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AAC in the Special Education Classroom (2 hrs)

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Literacy Instruction for
Students with Significant Disabilities

"Emergent literacy is not age dependent but is based on experiences with print!"
-Karen Erickson and David Koppenhaver

Who are emergent readers and writers?

Emergent literacy is the term used to describe the reading and writing experiences of young children before they learn to write and read conventionally (Teale & Sulzby, 1986). Emergent literacy begins at birth, regardless of whether or not a child has a disability. For older emergent literacy learners, it is important to keep all activities age respectful.

Emergent literacy is commonly defined as the behaviors of reading and writing that lead to conventional literacy and "comprises all of the actions, understandings and misunderstandings of learners engaged in experiences that involve print creation or use" (Koppenhaver & Erickson, 2003, p. 283), and these experiences are not only necessary but closely related to later literacy outcomes (Justice and Kaderavek, 2004).

Emergent literacy behaviours and understandings are directly related to opportunity and experience. Students with significant disabilities often have the fewest learning opportunities and experiences that lead to literacy.

Students who are emerging in their understandings of literacy are working to understand the functions of print and print conventions. Developing phonological awareness, alphabet knowledge, and important receptive and expressive language skills will eventually allow students to use reading and writing to interact with others. Emergent readers and writers are making discoveries and learning about literacy when they explore literacy materials, observe print within the natural environment, interact with conventional readers and writers, and see models of how and why print is used (Teale & Sulzby, 1992). Examples of emergent literacy behaviors may include interpreting a story through pictures rather than through text, manipulating books in nonconventional ways (e.g., looking at the book from back to front or holding it upside down), scribbling, and the use of invented spelling (Clay, 1993; Koppenhaver, 2000).

An emergent reader is one who is interested in books but can't yet read them independently or may be able to read some words but requires continued support to make meaning from print. It could also be a student who is not yet interested in reading books. An emergent reader may have not yet developed intentional or symbolic means of communication.

A emergent writer is one who is learning to use written language to express communicative intent, and beginning writing is defined as starting with emergent writing (drawing, scribbling, and writing letters) and ending with conventional writing abilities, usually acquired by second or third grade for typically developing children. (Strum, Cali, Nelson, & Staskowski, 2012)

Regular participation in reading and writing activities plays a central role in supporting typical children's understandings about print. Research in emergent literacy shows that students with significant disabilities, including those with complex communication needs, can benefit from the same type of literacy activities used with typically developing children but may require more time and opportunity. Regular participation in reading and writing activities plays a central role in supporting understandings about print for ALL students.

Many of the studies and literature surveys the last four decades have a common finding: nothing replaces sound early literacy instruction, even when taking into consideration recent technical advances.

If students with significant disabilities are not exposed to reading and writing materials, how can they learn to use them?

Old assumptions

An emphasis on functional skills, rote memorization, and readiness activities typically take precedence over in-depth literacy instruction (Skotko, Koppenhaver, & Erickson, 2004). Literacy development for 70-90% of students with significant disabilities rarely approached conventional literacy skills expected for typically developing students (Koppenhaver and Yoder, 1992).

Literacy is learned in a predetermined, sequential manner that is linear, additive, and unitary.

Literacy learning is school-based.

Literacy learning requires mastery of certain pre-requisite skills.

Some children will never learn to read.

New thinking

Holistic and explicit instructional approaches to balanced literacy that include daily reading, writing, and word study are critical for all learners, including those with significant disabilities (Erickson, Koppenhaver, & Cunningham, 2006; Sturm & Clendon., 2004).

Literacy is learned through interaction with and exposure to all aspects of literacy (i.e. listening, speaking, reading, and writing).

Literacy is a process that begins at birth - there are no prerequisites.

Literacy abilities/skills develop concurrently and interrelatedly.

All children can learn to use print meaningfully.

From an emergent literacy perspective, reading and writing develop concurrently and interrelatedly in young children, fostered by experiences that permit and promote meaningful interaction with oral and written language (Sulzby & Teale, 1991), such as following along in a big book as an adult reads aloud or telling a story through a drawing (Hiebert & Papierz, 1989).

Through the concept of emergent literacy, researchers have expanded the purview of research from reading to literacy, based on theories and findings that reading, writing, and oral language develop concurrently and interrelatedly in literate environments (Sulzby & Teale, 1991).

Where can I learn more?

Learning for All - This Alberta resource offers information, strategies and references for school leaders and teachers working with students with significant disabilities. This content was collaboratively developed through Learning for All, a one-year community of practice (2014-2015) for district leaders and consultants.

Literacy, Assistive Technology, and Students with Significant Disabilities. Karen A. Erickson, Penelope Hatch, and Sally Clendon, Focus on Exceptional Children, Volume 42, Number 5, 2010.

Quick Guide #13 "Supporting Literacy Learning in All Children" by David A. Koppenhaver and Karen A. Erickson (pp. 181-194) in Quick Guides for Inclusion: Ideas for Educating Students with Disabilities, 2nd edition

Research Based Practices for Creating Access to the General Curriculum in Reading and Literacy for Students with Significant Intellectual Disabilities. Karen Erickson, Ph.D., Gretchen Hanser, Ph.D., Penelope Hatch, Ph.D., Eric Sanders, M.S./CCC-SLP, 2009.

Comprehensive Literacy for All is written by Karen Erickson and David Koppenhaver. This is the new version of Children with Disabilities: Reading and Writing the Four-Blocks Way, which was used by the Literacy for All community of practice.

"Literacy improves lives-and with the right instruction and supports, all students can learn to read and write. That's the core belief behind this teacher-friendly handbook, your practical guide to providing comprehensive, high-quality literacy instruction to students with significant disabilities. Drawing on decades of classroom experience, the authors present their own innovative model for teaching students with a wide range of significant disabilities to read and write print in grades preK-12 and beyond. Foundational teaching principles blend with concrete strategies, step-by-step guidance, and specific activities, making this book a complete blueprint for helping students acquire critical literacy skills they'll use inside and outside the classroom." (Published 2020)

Preview Comprehensive Literacy for All here.

Support for Implementation

The resources found on this site were developed by the ERLC, a member of Alberta Regional Professional Development Consortia (ARPDC), as a result of grants from Alberta Education, to support implementation.

Learning for All | Copyright © 2016
Terms of Use | Contact Us

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Emergent literacy | Literacy Instruction for Students with Significant Disabilities

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Literacy Instruction for Students with Significant Disabilities "Emergent literacy is not age dependent but is based on experiences with print!" -Karen Erickson and David Koppenhaver Emergent literacy is the term used to describe the reading and writing experiences of young children before they learn to write and read conventionally (Teale & Sulzby, 1986).

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Augmentative and alternative communication is use of external devices (e.g. dedicated tablets) to help people with speech/language impairments communicate.

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Past, Present, and Future of Augmentative and Alternative Communication

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AAC can be a simple gesture or use a high-tech device. Here is a brief history, current state, and future of augmentative and alternative communication.

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Vol. 39 No. 6, November/December 2002, Supplement

Pages 39-53

A journey through early augmentative communication and computer access

Gregg C. Vanderheiden, PhD

Professor, Industrial Engineering and Biomedical Engineering; Director, Trace R&D Center, University of Wisconsin at Madison

When asked to write an account of the early days of augmentative communication and computer access, I first set out to create a documented history of all the early work and workers. I soon found that the task was beyond the time and resources I had available. For much of the very early work that I could remember, I soon realized I was unable to accurately date or document it, and the principals have died or are dispersed. After a couple of attempts I chose another approach, a personal narrative, which allowed me to both capture some important behind-the-scenes observations and to acknowledge some of those who were critical to this pioneer's entry, survival, and credited accomplishments.

This narrative consists of three parts, and each part tells a different dimension of the story. The first deals with my entry into the field and early support from others. Part 2 discusses the three different fields that converged to form the field of Augmentative Communication. Part 3 touches on some of the early aspects of Computer Access, particularly those that grew out of Augmentative Communication.

Although the narrative does capture some of the early history in these areas, its primary purpose is to show the role of individual action or initiative. Although many advances came from organized programs over an extended period of time, much of what has happened is the result of decisions by individuals who in turn caused things to move forward or allowed others to move forward. Often progress has been a chain of such individual events. This narrative seeks to highlight the importance of such individual decisions and action, often by people outside of this field. Without those decisions, actions, or commitments-including those by people unrelated to the field-the field would not have progressed as rapidly, and in some cases would perhaps have developed quite differently.

Some people enter this field through an early decision to dedicate and serve. I was tricked. A fellow student, David Lamers, had heard about a young boy with athetoid cerebral palsy at a local school who could not speak, write, or type. Searching for ideas, Dave stopped by the Behavioral Cybernetics Lab at the University of Wisconsin (where I worked as a student technician) looking for another researcher. When I suggested some approaches to solving the boy's communication problems, he talked me into walking out of my job in the middle of the day and going to the school, "just quickly, so I could show him what I meant, because he didn't understand."

