Children with Special
Needs can Listen, too!
Kimberly C. Jenkins, M.A., CCC-SLP
Emily C. Noss, M.A., CCC-SLP
Child Hearing Services
University of TN, Health Science Center
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Co-occurring conditions
• It is estimated that 30-40% of children with deafness and
hearing loss have additional disabilities such as:
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Cognitive impairments
Learning Disabilities
Autism
Cerebral Palsy
Sensory Integration Disorder
ADD/ADHD
Feeding and swallowing disorders
Oral-motor problems
Syndromes
CMV
Vision impairments
It’s all about
Expectations
• Our experience with these
children leads us to
strongly believe in
appropriate amplification
(hearing aids, cochlear
implants, and FM systems)
• Hearing may or may not be
the primary disability, but
may end up being one of
the child’s biggest
strengths
• Several benefits of
addressing auditory skills
can be observed
• Success is defined by the
family and the team
working with each child
• Expectations must be
realistic and everyone
must be on the same page
• Address the child as a
whole – not just each
specific disability
• Recognize when referrals
should be made to
professionals with specific
expertise
Team Approach to Assessment
and Intervention
• Require professionals from many
disciplines
• SLP
• OT
• PT
• Medicine
• Education
• Psychology
• Social Services
Auditory Skills
Hierarchy:
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Awareness
Discrimination
Identification
Comprehension
• We want to improve or
maximize the child’s
auditory and
communication abilities
• Develop a
communication mode
(complete
communication
approach can be used)
• Find approach that
incorporates best
practice for each
disability.
Benefits that can be defined as
success with auditory skills for
Children with Special Needs
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Response to environmental sounds
Response to name
Increased attention to speaking, music, voices
Ability to recognize sounds in the home and
school environment
– Ability follow a direction through listening and
then using their form of expressive
communication
– Participate in their environment
Success with auditory
skills
• Success may be difficult to define
• Success is individual
• Timeline may be longer
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Aural Habilitation
Strategies/Techniques
• Create a listening
and language rich
environment
• Handcue
• Acoustic
highlighting
• Auditory sandwich
• Hierarchy of cues
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Talk before
show
• Parent participation
• Self talk/parallel
talk
• Follow child’s lead
• Be flexible
• Model
• 1-2-3
• Suprasegmental
focus – learning to
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listen sounds
Sensory Integration
Dysfunction
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Sensory Integration
Dysfunction Defined:
Sensory Integration Dysfunction (DSI) is
a neurological disorder that resorts from
the brain’s inability to integrate certain
information received from the body’s five
basic sensory systems.
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Analogy
• “Good sensory processing enables all the
impulses to flow easily and reach their
destination quickly. Sensory Integrative
Dysfunction is a sort of ‘traffic jam’ in the
brain. Some bits of sensory information
get ‘tied up in traffic’ and certain parts of
the brain do not get the information they
need to do their jobs.”
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Sensory Integration
• SI provides a crucial foundation for later,
more complex learning and behavior.
• The normal process of SI begins before
birth and continues throughout life.
• Majority of DSI cases occur prior to the
teenage years.
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DSI
• Different from person to person
• Can vary from day to day
• Factors affecting DSI: fatigue, emotional
distress, hunger
• May co-exist with other handicapping
conditions (ADHD, Autism, Down
Syndrome, Hearing Loss)
• Can be severe or mild
• Can occur continuously or occasionally
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Sensory Integration
Why is it important?
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Sensory Integration
Function-Important for:
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Academic Skills
Attention
Auditory Perception
Balance
Bilateral Coordination
Body Awareness
Fine Motor Skills
Visual Perception
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Hand Preference
Muscle Tone
Self-Esteem
Social Skills
Speech/Language
Tactile Perception
Hand-Eye Coordination
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Diagnosis
• Qualified occupational or physical
therapist
• American Occupational Therapy
Association and Sensory Integration
International recommend specific
evaluation and training guidelines
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SI Therapy
• Sensory integration-based OT is
highly recommended
• PT
• ST
• School support/participation
• Home environment
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Sensory Integration
Activities for Treatment
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Childhood play
• Years ago: Sensory-rich experiences
• Swinging, climbing trees, rollerskating, riding bikes, jumping rope,
building sand castles, throwing
snowballs, stomping through mud
puddles, running through the
sprinkler
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Childhood Play
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2011: “Play” is soccer or gymnastics
Staring at a TV, computer, DS, iPod Touch
Sometimes old-fashioned is better!
