Cindy Nankee
CESA #3
WATI Consultant cnankee@cesa3.k12.wi.us

• Share assessment experiences
• Showcase low, mid & high tech AAC
• Communication Symbols
• Ideas for Using AAC
• Set Up Success
• Educational Opportunities
• Planning Communication Boards – the
80/20 rule
• Boardmaker

• Participants will increase knowledge of low to high tech AAC materials, devices and software.
• Participants will increase knowledge of AAC implementation in therapy, in the classroom, in the home and in the community.
• Participants will understand strategies for success in using a communication system
• Participants will increase knowledge of AAC resources.
• Participants will create materials using
Boardmaker software

Name some ways we communicate

Crying

Eye contact

Sounds

Words

Pointing

Falling asleep

Screaming

Silence

Communication boards

Picture exchange system

Voice output systems

Gestures/signing

Hair-pulling

Body position

Augmentative/Alternative
Communication
AAC
* refers to the ways (other than speech) that are used to send a message from one person to another (ASHA, 2005)
Examples
• Communication boards/books/picture symbols
• Voice output communication devices (VOCAs) now referred to as (SGD) Speech Generating Device
• Picture Exchange Communication System (PECS)
• Morse Code
• Eye Gaze

“Giving up” on speech
Only for those of a certain IQ
Only the job of the speech-language pathologist
Just “HIGH TECH” devices
A “one-time only” endeavor

AAC can be a vehicle for developing: expressive language receptive language literacy control over the environment communication initiation

• increased academic success
• increased participation in social situations
• increased self-esteem
• increased job opportunities
• And more…

– Pre-Readers
– Communication
Delays/Disorders
– English Language
Learners
– Attention Deficit
Disorder
– Comprehension
Problems
– Learning
Disabilities
– Developmental
Delays
– Traumatic Brain
Injury
– Down Syndrome
– Autism Spectrum
Disorder
– And many more…

• ASNAT
• AT Checklist/AT Wheel
• STAGES
• ATLAS
• Evaluware
• TASP Test of Aided-Communication
Symbol Performance
• Communication Matrix
– www.designtolearn.com
– Online Free/hard copy $8.00

Online Communication Matrix
• The Communication Matrix is an assessment tool designed to pinpoint exactly how a child is currently communicating and to provide a framework for determining logical communication goals.
• This online version was designed especially for parents
• The parent version is designed to be "user friendly"
• Results on a one page Profile

Showcasing Low to High Tech AAC
The WATI Continuum
Communication board or book
Eye gaze frame
Simple voice output device
Voice output device with levels
Voice output device with icon sequencing
Voice output device with dynamic display
Devices with speech synthesis that use typing

• Vocabulary that reflects all 4 categories
– Wants & Needs
– Exchanging Information
– Social Interactions
– Social Etiquette
• Using the available symbols, could you communicate about an activity in all categories?

http://www.ange
lfire.com/pa5/as/ asteachersites.ht
ml

www.autismshop.com

Placement of Communication
Boards
• Mount on Wheel Chair
• On Desk/table
• On locker
• On Wall/ by bathroom/ sink
• Play areas
• Work area
• Kitchen area

AbleNet www.ablenetinc.com/
BIGmack Switch
(800) 322-0956

http://www.amdi.net/ www.attainmentcompany.com

Pathfinder,
Prentke-Romich
Company http://www.prentrom.com

Voice Output with Dynamic
Display
Mercury
DV 4 and MT 4
E-Talk
Palmtop

Tango by Blink Twice www.blink-twice.com

• AAC Software with speech output
• www.mayer-johnson.com
• Windows and Mac
• Create personalized dynamic, multilevel, talking boards
• $649.00

Type and Talk speech Synthesis

Tablet PC Speech Assistant www.herbi.org

• VOCA – Voice Output Communication
Device
• SGD – Speech Generating Device

Companies handling dynamic display devices
• www.dynasys.com
DV4, MT4, MightyMo,
DynaWrite
• www.prentrom.com
Pathfinder, Vantage,
Vanguard, Springboard
• www.aacconnections.com
Mercury,
MiniMerc, Enkidu
• www.blinktwice.com
Tango
• www.attainmentcompany.com
E-talk

More on
Communication Symbols

1. Like
2. Again
3. Show me
4. Whole
5. Past
6. Fast
7. Correct
8. Short
9. Tomorrow
10. Word
11. Communication
12. That’s crazy!