The rest of the story resembles the story of many colleagues who came to this field by accident rather than design. What I found was not a "handicapped boy" that I might help, but an intriguing, clever (and not always polite) young lad who had severe athetoid cerebral palsy. He had been home schooled until the previous year. His only means of communication was to slowly, and with great effort, point to letters of the alphabet and a few words which had been wood burned into a twelve by sixteen inch piece of plywood. The boy, whose name was Lydell, was able to communicate in this way, but only if someone could provide undivided attention for an extended period of time. As a result, he was unable to participate in class or do any real amount of homework or, importantly, any independent work. Because I was struck by the boy's enthusiasm and also by the challenge of finding an effective interface approach for him, I quit my job and, with David Lamers, formed a volunteer group of undergraduate students to try to develop a solution for him. (Two of the ideas I had suggested previously would not work; and the third, scanning, was even slower for him than his already slow-pointing because of his severe athetoid cerebral palsy.) Andrew Volk (now with Intel), Jim Pazaris (now with Rockwell International), Candace Hill-Vegter (now with St. Paul Children's Hospital), Bob Norton (now at Physical Science Lab), and a half dozen others (names unfortunately lost to time and the lack of any records) joined with us. David Lamers, who had started it all, had a family of three to feed, and so had to leave six months later when he graduated, as did a few others. But the student group continued, grew, came to the attention of still more individuals similar to Lydell, grew some more, and eventually developed into what is now the Trace R&D Center at the University of Wisconsin-Madison.

Critical Contributors and Unsung Heroes

There were several individuals, many of whom were not directly involved in technology and disability, without whom there would not be a Trace Center. Without their support and contributions, I would not have been able to get traction or stay in the field long enough to make a contribution beyond the typical undergraduate project level.

The first unsung hero was Professor Richard Marleau, an amazing electrical engineering professor who provided the early support and encouragement for our group. Although this had nothing to do with his area (power systems and control theory), he took all of the analog computers out of his analog computing laboratory and arranged them in the back of a storeroom. He then taught his classes out of that storeroom in order to allow our group of undergraduate students to use his (previous) teaching laboratory as a place to meet and work. Having a stable place to meet and work (along with a small budget from the department for surplus parts) gave our interdisciplinary group the location, stability, and permanence needed to carry on for the extended period it took to address this difficult problem. There is no question that Trace would not be here today, that we would not have coalesced or been able to hold the group together, without this selfless action.

The second critical contributor was Professor Daniel Geisler, who gave up a major portion of several years of his professional career to help mentor and provide the necessary university supervision for a rag tag group of students from across the campus. The group included students from occupational therapy, physical therapy, rehabilitation counseling, communicative disorders, special education, psychology, journalism, math, and applied physics, as well as electrical engineering and mechanical engineering. Other key players were Professors Leo Jedynak and David Yoder, who took turns with the baton after Dr. Geisler; and Professors Rideout (department chair), Marshall (Dean, College of Engineering), and Young (Chancellor), all of whom "flexed" university policy extensively at one point or another to allow this student group to continue and extend its work over the years. This included support from their own personal funds as well as locating a largely unknown provision in the state regulations that allowed them to permit a student (the author) to act as principal investigator on grants at a time when this was reserved for tenured faculty at the University of Wisconsin (UW). I also recently discovered that a fellow author in this publication (Dr. Dudley Childress from Northwestern University) played an important role as well. Early in the process, the UW administration (via Dr. Geisler) asked Dr. Childress to visit the student group and give the UW administration a reading as to whether the efforts were novel, useful, and safe to let continue, since there were no faculty on the UW campus at that time with sufficient background to evaluate the student group's work.

Another key player was Dr. Max Ward, who ran the student-originated studies program at the National Science Foundation. That program provided the critical early support to our group in its second year. Dr. Ward's personal involvement, support, and encouragement of the group was responsible for gaining the attention of the head of the NSF Directorate for Education, who allowed our student group to submit a regular peer-reviewed proposal to NSF at a time when the NSF did not have a disability-related research program.

I take the time and space to relate this much detail because it is important to realize how much is owed, not just to early mentors in our field, but to many outside the field as well. Such people stepped up and provided the environment and the support that allowed many of us to succeed. It is also important to note that many of the opportunities that were available in the past no longer seem to be there for today's younger explorers and innovators. The student-originated studies program at NSF is gone, and many funding programs seem to be more focused on exploring and expanding existing areas rather than supporting riskier adventures into new areas. It is important to preserve those programs that continue to exist and/or develop new programs that provide young and very young students with the support and opportunities to explore new areas independently, and to develop into new leaders. This was but one story of initiation, but it shares many aspects with other early workers in other fields. Are the same opportunities available today? Are they increasing or decreasing?

Part 2: A Tale in Three Threads

In plotting the course of early augmentative communication, it is important to follow three different threads of development. One is the development of early electromechanical communication and writing systems. The second is research on ordinary (without disability) child language development, and the third is communication and language boards. These three threads developed largely independently until the 60s and 70s, when they merged to form what we now know as Augmentative and Alternative Communication (AAC). Computer access then evolved out of the interface portion of this work, particularly the thread dealing with human machine interface (with its roots in the conversation and writing machines).

Communication and Writing Devices

When our student group first set out to develop a solution for Lydell, one of the early tasks that the group took on was to gather information about systems that had been developed elsewhere. Led by Candice Hill, the group gathered and then over the years maintained a listing or registry of all of the communication technology [1] (until it was later merged into Able Data). What we found was that most of the early interface technologies first appeared in Europe. They took the form of either environmental control systems or special systems to control a typewriter. Relays and solenoids were used to control power for appliances or to activate the keys on keyboards. Stepping relays and lights were used to create scanning and encoding selection mechanisms.

Perhaps the earliest electric communication device was the POSM (Patient Operated Selector Mechanism), a sip-and-puff typewriter controller first prototyped by Reg Maling in 1960 (one of several he eventually created) (Figure 1). Reg was a volunteer visitor at Stoke Manderville hospital (for paralyzed people) and noticed that they had only a bell to communicate with. This inspired him to develop the very first POSM for them. A Communications System for the Handicapped (Comhandi) was developed in 1964, consisting of a scanning teletypewriter controller with an illuminated display. Other devices were operated by pointing light beams at photoelectric cells, such as the Patient Initiated Lightspot Operated Typewriter or PILOT (1967) (Figure 2), and the Lightspot Operated Typewriter or LOT, developed in 1973. Morse code was also used for typewriter control through voiced or sip-and-puff Morse code in the VOTEM system (1969), as well as by oral muscular control (1972). The best single source for information on many of these early systems is the 1974 book, Aids for the Severely Handicapped, edited by Keith Copeland [2].

These early systems gave way to transistorized systems, including systems operating through EMG (General Man-Machine Interface, or GMMI) (Figure 3) and even a pocket display, which was operated via a keyboard and called "The Talking Brooch" (Newell 1973) (Figure 4). The Talking Brooch and a communication device created by Toby Churchill called Lightwriter were probably the first portable communication aids, and the Talking Brooch is almost certainly the first wearable communication aid. Because it was designed for individuals with better motor control, it was also the first to allow face-to-face communication with near eye contact. Although portable devices like the Talking Brooch and Toby Churchill's Lightwriter began appearing in the 1970s, the earlier systems were all stationary and were essentially special typewriting systems.

Figure 4.
"The Talking Brooch," a wearable communication aid, was designed for individuals who could not talk but could type on a keyboard held in the hand.

Interface systems crossed the Atlantic first via Canada, where they first began appearing in the late 60s and early 70s. The Comhandi was an early stationary communication aid developed in Canada. In the United States the development of communication systems began in 1971 with two students who, completely independently (one in Wisconsin and then one in Massachusetts), were drawn to the field by a particular youngster for whom they were trying to develop a communication and writing system. One effort was lead by Richard Foulds at Tufts University and the other was our work at the University of Wisconsin. The Tufts efforts led to the development of the Tufts Interactive Communicator (TIC) (Figure 5), a scanning communication aid, and later the ANTIC, the first communication aid to change its scanning order in anticipation of the next most probable letter to be typed. The work at the University of Wisconsin led to the development of the Auto Monitoring Communication Board (AutoCom) (Figure 6), a direct selection communication system, which was picked up by Telesensory Systems Inc. and Prentke Romich Company, as will as the Trine and a number of other commercial communication, writing, and computer access aids. The AutoCom represented the first portable communication (and later, computer access) aid where the user had the freedom to change their own vocabulary and rearrange the letters, words, and phrases on their aids to meet their needs.

Other notable communication aids that came out around this time included the Tracy from Trace Inc. (no relation to the Trace Center), the Portaprinter, and the Canon Communicator. The Tracy was the first device to use a binary tree display to allow individuals to send Morse Code without having to learn Morse Code. The Portaprinter was the first portable printing communication aid and consisted of a device the size of a thick briefcase with a built in scanning display and strip printer (Figure 7). The Canon Communicator from Canon Inc. was notable because it was the only communication aid to come from a major corporation and was by far the smallest, with a palm-sized keyboard unit and a strip printer all in a 3.3 x 5.2 x 1.2-inch package (Figure 8). As the field evolved, an increasing number of electronic aides became available with expanding capabilities.