We need experiences that target all
senses (sight, touch, smell, taste, etc.)
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Tactile Dysfunction
Characteristics
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Child-Oversensitive to
touch may:
• Demonstrate tactile defensiveness
• Exhibits “fright or flight” response to
harmless touch
• Dislike brushing teeth or having hair cut
• Be bothered by sock seams, tags in shirts,
shoes, etc.
• Be a picky eater, avoiding certain textures
• Have poor peer relationships
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Child-Underresponsive to
touch may:
• Touch people/things constantly
• Shows little reaction to pain, gets hurt
without realizing it
• Physically hurt others without knowing it
• Invades others’ space
• Chews on inedible objects frequently
(fingernails, hair, collars, pencils)
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Child with Poor Tactile
Discrimination may:
• Seem out of touch with hands, as though
they are unfamiliar appendages
• Have trouble holding/using tools (pencils,
scissors, forks)
• Be clumsy when zipping, buttoning, tying
shoes, adjusting clothes
• Squirm or sit on edge of chair
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Activities
For the Tactile Sense
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Activities: Tactile Sense
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Shaving Cream: Window clings, mirror or
window, shaving cream
• Auditory targets (beginning listener):
1. Suprasegmentals of speech
2. Vocabulary (1 vs. 2 or more syllables)
3. Sound “on” vs. “off” awareness
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Activities: Tactile Sense
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Live rabbit or other pet, pet food, Easter grass
Speech/Auditory targets:
Auditory Comprehension: Follow commands:
“Give him some (food type)” or “Show me the
rabbit’s (body part)”
Expressive vocabulary, length, and complexity:
Have child describe the way the rabbit feels
(soft, fluffy), describe the sounds the rabbit
makes when he’s eating (carrot-crunchy).
Language web (Older children): Categories
(animals, types of food, habitats, etc).
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Activities: Tactile Sense
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“Buried Treasure”: counting bears, sorting tray,
bucket, tongs, sand
Speech/Auditory Targets:
Descriptive Vocabulary: colors, describe way
sand feels
Discriminate words varying in syllables: bear vs.
bucket
Verbs: dig, bury, cover, scoop
Position concepts: in, under, etc.
Where questions: “Where’s the blue bear?”
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Activities: Tactile Sense
• Sand Dunes: dry sand, spray bottle with water,
toy beach critters, cookie cutters
• Spread sand on tray, spray water until damp, mold
sand into dunes and play “beach” with toys
• Draw in sand with fingers
• Use cookie cutters to cut out shapes
• Speech/Auditory Targets: unit vocabulary,
descriptive language, 1-2 part auditory directions
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Activities: Tactile Sense
• DRESS UP:
• Fancy clothes (bridal veils, satin fabric, etc)
• Uniforms/professional outfits (nurse, doctor,
soldier, cowboy, clown, princess)
• Scarves, neckties, ribbons, aprons
• Feathery boas, old fur jackets, woolen shawls
• Hats, caps, headbands; belts; goggles/glasses
• Shoes: high heels, slippers, sandals, clogs, boots
• Costume jewelry
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Activities: Tactile Sense
• Dress-up good for children not yet ready for wet
textures
• Helps improve fine motor skills: buttoning,
zipping, tying
• Speech/Language: Community helpers vocabulary,
adjectives (describing outfits and textures),
language webs
• Imaginary play promotes social appropriate
behaviors and language
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Benefits:
• Hands-on experimenting with different textures
improves tactile perception, body awareness, and
creativity
• Squirting shaving cream and manipulating small
objects improves hand-eye coordination
• Pushing toys through shaving cream or other
textures improves kinesthetic awareness, fine
motor skills, and visual-motor integration
• If child refuses to touch textures, offer a stick,
spoon, or straw to begin
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Vestibular Dysfunction
Characteristics
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Balance: What and When
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About 2 months: Head control
6-7 months: Sitting
8-10 months: Crawling
9-10 months: Standing with support
9-16 months: Standing independently
9-17 months: Walking
21-30 months: Running smoothly
4-5 years: Hopping on 1 foot
5-6 years: Skipping
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Child-Oversensitive to
Balance and Movement may:
• Be intolerant to movement, try to avoid it
• Overreact to ordinary movement
• Dislike physical activities (running, biking,
etc)
• Dislike using playground equipment
• Be cautious, slow-moving, doesn’t take
risks
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Child-Underresponsive to
balance and movement may:
• Crave intense, fast, and spinning movement
• Be a thrill-seeker or daredevil
• Need to constantly move in order to
function (fidgets, shakes leg, etc)
• Have poor balance, falls easily
• Bumps into objects on purpose
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Child-Poor Discrimination of
Balance and Movement may:
• Easily loses balance (climbing stairs, riding
bike, standing on one foot)
• Move in uncoordinated, awkward manner
• Have low muscle tone (loose, floppy)
• Have poor posture
• Have difficulty remaining upright when
seated
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Activities: Vestibular
Sense
• Have child balance on large exercise ball
• Then sing/participate in body movement
songs: Clap, Clap, Clap your hands; Head,
shoulders, knees and toes; This old man, he
played one
• Speech/language: Promotes sequencing,
auditory memory, pitch/rhythm/intonation,
receptive/expressive vocabulary (body
parts), appropriate speech rate
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Proprioceptive
Dysfunction
Characteristics
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Proprioception: What
does it do?