Communication Symbol
Guideline
– REAL OBJECTS
– TANGIBLE SYMBOLS
– TOBIs (true objectbased icons)
– COLOR PHOTOS
– BLACK & WHITE
PHOTOS
– LINE DRAWINGS
– PICTURE
COMMUNICATION
SYMBOLS
– TEXT W/ PICTURES
– TEXT & LETTERS

www.adaptivation.com

• Tangible symbols are objects or pictures that stand for or represent something about which we need to communicate.

A T.O.B.I. can be a line drawing, photograph etc. which is cut out in the actual shape of the item it represents

When Billy gets home from school…

Picture Communication Symbols

Communication Board with words/letters/numbers

• In Therapy
• In the Classroom
• In the Home
• In the Community
• Behavior Regulation

Hodgdon, 2002
Give students information about their activities
Prepare students for what will or will not happen
Reduce the anxiety that comes from the unexpected, especially during transition times
Help students understand the concept of “finished”
Provide the structure for appropriate behavior and participation
Support communication and conversation

 What is it? A visual representation of a span of time or of a specific activity.
 When? They can be used to help cue a child as to what comes next (e.g., put on snow pants, put on boots, put on coat, put on mittens)
 How? Mount picture symbols or labeled photos on magnetic board, tag board with
Velcro, or tape and have the board with you during that activity. Model use of it so the child can eventually perform the task independently.

www.autismshop.com

“Behavior problems emerge because what the student is expecting and what is really happening are not the same.”
Linda Hodgdon, 2002
• Calming down board
• Rule Cards (“When I get to the gym, I sit on the red line.”)
•
International NO
•
Lightning Bolt
• Activity Termination Symbols
• Social stories w/ or without picture supports
• Card to hold (WAIT)

Hodgdon, 2002
*Student may need to LEARN what it means to make a choice
*Start with highly desirable choices
*Choices often motivate the student to communicate
*Offer immediate reinforcement for their choice
*Choice-making can be practiced multiple times per day
*Adults can structure the choices provided

• Which snack to eat
• Which toy to play with
• Which seat to sit in
• Which person to walk with
• Which cereal to buy
• Which washcloth to use
• Which job to do
• Which CD to listen to
• Which book to read

Tools for protesting or rejecting
"All Done“ Card http://www.cesa7.k12.wi.us/sped/autism/assist/asst13.htm

"Wait" Card http://www.cesa7.k12.wi.us/sped/autism/assist/asst13.htm

• Same as in Therapy
• Vocabulary
• Literacy Boards
• Literacy Activities to expand language
– Customize books
– You don’t have to talk before you read
– Reading comprehension increases if you are able to talk about it

 What is it? A single page containing pictures/words specifically relating to a particular story
 Why? Used to identify key characters of the story, along with messages like “turn the page,” “more” or other story-specific comments
 When? Use before, during, and/or after a story to help lead discussion and help the child fully understand the vocabulary and concepts within the story
 How? Model use by pointing to characters, comments as you talk/read about them

Boscobel ECH
Lily Rider, Louise Hebel

Boscobel ECH
Lily Rider, Louise Hebel

Boscobel ECH
Lily Rider, Louise Hebel

Software to expand language skills
• Laurette
• Stages choice
• Pixwriter

• Same as Therapy and classroom
• Create boards for playing games
• Follow a recipe
• AAC systems with infrared can be used to control anything that can be operated with a remote
– Channel surf the TV
– Purchase a infrared mini controller and automate small appliances (lights, fans, computer, robotic vacuum)
– Control infrared toys & switch adapted toys

Playdough recipe with Pixwriter

• Same as Therapy/Classroom/Home
• Make choices at the restaurant/library/
• Make comments about: sporting events/movies/concerts/ plays/festivals/fashions
• Create shopping lists

The focus is not on the technology
(low or high) rather, it is on communication, the academic activity and language.
??
Remember
??