A number of researchers experimented with speech synthesis for individuals with disabilities. Initial efforts involved stationary computers based on research from Sweden, MIT, and others. The use of synthetic voice by someone who could not speak to order a pizza (without prior warning) was probably done out of the Artificial Language Laboratory at Michigan State University, run by John Eulenberg. In the mid-70s our group at the Trace Center created a "portable" voice synthesizer by taking a commercial DecTalk synthesizer and, working with Digital Equipment Corporation (DEC), modifying the motherboard circuitry so that it could instantly turn on and off without running through a full power-up routine. Powered with gel cell batteries, the unit weighed 20 pounds and mounted to the back of a wheelchair. This first "portable" speech synthesizer later gave way to smaller and lighter systems based on the Votrax synthesizer from Federal Screw Works in Michigan. The first commercial mass-marketed communication aid with speech synthesis was probably the Handivoice from the Federal Screw Works and Phonic Ear (1978) (Figure 9). For additional information on early Augmentative Communication Aids, see "Providing a Child with a Means to Indicate" [3], The Trace Resourcebook Series [1], [4] and Electronic Devices for Rehabilitation [5].

Figure 9.
The Handivoice, a portable communication aid with voice output was available in both a direct selection version (shown) and in a version used with number codes for words.

Development of Language Intervention Programs

The second important thread in the development of the current field of augmentative communication was the work done in the area of language intervention programs in general. This is an area of research and development that was carried out independently of augmentative communication, but which provided an important underlying set of principles and concepts. This area included both research in the area of normal language acquisition and also work on the development of communication systems for primates. Although there is some debate as to the direct applicability to humans of some of the techniques developed for use with primates, the influence on, and its contribution to, understanding language can be clearly seen. (Many of the symbol systems developed for primate research were not designed to be easy to learn or to optimize communication systems. Often the primary objective was to prove that the primates could acquire language. As a result, the symbol systems were designed specifically to be difficult to learn with no natural meaning or iconicity so that abstract language acquisition could be demonstrated in primates.) A complete treatment of this area is not possible here. However, a good overview of the work in language development as it related to and effected development of augmentative communication can be found in the two books by Richard L. Schiefelbusch (Nonspeech language and communication-Analysis and intervention [6] and Language intervention from ape to child [7]).

Communication Boards, Symbol Systems, and Acceleration Techniques

Independent of the electromechanical developments and the language development activities that were occurring in parallel was a series of efforts by people who were trying to provide communication to children and adults who are not able to use speech to communicate. In

some cases they were not able to communicate because of physical inability to control the speech musculature. In other cases work was carried out to try to provide speech to individuals who were unable to speak due to severe mental retardation that could affect both motor control and language. This early work was key to allowing our group, and most programs and companies working on augmentative communication aids, to develop aids that were practical and effective as daily communication aids for people with severe speech, language, and motor disabilities.

The earliest known communication board that was generally available was the F. Hall Roe Communication Board. This was a board developed for and with F. Hall Roe, who had cerebral palsy. This board became famous because the Ghora Kahn Grotto (a benevolent men's group in Minneapolis) replicated and manufactured copies of F. Hall Roe's communication board (Figure 10). The boards were printed on Masonite and had notches that allowed them to be mounted between the arms of a wheelchair. They included both letters and commonly used words and were used both by individuals with cerebral palsy and others in hospitals who were temporarily unable to speak. These communication boards predated much of the other work in this area. The first boards, it is believed, were distributed in the 1920s.

Figure 10.
The F. Hall Roe's communication board consisted of letters and words printed on Masonite, and it was the first widely available communication aid.

Most of what we know today about the use of communication boards for individuals with a variety of language skill levels grew out of two independent and parallel efforts that were carried out between 1960 and 1973. One effort was led by Dr. Eugene McDonald and Adeline Schultz at the Home for the Merciful Savior for Crippled Children in Philadelphia. The second effort was carried at the same time by Beverly Vicker, a speech and language pathologist at the University of Iowa State Hospital-School. Both programs documented efforts to create communication boards for a wide variety of individuals. They included communication boards with pictures only, pictures and words, letters of the alphabet only, and combinations. Communication boards ranged from containing a few symbols to hundreds of words (some as many as 800 words). People used fingers, head sticks, pointers, and a variety of different mechanisms to communicate. Seating and positioning were recognized in both groups as critical to effective communication aid use. The McDonald/Schultz work first appeared in the Journal of Speech and Hearing Disorders in 1973 [8]. Although Beverly Vicker was discouraged from formally publishing her work as a speech pathologist, she was allowed to print up a report of her work and sell it through the local bookstore [9]. Her book, Nonoral communication system project 1964/1973, was an early mainstay and resource in this area along with the publications of McDonald and Schultz.

Around this same time, beginning in 1971, a group in Toronto, Canada, led by school teacher Shirley McNaughton, began exploring the use of a symbol system developed by Mr. Charles Bliss to allow children to be able to communicate more effectively. The Bliss symbols were selected to convey general concepts that could be combined together to form words. For example, the symbol for "long" and the symbol for "food" were used by the children to talk about spaghetti. Another early pioneer, Arlene Kraat, a speech pathologist, exemplifies how a single clinician, working alone and sharing her observations and insights with the field, can have a profound impact on both the clinical practice and research directions of a field.

The work of these early pioneers was later combined with the work being done using sign language with individuals who had mental retardation, and this combined body of work formed the underpinnings for the other communication symbol and communication rate acceleration systems to follow [10]. These included a number of different types of symbol systems, picture sets, vocabularies, and so forth, to make it easier for individuals with lower cognitive and/or communication skills to get started. These systems also made it easier for individuals with more advanced communication skills to communicate faster. The last significantly different and widely applied communication strategy was MinSpeak. This communication system uses a relatively small set of symbols and the alphabet to encode a large number of words and phrases in a way that makes it easy to remember the code and call them up quickly [11]. A summary of much of this early work and a more compete listing of the early leaders in this field can be found in the 1986 book, Augmentative Communication: An Introduction [12].

Origin of "Augmentative Communication" and the International Society for Augmentative and Alternative Communication (ISAAC)

The term Augmentative Communication was coined by this author in the chapter by Harris and Vanderheiden in the Shiefelbusch book, Nonspeech Language and Communication. The term augmentative was chosen to help offset a perception that communication boards and other similar devices were only to be used when there was no hope for speech. Speech pathologists at the time, in fact, were sometimes fired if it was discovered that they provided a communications board to one of their speech therapy clients-even if the individual had been in speech therapy in excess of a year and still was unable to utter a single intelligible word. There was a fear that the introduction of alternative mechanisms for communication would cause the individuals to cease trying to speak. Semiformal clinical research at the time, however, had shown the opposite to be true. Individuals who were given communication boards were not found to decrease in either their vocalizations or intelligibility level. Many individuals increased both their vocalizations and intelligibility after having been provided with the communication board. This was attributed to their becoming addicted to communication, their wanting to use speech whenever it worked because it was faster, and the fact that some were able to speak more easily when they had a back-up communication system because there was less pressure on them when they tried to speak. The term augmentative was coined to indicate that these nonspeech communication systems were being used by the children to augment their speech. Whenever their speech worked (and with whomever it worked), they would use speech. When it did not work, they would turn to their communication systems. (Historical note: The term in the chapter started as augmentive communication. However, after a debate I had with a copy editor, who pointed out that there was no such word as augmentive, it was changed to augmentative.)

The field really became organized with the formation of the International Society for Augmentative and Alternative Communication (ISAAC), an international, interdisciplinary organization that included engineers, therapists, teachers, researchers, and users. The name of the society and the journal (Augmentative and Alternative Communication) (AAC) stemmed from discussions between clinicians regarding the fact that, although these systems were augmentative for some individuals, for other individuals it was the only means of communication (that is, "alternative" mechanisms for communication). In the end, it was decided to embrace both, and the term "Augmentative and Alternative Communication" was coined and the Society was named.

Early work in augmentative communication was chronicled by John Eulenberg at Michigan State University in his newsletter "Communication Outlook," which was the primary means of communication and dissemination of information about this field, especially the nonpublication aspects, in the early years. He also sponsored the meeting at which ISAAC was formed and named. The journal ACC, spearheaded by Lyle Lloyd and then David Beukelman, documented the research base for this field. David Yoder led the early efforts to gain legitimacy for ACC in the speech and hearing profession.

The history of computer adaptation to allow disability access is a major story in itself and befitting its own article. The parallels with regard to the role of individuals and individual contribution, however, are noteworthy. Also of interest is the circuitous route that development took.