• Increases body awareness
• Contributes to motor control/motor
planning
• Allows us to walk smoothly, run quickly,
climb stairs, carry things, sit, stand,
stretch, and lie down
• Gives us emotional security (when children
trust their bodies, they feel safe and
secure)
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Child with inefficient,
integration of joint/muscle
sensations may:
• Have poor sense of body awareness
• Be stiff, uncoordinated, clumsy, falling frequently
• Lean, bump, or crash against objects and people
(invades others’ personal space)
• Manipulate hair clips, lamp switches, and pencils
so hard that they break
• Pull/twist clothing, chew sleeves/collars
• Difficulty climbing/going down steps
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Activities: Proprioceptive
Dysfunction
• 1) Jump rope rhythms (Ex. Cinderella)
• 2) Rope activity: child walks along rope on
ground, adult plays drum while child
marches with beat (Ex. Ten Little Indians)
• Speech/Language: Rhythm/intonation,
auditory memory, sequencing, loud/soft
concepts, thematic vocabulary (Ex.
Thanksgiving)
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Activities: Proprioceptive
Sense
• Pound Cookies: prepared cookie dough,
sweet/hard candies, gallon-size, zip-up plastic
bags, small hammer or wooden mallet, cookie
sheet, cookie cutters, and other cookie baking
items
• Activity: Child opens bag of candies, count 5-10
candies, put them in plastic bag. Let air out of
bag, then zip it up. Pound candies with
hammer/mallet until they are sprinkles. Sprinkle
pounded candies on top of cookies.
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Activities: Proprioceptive
Sense
• Pounding with vigor improves
proprioception and force, releases energy,
and increases gross motor skills
• Counting candies, sprinkling sprinkles, and
using tools all improve fine motor skills
• Speech/Language: Counting, cooking
related vocabulary, language webs,
adjectives (describing cookies: taste,
smell, etc).
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Activities: Proprioceptive
Sense
• Perform household chores: sweep, mop, dust, wipe
off the table after snack, clean windows, put
large toys away
• While on hands/knees, color a “rainbow” with
crayons on large butcher paper on the floor or
with sidewalk chalk outside
• Play “cars” under the therapy table, pushing with
one hand, while creeping/weight bearing with the
other hand
• Do animal walks (crab walk, bear walk, army crawl)
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Classroom
Accommodations
Children with Special Needs
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Reduce Background Noise
Level
• Close doors when background noise present
• Use screens, dividers, etc. to isolate various
classroom areas
• Practice good “turn taking” so that only one voice
is used at a time
• Make classroom acoustically friendly
• Have child listen with hands in his lap. This will
help reduce distractions, thus allowing him to be
more “focused” on the teacher or therapist
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Children with Special Needs
• For over-stimulated child, provide
quiet, “time-out” spaces to help child
regroup and become organized (ex. A
reading corner behind the bookshelf,
under a table with pillows or bean bag
chair in a quiet corner)
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Children with Special Needs
• For the child with tactile
defensiveness, allow for minimal
classmate contact (ex. Put child at
end of line, arrange classroom seating
so that he/she is not
jostled/touched by classmate)
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Children with Special Needs
• Tactile defensiveness: Modifications
to art activities
• Be aware of materials such as glue,
finger paints, clay, etc.
