Promoting Communication in Students with Complex Needs

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Indiana Area SD
January 19, 2015
Jayna Greenfield
ARIN IU 28
AT Consultant
 Understand
the definitions of
communication and AAC.
 Review the federal requirements for all
students to have access to
communication.
 Realize strategies to set up the
environment for communication.
 Define core vocabulary and learn how to
implement it.
 “A
process by which information is
exchanged between individuals
through a common system of symbols,
signs, or behavior.”- Merriam-Webster’s Dictionary
Simply put, it’s the EXCHANGE
of IDEAS!!!



A two-way process, consisting of:
• Sender (Expressive Communication)
• Receiver (Receptive Communication)
Intentional- to convey a message
Verbal or nonverbal
A system that is understood by both
parties!
A system is not in place or not understood
by both parties!
 How
they
communicate:
• Smile, laugh
• Cry, fuss, whine
• Ignore, stare
• Throwing, hitting,
tantrum
 What
they
communicate:
• Pleasure, enjoyment
• Displeasure, pain
• Disinterest, boredom,
over-challenged,
under-challenged
• Displeasure, pain,
overstimulated,
understimulated,
confusion
 Greet
others
 Reject what we don’t want
 Ask for what we do want
 Comment on what we see
 Tell stories
 Complain
 Ask questions
 Answer questions
 More…
• Self- initiated
• Spontaneous


“Being able to meet the changing demands and to fulfill one’s
communication goals across the lifespan.”
Communicative Competence should accomplish four main
purposes:
• Expressing wants and needs
• Developing social closeness
• Exchanging information
• Fulfilling social etiquette routines
(Light, 1997)

Augmentative and
Alternative
Communication
Includes all forms of
communication (other
than oral speech) that
are used to express
thoughts, needs, wants,
and ideas.
(ASHA, 2011)
Nova Chat 7
1. Not all students who need
a means to communicate are
provided with AAC.
2. Students who use AAC
are often provided with
insufficient opportunities
and messages.
3
Federal laws address the obligations of
all public schools to meet the
communication of students with
disabilities:
• Individuals with Disabilities Education Act
(IDEA)
• Title II of the Americans with Disabilities Act of
1990 (Title II)
• Section 504 of the Rehabilitation Act of 1973
(Section 504)
In order for our students to have
successful communication:
Communication partners must learn
efficient interaction techniques.
These techniques must be part of
every day activities and routines.
Environmental Communication
Training/ Teaching
Training project developed by Dr. George R. Karlan at Purdue
University during the period of 1989-92. This project was supported
by a research grant from the Office of Special Education, U.S.
Department of Education
A teaching approach that is
designed to assist classroom teams
in delivering communication
intervention within the context of
existing natural environments.
versus
Arrange Environment
Select Communication Targets
Respond to the Person’s Initiations
Reinforce Communication Attempts
Arranging the environment to increase
the likelihood that the person will initiate
a communication attempt!
• Bringing other students physically close to target student
• Providing a “choice” menu (same choices for all students)
• Omit expected materials or steps
• Swap materials among students
• Make favorite or needed materials visible but out of reach
• Establish routines and expectations







Interesting Materials & Activities
Materials in view but out of reach
Materials with which the learner will need
assistance
Small or inadequate portions
Sabotage
Something the person doesn’t like
Absurd or silly situations
1.
2.
3.
4.
5.
PAUSE
Ask an Open Question & PAUSE
 What, Who, When, Where, How
Provide a Partial Prompt & PAUSE
 Offer choice, give hint/clue, model initial sound(s)
in word
Request for Verbalization & PAUSE
 Request proper form, or for elaboration
Provide a Full Model & PAUSE
 Descriptive
feedback with praise.
 Provide desired object or activity.
 Reinforce with a statement, not another
question!
 Position
communication board/display for
access as well as interaction with task.
 Sufficient symbols for choice-making
throughout the activity.
 Messages that have potential to be generalized
or grow.
1.
2.
3.
Reinforcing items, also known as “Wants”
• Ex. iPad, spinner toy, Thomas the Train, goldfish cracker, etc.
Basic “Needs”
• Ex. Bathroom, tissue, food, drink, etc.
Activity based words
• Ex. Weather, numbers, colors, holiday vocabulary like turkey,
pilgrim, etc.
Our purposes for communicating
change over time:
Sharing
Information
WANTS
Sharing
Information
&
NEEDS
WANTS
&
NEEDS
Sharing
Information
WANTS
&
NEEDS
J. Cumley, 2001
Based on J. Light, 1988, 1997, 2005



“Core vocabulary is composed of high frequency
words that are very versatile. In contrast, fringe
vocabulary is composed of words that occur
infrequently and lack versatility.”
Core vocabulary consist of pronouns, verbs, question
words, prepositions, articles, etc.
Fringe vocabulary consist of only of nouns.