Efforts at computer access began in earnest with the introduction of the Apple II computer, which was the first widely available, easily programmable computer. Apple II was immediately embraced by individuals working on special communication systems and teaching mechanisms for people with disabilities. Special software was written for the Apple computer to allow the computers to be used by people who had disabilities. This included both special education training programs and education programs that paralleled regular education programs, except that they had special interfaces on them that could be operated by people with physical disabilities. A number of the computers were also programmed to function as special assistive technologies. These included systems that could be used by individuals who were blind-used as writing systems and as mechanisms for creating and printing Braille.

Later, it became clear that computers were being integrated into the classroom and into the workplace. At this time, a second line of effort was spawned. This line of research focused on developing mechanisms that would allow people who are unable to use the standard input and output mechanisms of computers to be able to use special input and output mechanisms to access and use the standard educational and work software. It was important that access to the standard software programs be provided, in order to allow people with disabilities to be able to participate in regular education and employment settings. This was first formally proposed in 1979 and published in 1980 [13] and in Computer in 1981 [14].

Special "transparent" access techniques were developed. These techniques allowed individuals to use communication aides, scanning input devices, sip-and-puff Morse code devices, and other specialized input systems to substitute for the keyboard (and later the mouse) on standard computers, in a way that the computer and software could not tell that the user was not using the standard input devices [15]. Without doubt, the most ingenious of these was developed by a cab driver (Paul Schwejda) to impress a regular fare of his (Judy McDonald). He was successful at both impressing his fare and advancing this new approach to computer access adaptations. Together the couple formed Adaptive Peripherals to market and further develop the Adaptive Firmware Card, which did near magical things to provide transparent access to Apple computers, even with games and other programs that directly read the hardware keyboard registers [16]. At the same time, special screen reading software was developed, which allowed individuals who are blind to be able to view the contents of the screen and have it read to them without interfering with the normal operation of the computer.

Over time, these techniques advanced. A number of the physical modifications developed by the Trace R&D Center became incorporated directly into computers and standard operating systems (the Macintosh OS since 1987, OS/2 and the UNIX X Window system since 1993, and Windows 95, 98, NT, ME, 2000 and XP) [15,17-22]. The programming efforts for these were led first by Charles Lee and later by Mark Novak. The history of this is interesting and the process is important to note. The original technique (StickyKeys, then called 1-Finger) was developed at Trace for DOS. Although we had many discussions with industry about incorporating it directly into DOS (and they initiated some of them), nothing happened. (Later, an add-on was developed for DOS, but DOS never did get built-in access features, although its successors all did).

Around this time, IBM was promoting MS Windows, and they instituted a program that provided free computers to any academic program that would port its work to Windows. We applied and were accepted into the program. We worked with a Windows Program Manager at Microsoft (Greg Lowney) who pirated time to help us as we developed StickyKeys, MouseKeys, and SerialKeys (keyboard emulating interface via serial port) for Win 2.0. It was an add-on, however, that users could download from Microsoft along with printer drivers. It was not yet possible to get the features built into Windows itself.

Interestingly, Apple was the first company to actually build access features directly into their product. And this work was based on the work we had begun for Windows. Apple brought Alan Brightman, PhD, into the company to better address the disability area. Alan arranged for several of us working in disability access to present to some managers and the president of Apple (John Sculley). After the presentation, the head of product development, Randy Battat, simply said, "we should do that." He then arranged for me to visit Apple every 3 months to review all Apple products to generate and track recommendations on how to improve the design of Apple's products to make them more accessible. He also, from the outset, set aside 10 K of the extremely valuable system disk real estate (and more later). These two moves, as well as the completely unfettered access to all research and development at Apple, was unheard of and surprised (and impressed) Apple engineers. However, even then, since there was no legal mandate to do anything, it took awhile to actually get programmers' time. Soon StickeyKeys and MouseKeys (and Closeview, an enlargement program developed by Berkeley Systems) were built into every Macintosh shipped and installed as part of the default install. The features followed later on the Apple GS and IIe (where they had to be built directly into the hardware).

In 1988 we developed a similar package for OS/2, working with IBM. This was only partially picked up (StickyKeys) and that was only partially implemented. (A full implementation with multiple access features was completed in later years by IBM, but that version of OS/2 was never released.) In 1990 IBM approached the Trace Center and asked if we could make a package of features that would work with PC-DOS. With funding from IBM, we created AccessDOS, which had StickeyKeys (for one-finger and headstick access), MouseKeys (keyboard control of mouse pointer), RepeatKeys (adjusted and/or turned off the key repeat rate), BounceKeys (filtered out hand tremor), Slowkeys (ignored errant key presses), ToggleKeys (provided audio equivalents to the Caps, Scroll, and NumLock keys), SerialKeys (allows users to connect their assistive technologies to the serial port and create "fake" keystrokes and mouse movements), and ShowSounds (which gave different visual indicators for output from the speaker). This was the most comprehensive package of access features yet. Although this was available from IBM as a commercial product, it was not built into their PC-DOS but rather provided as a separate (free) product that could be ordered from their order center.

In 1993 Microsoft asked for (and got) IBM's blessing and our permission to also ship AccessDOS from their site for MS-DOS. We also ported the new features to Windows 3.1, but again as an add-on. With Windows NT, access was implemented in a two-stage process. First, the core components of the access pack were built into Windows NT with the support of Paul Maritz and David McBride. However, the control panel to turn them on and operate them was not completed and therefore not shipped with the product. Thus the access features appeared and functioned like an add-on, even though much of its functionality was built into OS. (It was not until after Windows 95 that the functionality in NT would be fully built in and available without special installation.)

In 1995 Microsoft was launching a major rewrite of their operating system and its human interface. Greg Lowney, then a one-person accessibility program at Microsoft, lobbied hard along with us to get the access features built into the operating system as standard components. Progress was on again and off again until, with increasing pressure from the disability community, it made its way into the system. However, fear that the access features would interfere with operation of Windows 95 by its other customers almost caused the features again be add-ons, and not shipped on the precious system disks (but OEM only). Interestingly, Apple computer was responsible for allaying the fears. Since Microsoft writes many applications for the Macintosh, they had Macs throughout the Mac applications side of their company (though not the OS side). When it was pointed out to Microsoft decisionmakers that all of the Macs at Microsoft had the same features they were worried about and that the features had been there for over 5 years and had not been noticed (much less interfered with the computers' operation), the concerns abated. Even then, however, it took much discussion and the presentation of a business case for inclusion before they made it into the OS as default installed features. Once into Windows 95, the features were carried across to NT and forward on all subsequent versions as built-in features that were installed by default.

Today these accessibility features are found in or on Mac, Windows, OS/2, UNIX, Linux, and Solaris OSs as well as being implemented in some non-OS-based products. They are also found in the ANSI/HFES 200 Standard for Software User Interfaces currently out for ballot. The path, though, was long, with many deaths and resurrections. It also included people who made bold commitments, such as Randy Battat at Apple, people like Alan Brightman and Greg Lowney, and many others who repeatedly and constantly pushed systems and people when others would have eased up, and a couple of key programmers who defied their supervisors and, at risk of their jobs, worked on code to create critical first implementations without which the initial versions would not have occurred. Some of their names are known to a small circle. Others are not from our field, and are unknown except to a few beyond themselves. It is not possible to know what would have happened if these people had not stepped up. But from 20 years of trying to get these things to happen, I can say that once some opportunities are lost, an idea can be delayed 5 years or more. And even then, progress only occurs when someone else steps up.

As character-based systems made way for the graphic use of interface, computers became easier to understand and use for many people who had disabilities. However, the graphic user interface tremendously complicated the problem of providing screen reader access for individuals who are blind. Initially many individuals who are blind lost their jobs when their companies (or universities) switched to a graphic user interface for which screen readers were not available. Later however, screen readers started becoming available for graphic systems, though for many years, each release of a new version of the OS meant broken screen readers followed by the costs for upgrading to new (compatible) screen readers when they became available. Today there is a wide variety of specialized input, screen reader, and screen magnification systems available, either as extensions to the standard operating system or as special assistive technologies. This also is a story of opportunities lost, and delays that cost people dearly for many years. Again, individual efforts played a key role in getting us to where we are now. Screen reader access is an area that I only followed and supported from the periphery, so it is not one I can tell in detail accurately and without serious background omissions.

The recent passage of Section 508 of the Rehabilitation Act, which has caused government to give preferential purchasing to information technologies that are accessible, has provided tremendous market incentive to companies to create accessible information technologies and to ensure that their standard software will work with assistive technologies. This has completely changed the chemistry of the situation. In the past it was rare that assistive access technologies existed or would work with new software and operating systems when they were released. Assistive technology vendors did not have the resources, and mainstream companies rarely allowed access to their products in advance to allow this. As a result, each new release caused people who had access to software on the job or classroom to lose it. The government policy to purchase products that are accessible (including compatible with assistive technologies) when available, has now begun to put compatibility with assistive technologies on a par with compatibility with printers and other show-stopping issues. This has allowed the AT vendors to get the access and support they need if they are going to have any chance of keeping up with the advancing information technologies. It has also made it much easier for those in companies who are advancing access issues to make a clear, sales-based business case for access. UK Disability Discrimination Act and the European Human Rights Act are raising the awareness of European companies as well.