• Use tools (i.e. hammer, paint brush)
to help keep child involved
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Sensory Processing
• Minimize auditory distractions (making
classroom acoustically friendly)
• Notify child of any upcoming loud noises
such as fire alarm
• For the “active” child, allow her to stand
at the table while working (or help teacher
pass out papers….walking around the room)
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Children with Special Needs
• For children with low oral/postural
tone, allow gum chewing or hard
candy to suck during writing
activities (check with parent/school)
• This helps to encourage more fine
motor control
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Fine Motor Skills:
Writing
• Working on vertical surfaces (helps child
strengthen shoulder/wrist muscles for
writing) (blackboard, easel, paper taped to
wall)
• Provide spray bottle to squirt water onto a
picture
• Tweezers to pick up cotton balls
• Beads, sequins to make collages
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Fine Motor Skills:
Control
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Hole Punch
Push pegs into clay
Cut cardboard
Pick up small
objects with
tweezers
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Legos
Tinkertoys
Origami
Find “hidden”
objects in Silly
Putty
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Motor Planning and
Organizational Strategies
• Give simple step-by-step directions
• Demonstrate task or ask another child to
“model” the activity first
• Help child with task planning “What
materials do you need?” “What do you do
first?”
• Play “Simon Says” or other sequencing
games
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Motor Planning and
Organizational Strategies
• Use timer to prepare child for transitions
• Use pictures or written list on blackboard
(daily routines); Helps makes transitions
smoother
• Supplement handwriting with other
methods of written expression (typing on
keyboard; computer games)
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Work Activities
For children requiring “increased”
input
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Work Activities
• Place chairs on desks
at end of day
• Take chairs off desks
at beginning of day
• Wash desks or
chalkboard
• Rearrange desks in
classroom
• Help empty trashcans
• Take chewy candy
breaks (licorice, fruit
roll-ups, Tootsie Rolls)
• Take crunchy food
breaks (popcorn,
pretzels, dry cereal)
• Sharpen pencils with
manual sharpener
• Staple paper onto
bulletin boards
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Work Activities
• Climb on the
playground equipment
• Perform sports
activities that involve
running and jumping
• Run around the track
at school
• Have students “push”
against the wall (make
it a game: “Let’s make
the room bigger!”)
• Jump on a minitrampoline
• Stack chairs
• Do animal walks (crab
walk, bear walk, army
crawl)
• Allow the child to use
“squeeze toys” silently
at his desk
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Feeding Disorders and
Treatment
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Oral-Exploratory Play
• Encourages the child to self-discover his or
her own oral mechanism
• Requires visual input (mirrors and shadowing)
• Auditory input (amplification)
• Oral-proprioceptive input (pressure, tapping,
vibrating)
• Oral-tactile input (ice, dry/wet/chewy
snacks)
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What to use in oral play
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Ice
Dry snacks
Wet snacks
Chewy snacks
Liquid snacks
Warm/cold snacks
Washcloths
Rubber toys
• Toothettes
• Tongue depressors
• Toothbrushes
(manual/electric)
• Chew toys
• Straws
• Toothpicks
• Dental floss
• Dental floss holders
• Baby toothbrushes
• NUK toothbrushes
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What to do
• Let the child explore his
mouth (parts and
functions)
• Encourage an increase in
the number and types of
objects a child will
tolerate.
• Mutual imitation by
doing what the child is
doing at the same time.
• Comment on what the
child is doing using
verbal descriptions
(suprasegmentals, self
talk and parallel talk)
• Encourage a great
number, variety, and
range of oral movements
(jaw, lips, and tongue)
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How often and where to
perform oral play
• Can be done in therapy,
the classroom, or home!
• Therapy: 5-10 minutes
of a 30 minute
session/15 minutes of a
60 minute session
• Home: 5 minutes to 1
hour depending on the
child
• Classroom: 10-20 minute
activity in a group or
individually, a center, 510 minutes of a snack
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Oral-Motor Grocery List
• Strengthen suck and blow: sugar is
not good for droolers and citrus
encourages sucking
Applesauce, orange wedges, peanut butter
popsicles, puddings, Caramel suckers,
Jello cubes, Charleston chews , juice bars
Cran juices, lemonade
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Increasing jaw control,
facilitate munch, and 3dimensional chew
• Munch-crunch
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Apples
Carrots
Cheerios
Chips
Corn chips
Graham crackers
Granola
Pretzels
Popcorn
• Chew
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Bubble gum
Cheese
Dried fruits
French fries
Fruit roll-ups
Gummy bears
Jerky
Licorice sticks
Raisins
Skittles
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Jaw control, munch, and
chew continued…..