The following section from CCE Creating Communication Environments
– Activities that focus on communication
– Environment that’s conducive to communication by the child
– Partner that knows how to prompt, model, elicit language, pause
Communication

Arrange the Environment to Increase the Likelihood of Communication
Common Strategies….
 Use motivating materials and activities
 Materials should be in view but not accessible
 Student should need assistance with some materials
 Provide small or inadequate amounts of materials
 Sabotage
 Provide something the student doesn’t like/want
 Use communication boards/devices & visual tools

Increase Communication by being a good communication Partner
 Accept and respond to ANY communication attempt
 Provide descriptive feedback instead of praise
(“You wanted paint. Here’s more paint.”)
 Be silent when appropriate
 Be aware of use of figurative language
(“take your seat” vs. “sit”)
 Use a prompt hierarchy

• Environmental Cue
– PAUSE
• Open Question
– PAUSE
• Prompt OR Request for Communication
– PAUSE
• Full Model
– PAUSE
• Incorporate descriptive feedback into each step

• Set up the environment to signal to the student that an activity is about to begin.
– Ringing bell
– Lining up at the door
– Art materials prepared but out of reach
– Desired items visible but inaccessible
– Cutting the pizza, e.g.
• After student responds, provide...
Descriptive Feedback

• Focus your attention on the student
(expect communication!)
A
• PAUSE
N
D
• After student responds, provide...
Descriptive Feedback

• If the student does not respond to the pause by making a response:
– Ask a WHAT, WHY, WHO, WHEN, WHERE, OR
HOW Question
• “What do you want?”
• “Whose turn is it?”
• “Where does that go?”
• AND then…...
PAUSE
• After student responds, provide...
Descriptive Feedback

Prompt or Request Communication
• Provide a prompt to students
– Choices, carrier phrase, initial sound, visual cue
OR
• Request Communication
– “Tell me what you need.”
– “Tell me what goes next.”
• AND then…… PAUSE
• After student responds, provide...
Descriptive Feedback

• Provide a full model for student
– Use student’s AAC device
– Use developmentally appropriate model
• AND then…...
PAUSE
• After student responds, provide...
Descriptive Feedback

Pause Pause Pause Pause Pause Pause
Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause
Pause Pause Pause
Pause
Pause !

 Gives student the necessary time to process information and to formulate a message to communicate
 Provides a structure for adults that encourages communication
 Can be customized for individual students
 Organized least to most

• Visual Strategies – Susan Stokes www.wati.org
CESA 6 - 12/20 CESA 9
2/26/07
• CCE (Creating Communication
Environments) WATI Consultants
• Get A Grip On Communication www.wati.org
Cesa #2- 1/26 and 4/24
• DynaVox – www.dynavoxsys.com
• PECS (Picture Exchange Communication
System) Green Bay 1/4 & 5; Milwaukee
4/23 &24 www.pecs.com

Creating a Communication
Environment
(CCE)
CCE is for staff struggling with the implementation of
AAC systems including language boards and low tech to high tech devices, across the school environment.
Communication

Creating a Communication
Environment
(CCE)
• A four part sequential intervention
• A team is required (teacher, SLP, Para, OT, PT,
Parent)
• CESA #2 Milton Wisconsin
• $600. per 3 person team, $50. per additional team member
• Jill Gierach, CESA #2 WATI consultant
• Shelly Weingarten, CESA #1 WATI consultant
• www.wati.org
training link