Both the field of augmentative communication and the field of computer access seem extremely mature, widespread, and well supported today as compared to their years of early development. However, the increasing pace of innovation in our society and the increasing reliance on technologies is making both of these fields extremely challenging. Researchers and practitioners strive to develop and apply new techniques to provide individuals with disabilities better ways to communicate, write, and access computers so that they can participate and be competitive with their nondisabled peers in education, employment, and daily life. The advances to date have been the result of key people committed to ideals and persisting over time. But these advances are just as dependent on others who are not from this field, people who step up, take risks, provide the support, and make the allowances necessary for those in the field to succeed. Perhaps the greatest credit should go to those unsung heroes who make this possible when it isn't their area and it doesn't benefit them a whit in the long run. Taking risks for no personal or professional gain (and sometimes professional loss) is much harder than working hard and taking risks that advance your own cause and career. I believe we need to be aware of these people, recognize and thank them, and personally be willing to do the same outside of our field or profession when called.

All work credited to me over the years was the result of a team of individuals, both staff and students at Trace and colleagues in the field. This article is dedicated to all those without whom we would not have been able to contribute as much as we have. Especially those we did not even know about, but who used up personal capital to forward our causes.

1. Vanderheiden GC, editor. Non-vocal communication resource book. Baltimore: University Park Press; 1978.

2. Copeland K, editor. Aids for the severely handicapped. London: Sector Publishing Limited; 1974. (Contact Trace R&D Center for more information.)

3. Vanderheiden G. Providing a child with a means to indicate. In: Vanderheiden G, Grilley K, editors. Non-vocal communication techniques and aids for the severely physically handicapped. Baltimore, MD: University Park Press; 1976 (and later published by Pro-Ed, Austin TX).

4. Bower R, Kaull J, Sheikh N, Vanderheiden G, editors. Trace Resourcebook: Assistive Technologies for Communication, Control & Computer Access. Madison: University of Wisconsin Trace R&D Center; 1988.

5. Webster JG, Cook AM, Tompkins WJ, Vanderheiden GC, editors. Electronic devices for rehabilitation. London: Chapman and Hall Ltd; 1985.

6. Shiefelbusch RL, editor. Nonspeech language and communication: Analysis and intervention. Baltimore: University Park Press; 1980.

7. Schiefelbusch RL, Hollis JH. Language intervention from ape to child. University Park Press, Baltimore; 1979

8. McDonald E, Schultz A. Communication boards for cerebral palsied children. J Speech Hear Disord 1973 Feb;38:72-88.

9. Vicker B, editor. Non oral communication system project 1964/1973. Iowa City Iowa: The University of Iowa; 1974.

10. Vanderheiden GC, Lloyd LL. Communication systems and their components. In: Blackstone SW, Bruskin DM, editors. Augmentative communication: An introduction. Rockville, MD: American Speech, Launguage, and Hearing Association; 1986. p. 186-202.

11. Baker B. Minspeak. Byte 1982 Sep; p. 186-202.

12. Blackstone SW, Bruskin DM, editors. Augmentative communication: An introduction. Rockville, MD: American Speech, Launguage, and Hearing Association; 1986.

13. Vanderheiden G. Microcomputer aids for individuals with severe or multiple handicaps: Barriers and approaches. In: Proceedings of the IEEE Computer Society of the Application of Personal Computing to Aid the Handicapped; 1980 April 2-3; Johns Hopkins University; 1980.

14. Vanderheiden G. Practical applications of microcomputers to aid the Handicapped. In: Computer, IEEE Computer Society; January 1981.

15. Lee C, Vanderheiden G, Rasmussen A. One finger operation of the IBM family of personal computers. Proceedings of the Ninth Annual Conference on Rehabilitation Technology; 1986 Minneapolis, Minnesota. Washington, DC: RESNA: The Association for the Advancement of Rehabilitation Technology; 1986.

16. Schwejda P, Vanderheiden G. Adaptive firmware card for the Apple II. Byte 1982 Sep;276-314.

17. Lee CC, Vanderheiden GC. Keyboard equivalent for mouse input. Proceedings of the Tenth Annual Conference on Rehabilitation Technology; 1987 June; San Jose, California; 1987.

18. Lee CC, Vanderheiden GC. Accessibility of OS/2 for individuals with movement impairments: Strategies for the implementation of 1-finger, MouseKeys, and software keyboard emulating interfaces using device drivers and monitors. Proceedings of the International Conference of the Association for the Advancement of Rehabilitation Technology; 1998 Montreal, Quebec.

19. Schauer J, Rodgers BL, Kelso DP, Vanderheiden GC, Lee CC. Keyboard emulating interface (KEI) compatibility standard. Madison, WI: Trace Reprint Service, Trace R&D Center, University of Wisconsin-Madison; 1988.

20. Novak M, Schauer J, Hinkens J, Vanderheiden G. AccessDOS: Providing computer access features under DOS. Minneapolis, MN: 1991 Closing the Gap Conference.

21. Novak M, Schauer J, Hinkens J, Vanderheiden G. Providing computer access features under DOS. Proceedings of the RESNA 14th Annual Conference; 1991. p. 163-65.

22. Novak M, Vanderheiden G. Extending the user interface for X Windows to include persons with disabilities. Proceedings of the 16th Annual RESNA Conference; 1993. p. 435-36.

U.S. G.P.O. 2002-491-995: 40013

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A journey through early augmentative communication and computer access

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Vol. 39 No. 6, November/December 2002, Supplement Pages 39-53 A journey through early augmentative communication and computer access Gregg C. Vanderheiden, PhD Professor, Industrial Engineering and Biomedical Engineering; Director, Trace R&D Center, University of Wisconsin at Madison When asked to write an account of the early days of augmentative communication and computer access, I first set out to create a documented history of all the early work and workers.

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Open Access AAC Resources | Open Access 2.0

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The objective of the Open Access website is to facilitate the Learning and Participation for ALL students by eliminating barriers to learning.

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This board was created by Heather Filice, SLP. You can print it back to back with your favorite core board for easy modeling.

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The Universal Core vocabulary is a set of 36 highly useful single words that can be used alone or in combination to communicate for a range of purposes on countless topics with a wide variety of communication partners. The Universal Core vocabulary is licensed under a Creative Commons Attribution 4.0 International License. Several formats are available to support student access through direct pointing or touch, eye gaze selection, and partner-assisted scanning. High contrast versions are available to address the needs of some students with visual impairments and 3D symbols are available for students who are blind. Additionally, the Universal Core vocabulary is available on many communication apps and speech generating devices.

A 6 page universal core communication book with 6 words/symbols on each page.

A 3 page universal core partner-assisted communication book with 6 words/symbols on each page.

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The Universal Core vocabulary is a set of 36 highly useful single words that can be used alone or in combination to communicate for a range of purposes on countless topics with a wide variety of communication partners. The Universal Core vocabulary is licensed under a Creative Commons Attribution 4.0 International License.

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A low-tech option is a great tool as a back-up to the dedicated solution, use for modeling or during water activities. These low-tech printable options are available to support some of the WordPower ™ files. Pre-made downloadable options are offered for the WordPower42 Basic, 60 Basic, 60 and the 108 location files. Note the 108 location option will include a full page flip to verbs. WordPower48 Español Básico recently joined the WordPower low-tech family. The flipbook downloads include instructions to make the flipbooks for these great low-tech options. These options are designed with flips to the access more vocabulary within various categories, similar to the way you would navigate the vocabulary on a NovaChat® or ChatFusion™.

*Please note that printers may have variations that cause downloaded pages do not line up perfectly. It is recommended to print, laminate, cut and check the alignment of the flips before you punch holes. Adjust by cutting or aligning flips before punching holes.

You will find personal manual communication board options and poster size options. The manual communication boards can be printed on standard or legal size paper. The poster size options allow you to customize the size. We have tried printing at 34.5 by 53 inches with success. In addition to the 88 location Core Words Poster, you will find an option to download the individual core words (grouped 4 on a page) to create pull-offs to the poster or build the poster through individual buttons.

If you want to create your own customized low -tech option, check out the video tutorial providing you with a how-to demonstration. The ChatEditor software is used to customize the low tech options. Create a low-tech option using the customized NovaChat or ChatFusion file.

Virtual Background

Flip Options

Personal Manual Communication Boards

Cantonese Translation
Russian Translation
Japanese Translation
Traditional Chinese Translation
Poster

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The Developmental Writing Scale (Sturm et al., 2012) is a 14-point measure of developmental writing progress, from scribbling to paragraph writing. It is intended to assess the writing quality of typical writers and writers with disabilities at the beginning stages of writing. It was designed to be sensitive to small changes in writing and capture the refined progress of any beginning writer, including those with complex learning needs (CLN). The DWS tool can be used to inform instruction, drive goal setting, and support progress monitoring.