Two people on the phone…The first one
says, "What would you like to do?" The
second one responds, "I don't know." The
first one replies, "Why don't you come
over, and we can watch a movie.“ (*Contractions
count as two words.)
1.
2.
3.
4.
Count the total number of words spoken. 22
Count the number of nouns (not
pronouns). 1
Subtract #2 from #1. 21
Divide #3 by #1. What do you get? 21 ÷ 22 = .95
95% Core
-www.aaclanguagelab.com

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
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

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
Percentage
9.5
8.5
7.6
5.8
5.2
5.0
4.9
4.9
4.9
4.6
4.4
3.8
3.2
3.1
2.8
2.7
2.7
2.6
2.4
2.3
2.3
2.1
1.0
96.3%
These 26 core words
comprise 96.3% of
the total words used
by toddlers in this
study.
Banajee, M., DiCarlo, C, & Buras-Stricklin, S.
(2003). Core Vocabulary Determination for
Toddlers, Augmentative and Alternative
Communication, 2, 67-73.
1. Choose
high frequency words
(Core vocabulary)
2. Look at normal language
development



Gives you a starting point…a guideline!
Allows you to focus on providing and teaching a planned
set of high-frequency, re-usable vocabulary!
Same vocabulary can be used across all settings…don’t
need to get bogged down in creating new boards for
every class, situation, and setting!
 Gives
them a CONSISTENT
communication tool!!
 Gives them access to
communicative POWER!!!! They can
say a wide variety of concepts with a very small
number of words, and can be used in many
ways.
ACTIVITY:
50 Core Word Board


The top words needed for reading are CORE WORDS!
Learning to read and write is the best example for the
need for focusing on core in the classroom.
• Dolch words list
• Teacher word walls
-Gail VanTatenhove, 2013
1. SELECT Core, Personal Core, & Fringe Vocabulary Set
2. STRUCTURE Your Environment
3. PLAN Starter Word Set and Activities Throughout the Day
4. MODEL- Aided Language Input
5. TEACH the New Word(s) with Direct Instruction Activities
6. PRACTICE- Elaborate and Provide Repeated Exposure
7. CHECK for Understanding & Reteach if Necessary

Think about the FUTURE! (If this student went to grad
school, could he still use this same system?)

Will you be using a board, device, or a combination if
using this as a classroom approach?

How many icons- 50, 84, 100? (Think FUTURE!) You will
mask/hide icons at first!

If student has major cognitive issues, consider working
towards 20!

Personal Core- Nouns that are very important to the AAC
user….words they use on a daily basis.

Fringe- Nouns that are used everyday in the classroom.
• THINK HIGH FREQUENCY OVER THE YEAR, NOT THE SEASON.
-PrAACticalAAC.org

Label classroom with CORE, not nouns. (Or do
both, but at least add CORE with symbols!)

Word walls with Core Words.

Laminated CORE board for YOU to use during
instruction, placed where you can easily reach it!
• Chalkboard?
• Directly on table?
• Use of a “Pointer Finger”

Put highly motivating items in view, but out of
reach. (Principles of ECT)

Don’t make this difficult! Use your CURRENT activities, and
find ways to incorporate AAC use.

Mask/ Hide the words you aren’t yet going to introduce on
the student’s board, but keep YOUR classroom board full.



Identify parts of the day you want to focus on implementing
CORE. The words are so versatile, this will be easier than
you think!
Consider adding a “language lesson” time in your day, in
addition to all the other incidental learning times!
Think about current communication level- emergent, context
dependent, or independent communicator. One word? Twothree word phrases? Sentences?

Lessons need to be motivating and meaningful to the student!
Finding icons on the board/device is a labeling activity, not
communication.

Have parents/ caretakers do an “Interest Inventory” or
“Reinforcer Survey.”

You don’t have to spend a fortune…look for cheap toys at the
Dollar Store, Goodwill, or your kids’ old toys.

Do craft activities…if they are motivating to the student.