• Nonfood items
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Balloons
Blowers
Cotton balls
Harmonicas
Bubbles
Pinwheels
Sports bottles
– Straws (variety)
• Arousal/alerting
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Fireballs
Hot tamales
Hot gumballs
Ice chips
Red hots
Sour fruit popsicles
Sour fruit gumballs
Sour gum balls
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Oral-Motor Classroom
Activities : Blowing
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Bubbles
Whistles
Feathers
Cotton balls
Ping pong balls
Breath on a mirror
Party blowers
• Soap bubbles with
colored water
• Painting with balls
• Soap and water
painting
• Kazoos
• Pinwheels
• Mobiles
• kleenex
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Oral-Motor Classroom
Activities : Sucking
• Sucking laminated
materials with
various sized
straws
• Use straws to
drink liquids
(milkshakes,
pudding, yogurt,
Jell-O, etc.)
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Alternative and
Augmentative
Communication with
Children who are Deaf
or Hard of Hearing
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Communication
Methodologies:
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Auditory-oral
Auditory-verbal
Total Communication
Cued speech
American Sign Language
Alternative/Augmentative
communication (AAC)
• If needed, Alternative/Augmentative
Communication may be warranted,
explored, or investigated such as:
– Picture Exchange Communication System
(PECS)
– Picture Exchange/Visual Schedules
– Speech Generating Devices
– Switches
Why might we need to
pursue AAC?
• A poor rate of
progress with
spoken language
skills
• Oral –motor
impairments impact
speech production
• Poor motor control
if using sign
language (no one
can recognize signs
produced by the
child)
• Extreme
frustration from
the child because
he/she can’t
communicate
What is AAC?
• Defined by ASHA:
– AAC refers to an area of research, clinical and
educational practice.
– AAC involves attempts to study and when necessary
compensate for temporary or permanent impairments,
activity limitations, and participation restrictions of
persons with severe disorders or speech-language
production and/or comprehension, including spoken and
written modes of communication.
– Involves the use of multiple components or modes for
communication.
– AAC has 4 primary components:
• Symbols, aids, strategies, and techniques
Terms defined
• According to ASHA:
– Symbols – graphics, auditory, gestural,
textured or tactile symbols
– AAC aid – a device, either electronic or nonelectronic, that is used to transmit or receive
messages.
– Technique – the ways that messages can be
transmitted
– Strategy – the ways in which messages can be
conveyed most effectively and efficiently
• 3 different purposes (timing, grammatic
formation, rate)
Central Goal of AAC:
• To communicate messages to interact
in conversations
• To participate at home, school, and
recreational activities
• Learn native language
• Establish social roles (friend,
student, child, sibling, spouse)
• Meet personal needs
Beginning communicators
• Require support to learn that through
communication, they can have a positive impact on
their environment and the people who surround
them
• Focus on strengths of the child. Build intervention
based on natural contexts. What do peers do in
certain situations? What could child do?
• Use of routines is important
• May exhibit problem behaviors.
Beginning communicators
– Rely primarily on nonsymbolic modes of
communication such as:
• gestures, vocalizations, eye gaze, and body language
• may be intentional or unintentional
– Are learning to use aided or unaided symbols to
represent basic messages for communicative
functions such as:
• requesting, rejecting ,sharing information, and
engaging in conversation
– Use nonelectronic communication displays,
simple technologies, or pictures
(switches/electronic devices with limited
message capabilities) to communicate.
Nonverbal
communication and play
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Joint attention
Eye contact
Gestures
Eye gaze
Body language
– Also important are:
• Pretend play
• Symbolic play
• Adaptive play - AAC
Gesture dictionaries
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What the child does
What does it mean?
What should the interventionist do?
Is it consistent across settings?
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Symbolic Approaches
• Applicable to individuals who have
developed the basic skills of attention
getting, accepting, and rejecting
• Being introduced to symbolic
communication
• Expand their repertoire to include basic
skills such as following a symbol schedule,
engaging in simple social routines
Where to start…..
• Start with Objects
• Match object to picture/picture to object/object
to object
• Use photographs
• Use symbols (boardmaker, line drawings, picture
this, etc.)
• Combine symbols (2 words)/ Use Carrier phrases
• Switch
• Speech generating device??? Trials with different
types
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Teaching Basic
Requesting
• Requesting is one of the most basic and
essential communication skills
• Facilitators need a systematic approach to
teach it.