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This video clip shows a student at the beginning of his exploration with an alternative pencil. He is writing with a purpose- about a recent visit to the zoo.

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Comprehension is the goal of reading. We use the other four big ideas to build up to reading comprehension. This can start with listening comprehension for pre-readers and readers who are still learning how to decode.

Phonemic Awareness

The ability to identify and play with individual sounds in spoken words. Practice blending phonemes prepares students to read words, and practice segmenting phonemes prepares them to spell words.

Phonics

Understanding how letters and groups of letters link to sounds to form letter-sound relationships and spelling patterns. It involves learning letter-sound correspondences and common spelling patterns. Phonics supports decoding and spelling and leads to fluent reading.

Fluency

The ability to read words, phrases, sentences, and stories correctly, with enough speed and expression. When decoding skills become automatic, students can more easily focus their attention on understanding words and text. Fluency is the bridge to comprehension.

Vocabulary

Knowing what words mean and how to say and use them correctly. Many word meanings are learned through reading, but before students can read text on their own, vocabulary can be taught through oral language interactions and reading books aloud.

Reading Comprehension

The ability to understand what you are reading. In addition to vocabulary and fluent reading of text, reading comprehension requires background knowledge, understanding sentence and text structures, monitoring understanding, and connecting ideas.

National Center on Improving Literacy (2023). The 5 Big Ideas of Beginning Reading. Washington, DC: U.S. Department of Education, Office of Elementary and Secondary Education, Office of Special Education Programs, National Center on Improving Literacy. Retrieved from http://improvingliteracy.org.

University of Oregon, Center on Teaching and Learning. (n.d.). Big Ideas in Beginning Reading. Retrieved January 24, 2023, from http://reading.uoregon.edu/.

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If you prefer, read the text-version of the infographic. Comprehension is the goal of reading. We use the other four big ideas to build up to reading comprehension. This can start with listening comprehension for pre-readers and readers who are still learning how to decode.

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Access to Descriptive Language

AAC users need to learn language, not just make rote responses. They need the ability to say new things and not just mechanically respond. Many SLPs are now familiar with the concept of Core Vocabulary. These are high frequency words that form the DNA of language. Using core words, we have the ability to produce spontaneous novel utterances. Core includes words like need, do, want, see, you, I, don't and make.

Core language systems don't come with the words "SARS CoV-2" and "epidemiology" as part of their vocab sets. How can we talk about something medical, or academic, without this specialized vocabulary? By using core words to describe concepts, we allow the student to participate in learning I might use core to say, "crown bug feel sick scared." Grammatical? Perhaps not, but it gets the point across.

Let's compare the use of descriptive vocabulary instead of specialized words:

"Why not just put the academic words on the talker?"

With limited space, "one and done" words are simply not that useful. Can you imagine programming yet another set of topical words for each new unit in the classroom? That would be tons of work and very confusing. Imagine adding new characters to your computer keyboard every week. Try typing an essay!

As well, simply referencing these new words on the AAC device does nothing to demonstrate what the student has actually learned. If we instead describe a new concept, we show that we understand it.

We can positively impact AAC learners by using this Descriptive Teaching Model (Van Tatenhove, 2008). One natural result is that we help grow a student's language skills. By describing key concepts, we are naturally combining words to say something new. That is the essence of generative language. The use of descriptive language can then be generalized outside of the classroom, to recess or a class trip (these happen again someday!).

Schools are charged with demonstrating student mastery of certain grade-based concepts. How do we accomplish this with our AAC users? By using descriptive language, the student can show us what they genuinely understand and give us measurable information about their academic performance.

Teachers and therapists can take Common Core standards and translate them into core words. These become the basis for modeling during academic instruction. A bonus is that the student gets to focus on the concepts, and not just on learning new navigation patterns on their device. It's a win win.

Core vocabulary words largely correspond to early reading lists, such as the Dolch word list. This is also based on high frequency words. There is overlap. Pointing this out can help you get buy in from teachers. By using the Descriptive Teaching Model, you are actually making their lives easier.

Now, how do we make this fun? We want to play with language, not engage in drill and response. There are loads of activities that can involve students in meaningful learning. We can go on a core word scavenger hunt. Or try a verbal version of Guess Who. The AAC user names 5 descriptive words and the rest of the class has to guess what or whom they are referring to. Carry this over into Predictable Chart writing to work on literacy skills.

Don't forget to use the new https://shared.tarheelreader.org ! The books come with core word icons from Project Core and tips for commenting on what you read.

Create a classroom Word Wall for the core words of the week. Students can hunt for related pictures in magazines and create a descriptive collage. A talking picture album can be used to "collect" pictures or items related to what we've learned. Click on the link below to read an article on Strategies For Teaching Core Vocabulary Throughout the School Day (Smolen & Helland, 2015).

Click here for a copy of the Describe an Elephant poster.
High Contrast Describe an Elephant poster
Resources

Gail Van Tatenhove has a series of Youtube videos illustrating descriptive teaching. Here is the first: https://www.youtube.com/watch?v=40p5SToHmzI

Gail Van Tatenhove's website has many free resources for AAC implementation: http://www.vantatenhove.com/main

This webinar is part of ASHA's Learning Pass series (not free): A Roadmap to Integrating AAC Into the Classroom (WEB16207-IND) Presenter: Lauren Kravetz Bonnet, PhD, CCC-SLP

AAC Community article on Core Vocabulary.

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AAC & The Descriptive Teaching Method - AAC Community

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AAC users need to learn language, not just make rote responses. They need the ability to say new things and not just mechanically respond. Many SLPs are now familiar with the concept of Core Vocabulary. These are high frequency words that form the DNA of language.

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Talking Mats | Improving communication, improving lives

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Talking Mats is a social enterprise whose vision is to improve the lives of people with communication difficulties. Improving communication-improving lives.

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Welcome Teachers & Parents of Emerging Readers!
The free books and resources shared on this site have been created for teachers & parents to use with emerging readers with significant disabilities of all ages. You are welcome to make copies of the books & resources and edit to meet the needs of

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Digital books for beginning readers of all ages

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What is the purpose of this website?

This website provides guidelines for teaching literacy skills to learners with special needs, especially learners with complex communication needs (CCN) such as:

Autism spectrum disorders

Cerebral palsy

Down syndrome

Developmental apraxia

Multiple disabilities

This website provides information on:

What skills to teach

How to teach these skills

Videotaped examples of instruction with learners with special needs

Meet one of our students
Krista

Krista has multiple challenges, including a hearing impairment, a visual impairment, and a motor impairment. She also has a tracheostomy.

Krista has a dynamic personality. She makes everyone smile.

Like many of her peers, she loves Zac Efron from High School Musical and Zack and Cody from the Suite Life of Zack and Cody.

She uses sign approximations and a computer with speech output (a Mercury with Speaking Dynamically Pro software). Because of her hearing impairment, she does best when others sign as they talk.

We started to work with Krista when she was 8 years old. At that time, she was in a special education class at school and was not receiving literacy instruction.

Watch this video of Krista at 9 years of age. She is independently reading a personalized book about a summer adventure with Zac Efron.

She is so excited to be a reader!

Visit the rest of the website to learn more about how Krista learned to read stories independently.

Krista reading about Zac Efron from AAC Learning Center - Penn State on Vimeo.

Last Updated: August 31, 2012

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Research-based guidelines for early intervention designed to maximize the language and communication development of young children with complex communication needs including those with autism, Down syndrome, cerebral palsy and multiple disabilities.

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Aided Language Stimulation Explained With Voice Over

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SPANISH Aided Language Stimulation Explained

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Augmentative and Alternative Communication (AAC) is EVERYTHING an individual uses to communicate or to enhance communication.

Different strategies may be needed for different situations and communication partners.

Strategies and tools may be combined to meet a variety of communication needs.

There are a variety of naturally-occurring behaviors that may be combined in a multimodal repertoire.

Verbal Speech and Verbal Approximations (attempts at verbal speech that may be difficult to understand).

Eye-Gaze is the act of using one's eyes to direct or redirect the attention of another person (like looking at the door to indicate they want to go out to recess).

Some things to think about...

​

With emerging communicators, body language can help give clues to a person's "intent" (putting a head down might mean the child is sad that mom is leaving).

Body language can sometimes be shaped into a more formal communicative gesture (e.g. turning the head to the side can be shaped to a head shake for "no").

Gestures are part of our earliest communication behaviors and remain an effective part of our repertoire throughout our lifespan. Some gestures are universal and are understood even across cultures. Some are "culturally relevant" (e.g. "dabbing").

Even if difficult to understand, verbalizing is often a communicator's first choice of a strategy.

Verbal approximations are often better understood by very familiar partners or at home.

Verbalization is the best way to communicate "what you want to say, how you want to say it" (don't have to rely on what someone has "programmed" for you to say!) in as efficient way as possible (faster than looking for a symbol and touching a location or navigating to another page)...encourage any and all attempts!