• 2 part training – assessment & programming
• Severe and profound multiple disabilities
• Special educators, SLP’s, OT’s,
Paraprofessionals, Parents
• $225
• College credit
• www.cesa2.k12.wi.us
registration forms

DynaVox Trainings www.dynavoxsys.com
• DynaVox Local Trainings
– Introductory and Advanced Trainings
• Online Programming Tutorials
– Video and slide presentations
• DynaVox Virtual Classroom
– an online learning environment that features a live instructor

Picture Exchange Communication
System (PECS):
• PECS allow the child to spontaneously initiate a communicative interaction by actually exchanging, or giving a visual representation system to another person.
• By making a physical exchange with another person, the child develops a concrete understanding that communication is an actual exchange of information between two or more people
• The PECS program is composed of various phases or levels, starting with simple, concrete communicative exchanges and moving to more abstract communication.
• Visual representation systems which can be used: miniature objects, T.O.B.I.s, photos, real drawings, line drawings, written words.

Visual Resources for Enhancing
Communication from the Indiana Resource Center for Autism www.iidc.indiana.edu/irca
*Attainment Company, Verona, WI 800-327-4269 www.attainmentcompany.com
*Autism Resource Network www.autismshop.com
*Don Johnston Company, Volo, IL 800-999-4660 www.donjohnston.com
*Imaginart Communication Products, Bisbee, AZ 800-828-1376 www.imaginart.com
*IntelliTools, Inc., Novato, CA 800-899-6687 www.intellitools.com
*Mayer-Johnson Company, Solana Beach, CA 800-588-4548 www.mayerjohnson.com
*Pyramid Educational Consultants I nc., Newark, DE 888-732-7462
*Silver Lining Multimedia, Inc., Poughkeepsie, NY 845-462-8174
*Slater Software, Inc, Guffey, CO 719-479-2255

• Planning
– Assessment & Design
• Boardmaker
• Speaking Dynamically Pro
• PixWriter
• Microsoft Word Table www.imaginesymbols.com

Augmentative Alternative
Communication is 80% planning and
20% programming

• Evaluware
– Computerized assessment
– Assesses size/spacing/visual preferences/auditory preferences
• TASP
– Hard copy assessment
– An easy-to-use tool for assessing symbolic skills,
– Design communication boards
– Help select Aug Communication device
– Set appropriate AAC goals
– Serves as a tool to benchmark progress in aided communication performance.

Designing Communication Boards
• Physical considerations:
– Size of symbols
– Spacing between symbols
– Physical access to all locations of board
– Landscape vs. Portrait orientation

Designing Communication Boards
• Visual considerations:
– Color vs. black/white
– Color background
– Size & spacing

Designing Communication Boards
• Language/Cognitive Considerations:
– Type of message (single word vs. phrase)
– Type of symbol (Photos, line drawings)
– Amount of vocabulary to be displayed at a time
– Organization
Brandenburg, S., & Vanderheiden, g.C. (1988)
The Vocally Impaired: Clinical Practice and Research pp. 84-135

Arrangements for
Communication Displays
Activity-Based Category-Based
Grammatically
Correct-Based
Alphabet and Word
Based

• For use with a specific activity (block play, cooking, office help)
• May necessitate repeating of symbols across multiple displays
• Should include comments and social etiquette messages
• General left-to-right progression (personaction-attribute-object-location)
• Should include problem-solving messages

• Groupings are based on categories with vocabulary items arranged according to familiar categories
• May include a main board (e.g., I want to tell you a joke) with branching subtopic messages
• Requires knowledge of categorization and the hierarchy of language
• Difficult to express relational concepts, or complex thoughts, and difficult to use appropriate syntax

• Groupings are based upon some knowledge of grammar
• Provide a way to generate more complex thoughts, to develop linguistic and literacy skills
• Includes semantic arrangements, grammatical arrangements, or a modified
Fitzgerald Key
• Makes it possible for communication partners to model language (augmented input/aided language stimulation

Alphabet or Wordbased Displays
• Groupings are based on the alphabet
• May include combination word-symbol messages
• Effective use depends on the student’s prior knowledge, future goals, and the message selection techniques being used

www.aacintervention.com
Tip of the month

Goosens’ Crain & Elder Color Coding System
C ommunication Displays for Engineered Preschool Environments (1994)
• Verbs…………………..Pink
• Descriptors………..Blue
• Prepositions……….Green
• Nouns…………………..Yellow
• Miscellaneous……Orange
– “WH” words, exclamations, negations, etc.

