it doesn't now.

      This month's discussion, like the others, will be archived. Please come back to it when you want a refresher on all that was discussed.

    • Re:Thanks FCTD, Robin and Katya posted by patty on Apr 29, 2007

      The binder idea is great! I keep a big notebook with all sorts of info about my son's device. I think I will start a new one like yours!

      THANK YOU SO MUCH ROBIN AND KATYA! I HAVE LEARNED MUCH. YOU HAVE STRETCHED MY BRAIN TO BE BETTER ARMED TO HELP MY CHILD. AS A PARENT, I AM VERY GRATEFUL.

  • Many thanks for your contributions! :) posted by Katya on Apr 28, 2007

    I’ve enjoyed participating in this month’s discussion. As usual, I’ve learned a lot from the parent’s contributions! Next time perhaps, we can have participation from individuals who use AAC.

    Jennifer Lowe, Executive Director of SHOUT accompanied me to Singapore to present at the inaugural i-CREATe (international convention for rehabilitation engineering and assistive technology). Then we participated in the first Town Hall meeting of augmented communicators in Singapore at the Society for the Physically Disabled (SPD). For many Singaporeans, Jennifer was the first competent augmented communicator they met. Jennifer told of her journey using AAC: from bliss board – to Words Strategy on a Lighttalker – to Words Strategy on a DeltaTalker using optical headpointing.

    Many may think that Jennifer is a rare individual – someone who can carry on a conversation using AAC in real time. That’s really not the case, and Jen is the first to admit this. Although Jennifer provided a unique opportunity for the people of Singapore to interact with a confident, successful individual who uses AAC, many individuals in the United States are just as capable and lead just as fulfilling lives. Unfortunately, most teachers, therapists, and administrators don’t have the opportunity that the people of Singapore (not to mention the Princess of Thailand) had this week - just talking with someone without even considering that assistive technology was supporting the interaction.

    Providing a system that handles vocabulary based on the principles of core and extended vocabulary and organizes vocabulary to provide for the rules of language can make this possible. Such systematic, principled approaches to AAC intervention and using spoken language intervention methodologies, allow each person to reach their maximum potential.

    I’d like to invite everyone that participated this month to attend the Pittsburgh Employment Conference (PEC) for Augmented Communicators this August to experience the accomplishments of individuals who use AAC. (A link is at the AAC Institute website at www.aacinstitute.org.) Also, I hope that many parents reading this month will consider attending the AAC Institute Symposium on Evidence-Based Practice, the day before PEC, to talk about aspects of this discussion that time didn’t permit continuing.

    I feel so excited and motivated by knowing the wealth of information that is being shared by families, and hope that each parent feels valued for the knowledge they contribute to improve the life experience of children with complex communication needs.

    Jennifer and I are heading for the airport shortly, and may still be enroute has our discussion comes to a conclusion. If that is the case, I wish to extend a heartfelt "thank you" to everyone that added to our knowledge this month.

    Katya

  • Thank you all and for future reference posted by Jackie Hess on Apr 30, 2007

    On behalf of the Family Center on Technology and Disability I'd like to thank all of you for April's incredible discussion of AAC and Vocabulary Selection. Robin Hurd and Dr. Katya Hill did as fine a job as I've ever seen done, of leading the discussion and sharing a wealth of information resources. Thanks as well to all those took the time and made the effort to post comments, experiences, and questions. Special thanks to Terry Gibson and Patty, our most active participants.

    The discussion transcript will remain available to you in our "Online Discussion Archives". By accessing the discussion by transcript rather than by post, you may find it easier to read and/or print. The discussion transcript will also be included on our 2008 "AT Resources" CD-ROM, which will be released in October 2007. There it will be available in a printer-friendly format.

    We hope you'll join us in June for a discussion of "Best Practices for Implementing Universal Design for Learning." See you online!

    Jackie

Family Center on Technology and Disability (FCTD)
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