For individuals who struggle to communicate, an AAC system can augment or support multimodal communication strategies. Natural ways of augmenting communication (e.g. body language, eye gaze, vocalizing or verbalizing, proxemics) provide important avenues for expressing thoughts and ideas, but cannot meet the wide range of communication needs that a communicator requires.

AAC Systems can be broken down into two types:

Unaided systems - you do not need anything but your own body to use an unaided system. Manual sign language and eye blink codes are examples of an unaided system.

Aided systems - require some sort of aid (like a tool or a device) to use. This could be a picture book, a spelling board or a speech-generating device.

An aided AAC system is an integrated group of three primary components that we'll break down further:

Strategies , which are what WE do as facilitators and partners to support a student in developing or using aided forms of communication; or a novel method a student may use to convey a message;

the Tools themselves; and

Symbols , or how the system represents thoughts and ideas.

A strategy is a specific way of supporting the use of AAC tools, symbols and/or techniques (like how an individual accesses a system) more effectively for enhancing communication or building foundational skills. Strategies can lead towards more advanced expressive language development or increased proficiency with an access method. Strategies require partner and/communicator understanding and skill.

What are some common strategies we should be familiar with and comfortable using with our students?

Choice Making is a foundational skill from which we build competence with aided communication strategies! A communicator's ability to make choices increases their options, allows them to control their environment, increases engagement and improves behavior! Present as many options as a communicator can (cognitively, physically and visually) handle. Go beyond choices of "things" (include things like who they want to sit next to, or what they want to tell mom when they get home). Choices can be presented via objects, environmental cues, pictures/icons, or verbally (with or without a physical or visual cue like touching a finger as you present a choice).

Use this handout for ideas to help expand what we give our students to talk about:

Modeling/Prompting are two different things, yet two critical strategies to have in your toolbox and to use! Modeling is a "less intrusive" teaching strategy that can help a communicator learn how to communicate in a new or novel way or learn how to use a communication strategy to more actively participate and engage (like showing them how to touch pictures to say "my" "turn" while playing a game). Prompting usually follows a hierarchy (most-to-least or least-to-most), and is a systematic way of scaffolding students in acquiring new skills.

For examples of prompt hierarchies, download a copy of this handout:

Social Scripts are a set of sequenced steps that move a communicator through a conversation. They can be plugged into a routine (like greeting my classmates every morning) or used for a more spontaneous interaction (like asking a friend to the movies). Scripts usually involve both the communicator and their partner, and can be used to expose a communicator to using more varied communication functions.

Download and use this "script builder" to help develop social scripts for your students:

Aided Language Modeling is how we take modeling to the "next level" when supporting our communicators! We can't expect our communicators to learn to use communication symbols without seeing/hearing those symbols used in meaningful ways. In this strategy, partners model the words we are targeting for our learners and use them in as many natural environments or contexts as we can. As you are modeling, the communicator is building a connection between the symbol and the meaning behind that symbol. Modeling the same word in different contexts allows the communicator to learn that words can be used in different ways. Open Access encourages teams to use Aided Language Modeling in conjunction with providing students with access to a Universal Core vocabulary.

For more information, explore the Project Core website, or the Universal Core Vocabulary [Technical Report] from the Center for Literacy & Disability Studies at the University of North Carolina at Chapel Hill.

Partner-Assisted Scanning is a strategy that allows a communicator with physical and/or visual impairments to communicate more actively by participating in conversations using choices presented by a skilled partner. This strategy provides communicators with the language they need to interact with partners and participate in activities without having to independently access a system. Choices can be visual, auditory or a combination of both. Using a "smart partner" allows for flexibility and scaffolded support that would not be available in a technology based system (while the student is developing those critical access skills), giving the student access to communication opportunities that might not otherwise be available.

Check out this video from Practical AAC to familiarize yourself with this strategy.

Spelling is the ultimate strategy for generating novel messages! Spelling-based systems can be no-tech (a spelling board) or high-tech (an alphabet layout in a speech generating device). Using these supports is NOT just for proficient spellers. Even communicators with more rudimentary spelling skills can make very good use of spelling layouts to communicate (e.g. the first letter of a word) and/or repair breakdowns. Many more proficient communicators prefer spelling because it allows them to say what they want to say exactly how they want to say it!

Encoding is any technique in which a communicator gives multiple signals that together specify a desired message. For example, picking a letter and a color determines a specific message.

Tools are the physical object or device used to transmit or receive messages. We can break down these tools with the following descriptions:

No-Tech or Technology

They can be no-tech (e.g. a communication book, flipbook, eye gaze board) or technology based (a single message communicator up to a robust speech generating device). No-tech does not necessarily mean less sophisticated, however! Some no-tech systems can be quite robust language systems. No-tech systems can be used in conjunction with technology based systems; they are not mutually exclusive.

Static or Dynamic Displays

For a technology-based system, we can also categorize tools as having either "static" displays (meaning that the symbols on the overlay are fixed or static; the symbols on the display don't change, unless you physically change the overlay) or "dynamic" (meaning that locations on the display can be programmed to link to another page set with a new display of symbols).

Digitized or Synthesized Speech

Tools can also have different output features. A tool with "digitized" (recorded) speech stores a real person's actual words, phrases or sentences in the form of digitized sounds. A tool with "synthesized" speech (often referred to as text to speech) produces sounds similar to human speech and is needed to translate spelling into speech output.

Dedicated or Integrated

And finally, we can categorize tools by whether they are a device made specifically for use by individuals with communication needs (a dedicated tool), or a commercially available tool that can be used for multiple purposes, but with the right app or software can be used as a speech-generating device (an integrated tool).

To explore examples of tools, navigate to the AAC Resource FlipKit.

A symbol is how a word or concept or message is "represented" so that a communicator can select it in order to send a message to his or her partner. Symbols can be tactile (like objects or parts of objects), visual (like a picture, drawing, letter or word) or auditory representations of concepts or ideas.

Symbols can be sequenced to build sentences from separate parts.

Not all symbols are alike! Some are what we call "representational" (or more concrete). They look like what they are trying to convey. Sometimes these are referred to as "picture producers". For example, all of these are symbols for "cat".

But not all words or ideas are so easy to represent. Some are more "abstract" (symbols that will require some explanation, teaching, or modeling in order for them to be understood and used by the communicator). These are sometimes referred to as "non-picture producers". For example, all of these are symbols for "on".

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The objective of the Open Access website is to facilitate the Learning and Participation for ALL students by eliminating barriers to learning.

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Seven years ago I wrote about and created a new prompt hierarchy, designed for use with those who have apraxia. Soon after Shelane Neilsen collaborated with me to create a visually more appealing Adapted Prompt Hierarchy. Quickly translations began appearing, at first with or Shelane's my consultation and, eventually, without it. Eventually new versions appeared, usually copying my premise, and often times my exact language, sometimes with credit or consultation and most times not. Sometimes these were sold by others. They are making money off of work I have deliberately only offered for free. Work I've only offered for free because it is so vital to what we do as AAC caregivers and practitioners.

The Adapted Prompt Hierarchy came into being because of my experiences observing a traditional, ABA based hierarchy used with AAC learners. Those prompt hierarchies always started with an adult who had something specific that they thought the user should say. It was assumed the adult was always correct in their choice of what should be said and no other response was acceptable. As a means to that end the prompts had the end goal of encouraging, and if that didn't work, forcing the individual to say what they adult wanted them to say. Such procedures ignored the humanity and human rights of the AAC user to be in charge of if, when and what they communicate. These procedures, especially physical prompting, could create learned helplessness. Furthermore, AAC users are taught that the AAC system doesn't belong to them, it is merely a tool that someone else is in charge of, that they can be pressured or forced to use to say anything someone else wants, regardless of their desires. This may make the AAC system aversive, which will limit the success of it's use.

The major ways this Adapted Prompt Hierarchy for AAC is different from other prompt or cue hierarchies are the following:

Aided Language Input (aka Aided Language Stimulation, Partner Augmented Input, modeling) is the umbrella under which all other intervention occurs. It is a setting event for learning AAC.

This model focuses on maintaining the humanity and autonomy of AAC users. It safeguards AAC and communication as a choice.

It suggests use of a pause of a minute or more. Many prompt hierarchies suggest mere seconds. This is often not enough time for AAC users to process language, formulate a response and use their AAC system to say that response. The amount of wait time should be based on the individual AAC user. Data can be collected to determine the average wait time needed for many different types of responses to determine how long to wait.

This prompt hierarchy completely eliminates hands on prompting - including partial, full physical, hand over hand and hand under hand. No one should be touching an AAC user or their system while they are communicating. Ever. There is a myth that hand under hand prompting is acceptable if the user consents and can withdrawn at anytime. However, any physical prompting sends the message that the adult knows better than the child what to say and teaches the child to accept being physically manipulated to communicate. This is what we want to avoid. There may be some exception for Deafblind AAC users, but even then physical prompting is discouraged.