Planning is Ongoing
Continue to Adjust Variables
• Expand vocabulary
• Increase size & array of symbols
• Increase settings: home/community/other people/times in a day
• Differ communication: requests/labeling/commenting/questions
• Multi symbol utterances
• Accessible/portable
• Bridge up/down hierarchy

• Calendars
• Schedules
• Vocabulary
• Worksheets/Quizzes
(matching/fill in)
• Math/Reading/
Science/SS
• Social Stories
• Community
• Picture supported story/newsletter
• Literacy board
• Weather Board
• Snack placemats
• Games (bingo)
• Certificates
• Greeting Cards

Kristin Whitfield
DynaVox educational specialist

• Picture communication symbols used to create communication boards, device overlays, worksheets, picture schedules
• Teacher Tool
• www.mayer-johnson.com
• $299.00

• This is Boardmaker plus voice
• Create interactive Activities
• Minus SDP bells and whistles
• Student/classroom Tool
• www.mayer-johnson.com
• $399.00

Boardmaker with Speaking
Dynamically Pro Software
• SDP is a speech output program
• Use to create dynamic, talking, multilevel communication boards
• Teacher Tool
• Individual Student Tool
• www.mayer-johnson.com
• $649.00

http://www.imagineSymbols.com
• 4000 symbols include emotions, animals, verbs, nouns, computer technology, and many more. Imagine
Symbols are available for download for non-commercial use.

• This is a great site for nonreaders. Everything is in symbols. Stories, news, recipes, personal care, and much more. There is even a newsletter that is similar to
News 2 You.....but it's free.

• Resources on symbol use
• Symbols for literacy
• Products
• Webwide – see websites with symbol support

American Speech-Language-Hearing Association website: www.asha.org
Burkhart, L. 1993, Total Augmentative Communication in the Early
Childhood Classroom, p.38
Binger, C. & Kent-Walsh, J. (2005). Evidence-Based Language Supports for Children Using AAC: Increasing Expressive Communication.
Closing the Gap conference, Oct. 2005, Minneapolis, MN.
Casey, K. & Kornfeld S. (2004). Developing language-rich light tech AAC systems for young children. Closing the Gap, October/November
2004, 23 (4).
CESA 4 & 5 Cumley, J. and Pallaske, M., CESA 1 & 2 Weingarten, M. and
Gierach, J., Creating Communication Environments training, 2005
DynaVox educational specialist Whitfield, K., Planning for and supporting
Meaningful Participation and Learning for children and Adults Using
AAC

Problems in Autism: Improving Communication with Visual Strategies,
QuirkRoberts Publishing, www.usevisualstrategies.com
P.O. Box 71
Troy, MI 48099-0071
Hodgdon, L., Solving Behavior Problems in Autism: Improving Communication with
Visual Strategies, QuirkRoberts Publishing, www.usevisualstrategies.com
P.O.
Box 71 Troy, MI 48099-0071
Karlan, George. Environmental Communication Teaching Training. Field-Initiated
Research Grant Award No. H023C9005 from the Office of Special
Education, U.S. Department of Education. Lafayette, Indiana: Purdue
University.
Quill, Kathleen, Do-Watch-Listen-Say , Paul H. Brookes Publishing, 2000
Raising a Reader, Raising a Writer: How Parents Can Help. Washington DC:
National Association for the Education of Young Children (NAEYC) #530
Teaching Our Youngest: A Guide for Preschool Teachers, Child Care & Family
Providers, U.S. Department of Education