• Relationship to problem behavior
(inappropriate requesting behaviors)
– Make generic requests (more, please, want)
• Naturalistic teaching interventionsgeneralized and explicit requesting within
natural contexts using a behavioral framework
• Generalized
• Self-initiated generalized requests (gain attention from
partner)
Teaching Basic
Requesting
• PECS – behavioral approach
– Teaches requesting as the 1st skill without requiring
other skills
– Exchange symbols for desired items
– Phase 1 – person learns to pick up a single symbol and
hand to facilitator who give the associated item (can use
an assistant for physical and gestural prompts but no
verbal)
– Phase 2 – assistant gradually moves away to the person
learns to find the picture and take to the facilitator)
– Phase 3 – the number of symbols is increased and one of
the comprehension check procedures is used
– Upon based requesting mastery, may progress to phases
4-6 to build sentence structures
Teaching Basic Rejecting
• Functions as an escape to terminate an ongoing
event
• Relationship to problem behavior – aggression,
tantrums, self-injury
• Teaching generalized and explicit rejecting
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Generic: indicate “no” by gesturing, symbol, etc.
5 main steps for generalized rejecting:
1. an approp. AAC modality selected
2. Nonpreferred items or activities are identified
across a wide range of routines and contexts
– 3. need for rejecting is creased in each of the
identified positive situations
– 4. prompts are provided and gradually faded over time
– 5. remove the nonpreferred item or activity following
the appropriate rejecting behavior
“Talking Switch”
Techniques
• BIGmack and LITTLEmack switches
• Small battery-powered communication aid that is
programmed with a single/short message
• Record voice messages, music, or other sounds
• Recorder should be same age, gender as user
• Activation may be direct or via remote
• Context should be within a preferred activity
• Examples (circle time, transition times, continuation,
turn taking, cheering, greeting, initiating
conversation)
• Step-by-Step Communicator – series of messages
(tell a joke, recite scripted lines in a play
• AbleNet, Inc. Adaptivation, Inc., Enabling Devices
Visual Schedules
• Calendar system, schedule system, activity
schedule
• Represents each activity in the day with
symbols
• May serve several purposes
– Introduce the individual to the concept of
symbolization (the idea that 1 thing can stand for
another)
– Provide an overview of the sequence of activities
across a day
– Provide specific information about what happens
next
– Ease transitions from one activity to the next
– Serve as one component of a behavioral support
plan for predictability
Visual Schedules
• Used with a variety of disabilities
• Can be effective in home, school, and
community settings
• Can be used with a variety of ages and
abilities
• Can use real objects, tangible symbols,
photographs, or line-drawing symbols
• Hierarchy of prompts that are gradually
faded
• Creating and using a visual schedule
• Book “Schedule It! Sequence It!” MayerJohnson / Boardmaker
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Case Example
10 year old
Profound hearing loss/ CP
Utilizes a Cochlear Nucleus 5 CI
Nonverbal
Uses gestures, vocalizations, few signs, and
Dynavox to communicate
Participates with his typically developing peers at
school
Has increased awareness to participate in his
everyday environments
Is able to reject and request nonverbally and with
the use of his Dynavox.
Consistently navigates and selects preferred
activities with at least 5 buttons.
89
References
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Functional Communication training and/or visual schedules interventions for persons
with developmental disabilities – Bopp, Brown, & Mirenda, 2004; Mirenda 1997
Behavior chain interruption strategy – Carter & Grunsell, 2001
Graphic symbol techniques and/or manual signing for individuals with autism Goldstein, 2002; Mirenda, 2001, 2003b
Efficacy of AAC interventions with person with chronic severe aphasia – Koul &
Corwin, 2003
Effects of AAC on natural speech development – Millar, Light & Schlosser, 2002;
Schlosser, 2003a
Presymbolic communication interventions – Olsson & Granlund, 2003
Effectiveness of aided and unaided AAC strategies for promoting generalization and
maintenance – Schlosser & Lee, 2000
Selecting graphic symbols for requesting – Schlosser, Sigafoos, 2002
Use of speech-generating devices in AAC – Schlosser, Blischak, & Koul, 2003
AAC strategies for beginning communicators – Sigafoos, Drasgow & Schlosser, 2003
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References
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Swigert, N. (1998). The Source for Pediatric Dysphagia, LinguiSystems, East Moline,
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Klein & Delaney. (1994). Feeding and Nutrition: Oral Alerting Activities. Therapy Skill
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Contact Information:
kclift@uthsc.edu
eclark1@uthsc.edu
97