Use materials already in the room/ school! (Spinning chair,
wagon, swing, slide, music, trampoline, computer videos if
appropriate, power point books*, fan, water fountain, door,
window, light switch, etc.)

Be GOOFY !

Make BIG reactions!

BE THE CHOCOLATE CHIP COOKIE!!
Learning AAC must occur in the
natural environment.
The chances
of students transferring
the skills taught
outside the natural environment
are SLIM!
 “Content
is key. Real learning doesn’t
occur in isolation or via discrete tasks.” –
PrAACticalAAC.org
 Lessons can occur in speech therapy
and/or in LSS/ LS.
 Get lesson ideas from:
• www.aaclanguagelab.com
• www.minspeak.com
• A Year of Core Words- On WikiSpace
Theory never becomes
reality without
practice!
-Kelly Fonner, 2014
Practice, practice, practice!!!
Consider taking a copy of the board or
device home for you to get familiar with it.
 Make as many opportunities as possible!
 An IA can help transfer this across school
classrooms.
 It can become “a way of doing business.”
 The student may be only at the one-word
level, but you can elaborate by talking to
them using 2-3 words on the AAC system.
 Also, consider multiple word meanings!


• Turn on the water, my turn/your turn, turn around, etc.


This is an ongoing process.
If the student begins to use the words without
cues/prompts, then we know they get it! 



Getting off/on bus. (Greetings, OFF bus, IN building, GO OUT,
GET READY)
Settling in room. (Coat OFF, Hang UP, Backpack OFF, Take OUT
papers, PUT papers HERE, Hang UP backpack, DO YOU WANT
HELP)
Morning Meeting (LOOK at board, HOW are YOU, GOOD/
BAD/HAPPY/SAD/SICK, WHO is HERE, WHO is NOT HERE,
WHAT’S the weather NOW, WHEN DO we GET our next break,
YOUR TURN, MY TURN)

Transitions. (COME, GO, STOP, HERE, THERE, WHERE are YOU
Going)

Academics/ Lessons. (LISTEN, TELL, LOOK, MAKE, READY,
HELP, BIG, LITTLE, DIFFERENT)

Lunch. (ALL GONE, MORE, HELP, I WANT DIFFERENT, IT GOOD,
IT BAD, ALL DONE, DRINK, EAT, LIKE IT, DON’T LIKE IT)

REQUESTING (FOR SELF)food/drink, toy/objects, help,
activity/permission

• CORE WORDS- I WANT, HELP,
DO, GO

WANT SEE, WHO, WHAT, WHEN, I
WANT TURN

• If using a communication board,
consider the use of a Vocal Output
device for greetings.
• CORE WORDS- IT, GOOD, BAD,
SILLY, IT MINE
REQUESTING (FOR SOCIAL)attention, peer interaction,
information
• CORE WORDS- I WANT YOU, I
NEGATION- refuse object,
protest an activity, indicate
finished
• CORE WORDS- NO/ DON’T, I
DON’T WANT, I DON’T LIKE, I
ALL DONE/FINISHED
COMMENT- greetings, labeling,
answer questions, comment on an
event

EXPRESS FEELINGS
• CORE WORDS- I GOOD, I BAD, I
HAPPY, I SAD, I SILLY, YOU
GOOD, YOU BAD, YOU SILLY, YOU
SICK, I LIKE IT, I DON’T LIKE IT
-from PrAACticalAAC.org
 Breathe
and forgive yourself!
 Get your own copy of the learner’s AAC
display.
 Give it a try- start pointing to words by
yourself.
 Pick one core word explicit teaching.
 Spread the word- get others involved! It’s
not just YOUR responsibility alone!
Again
2. All done
3. All gone/gone
4. Different
5. Do
6. Help
7. Look
8. More
9. Stop
10. What
-from the PIXON Project, 2009
1.
GOAL:
TO ENCOURAGE THE
PERSON TO DIRECT
THE BEHAVIOR OF
OTHERS AND THE
COURSE OF
ANY ACTIVITY WITH
WORDS INSTEAD OF
BEHAVIOR.
www.praacticalaac.org
 www.minspeak.com
 www.aaclanguagelab.com
 www.pinterest.com/lasenders
 www.aactechconnect.com
 www.arin-atwiki.wikispaces.com
 www.vantatenhove.com
 http://teachinglearnerswithmul
tipleneeds.blogspot.com/
 www.youtube.com

Jayna Greenfield
ARIN IU 28
724-463-5300, ext. 1107
jgreenfield@iu28.org
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