Other prompt hierarchies focus on getting an AAC user to say what the adult wants them to say, but this prompt hierarchy focuses on helping the AAC user figure out what THEY want to say.

​As well as their being a plethora of research supporting Aided Language Input as a primary intervention in AAC and a recommended best practice, there is also research indicating passive observation is better than using physical prompting in individuals with intellectual or developmental disabilities.
Additionally, seven years ago I had begun to work with a number of individuals who had been assaulted at school. I had to wonder how being forced to communicate specific messages using hands on prompting (be it hand over hand or hand under hand) created an easier target for abuse. Especial since these individuals were also subject to hand over hand prompting for other tasks, physical restraints and they were given rewards for allowing others to do things they found invasive or for allowing their bodies to be manipulated. Certainly, hands on prompting, compliance based education and therapies and the inherent ableism in forcing a disabled person to do undesired activities was grooming disabled children and adults into being easier targets for abuse.

In my original post, I went into great detail about the studies that show that individuals with disabilities are abuse at exponential rates compared to non-disabled individuals. The statistics have not gotten any better in seven years:

Adults with developmental disabilities are at risk of being physically or sexually assaulted at rates four to ten times greater than other adults. (From Sobsey, Dick (1994). Violence and Abuse in the Lives of People with Disabilities The End of Silent Acceptance? Maryland: Paul H. Brookes Publishing Company.)

Sixty-eight (68) to eighty-three (83) percent of women with developmental disabilities will be sexually assaulted in their lifetime, which represents a 50 percent higher rate than the rest of the population (Pease & Franz 1994, Warick, Jason (1997).

According to one study in 2000, approximately five (5) million crimes were committed against persons with developmental disabilities in comparison to 1.4 million child abuse cases and one (1) million elder abuse cases. (From Joan Petersilia, Ph.D., When Justice Sleeps: Violence and Abuse Against the Developmentally Disabled.)

More than ninety percent (90%) of people (both male and female) with developmental disabilities will experience sexual abuse at some point in their lives. Forty-nine percent (49%) will experience ten or more abuse incidents. (Valenti-Hein, D. & Schwartz, L. (1995). The Sexual Abuse Interview for Those with Developmental Disabilities. James Stanfield Company. Santa Barbara: California)

(https://shorturl.at/rwyV7)
Certainly, when the hierarchy was first shared seven years ago there was a backlash. Some caregivers, but mainly paraprofessionals and professionals, could not conceive of a world where what an AAC user communicated was up to the AAC user. Talking about abuse against those with complex communication needs and developmental or intellectual disabilities caused great upset. There was a lot of push back about the rates of abuse reported being untrue, despite experts saying they were actually low. Many practitioners doubled down on using hands on prompting. Slowly, but certainly some practitioners have begun to see the risk in using physical prompting and compliance based programming. Most and more parents and other stakeholders are demanding their child's interventions NOT be based in compliance training and instead support neurodiversity. Using the Adapted Prompt Hierarchy supports neurodiversity in many ways. It supports communication autonomy by allowing the child to decide if, when and how they communicate. It supports physical autonomy by avoiding any hands on prompting. It allows for extended wait times of a minute or more to allow neurodiverse brains time to process what is happening and form a response.

The Adapted Prompt Hierarchy for AAC is designed to create autonomous communicators who make their own choices surrounding what they wish to communicate, while offering them supports in choosing what to say,

Please contact us if you wish to translate this into another language. We will be happy to assist.
​Download file here.

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Revisiting the Adapted AAC Prompt Hierarchy:

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Empowering parents and professionals with effective, respectful strategies so you can connect authentically with your AAC learner

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Why Hand-Under-Hand Prompting?

A child who cannot see or hear, or who lacks a considerable amount of these senses, must be given a way to compensate for the missing information that these senses usually provide. Most commonly, it is the hands that take over the function of the eyes and ears for a child who is deafblind. When a sense is used a great deal, the brain is able to process information from that sense more efficiently. In individuals who are deafblind and use their hands extensively, areas previously devoted to visual or auditory processing have been shown to reconfigure for the processing of tactile information. Therefore, it is imperative that adults who work with children with deafblindness begin to develop the use of these children's hands as early as possible. Because the hands of a person with deafblindness are so important - functioning as tools, sense organs, and voice - it is crucial for edu-cators, parents, and friends of children who are deafblind to become especially sensitive to the child's hands. One evidence-based method of engaging the hands of a child with deafblindness is to use hand-under-hand prompting when assisting the child with a task or activity.

What is Hand Under Hand Prompting?

Hand-under-hand prompting refers to physical prompting that involves the adult facilitator guiding a child's hands from underneath (not over top) the child's hand. By using hand-under-hand prompting, the child is not forced to comply, but can move his or her hands at will. This process is less intrusive than manipulating the student's hands, which is especially beneficial for children with deafblindness who are often tactilely defensive. The hand-under-hand approach also allows the child who is deafblind to:

have more control

play a more active part in tasks and in learning

focus on objects being touched rather than exclusively on the facilitator's hands

retain access to the world

the hand-over-hand approach, in contrast, is equivalent to blindfolding a sighted child-the child who has no sight needs his/her hands to access the world.

The hand-under-hand approach is appropriate in all contexts when supporting a child with deafblindness, including but not limited to:

using physical prompting to demonstrate an activity to the child

demonstrating/teaching tactile signing

jointly exploring items by touch

using on-body signing

Important Points to Remember When Using Hand-Under-Hand Prompting

When you as a parent or service provider use the hand-under-hand technique, your hands perform the activity while your child or student's hands rest on top of yours - in this way the child can feel what your hands are doing. If the activity is new to the child and the child is hesitant, he or she may feel more secure touching your hands rather than the unknown object or activity, and so introduction of the object or activity may need to be gradual. Also, because the child's palms are on your hands, the child will be able to focus his or her energy on feeling the movements of your hands. With hand-under-hand prompting, it is common for the child to feel more comfortable and in control due to the fact that the child can move his or her hands freely if so desired. Remember that if the child you are working with does have some hearing capabilities, it is also important to pair the hand-under-hand prompting with a verbal description of the activity or task tin which you are engaging with the child.

References

American Foundation for the Blind. (2013). Hand under Hand and Hand over Hand. Retrieved on June 28, 2013

Downing, J. (2010). Academic instruction for students with moderate and severe intellectual disabilities in inclusive classrooms. Thousand Oaks, CA: SAGE

Miles, B., & Lane, H. (2003). Talking the language of the hands to the hands. The National In-formation Clearing House on Children Who Are Deafblind. 1-12.

Royal National Institute of Blind People. (2013). Supporting the child with the hand-under-hand approach. Retrieved on June 28, 2013

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Tips for Home or School | Hand-Under-Hand Prompting | Nevada Dual Sensory Impairment Project

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A child who cannot see or hear, or who lacks a considerable amount of these senses, must be given a way to compensate for the missing information that these senses usually provide. Hand under hand method is a great way to fill the gap.

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UNC Center for Literacy & Disability Studies

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UNC Center for Literacy & Disability Studies

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The Center's mission is to promote literacy and communication for individuals of all ages with disabilities. It is the belief of the CLDS that disabilities are only one of many factors that influence an individuals ability to learn to read and write and to use print throughout their life and across their living environments. All individuals, regardless of their abilities or disabilities, have the right to an opportunity to learn to read and write in order to increase and enhance their educational opportunities, vocational success, communicative competence, self-empowerment capabilities, and independence.

Writing With Alternative Pencils

Writing is undeniably an essential component of literacy instruction for students without disabilities. Without question it is a part of their daily instruction. In order for students with significant disabilities to develop as readers and writers, daily writing is equally, if not, more important. However, this becomes a challenge when most students with significant disabilities are unable to hold a traditional pencil. To address this challenge, the CLDS has developed a variety of free "alternative pencils" for students with the most significant disabilities, including deaf-blindness.

Learn More About Alternative Pencils

Current Projects

Tar Heel Shared Reader

Tar Heel Shared Reader provides free access to quality professional development, materials, and technology that support the implementation of shared reading for school-aged students with significant cognitive disabilities (SCD) who do not read connected text with comprehension above a 2nd grade level.

Tar Heel Shared Reader Website

Building Bridges

Building Bridges will provide resources for teaching reading, writing, language and communication as integrated parts of comprehensive literacy instruction. The model will align with 3 rd-5 th grade ELA standards and address the needs of students with significant cognitive disabilities and complex communication needs.

Building Bridges Website

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Center for Literacy and Disability Studies

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The Center's mission is to promote literacy and communication for individuals of all ages with disabilities. It is the belief of the CLDS that disabilities are only one of many factors that influence an individuals ability to learn to read and write and to use print throughout their life and across their living environments.

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NEW ON THIS SITE
Check out Giphy Activities under “Augmentative and Alternative Communication” on the drop down menu.

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The Problems with Hand Over Hand (Farrall)

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The Problems with Hand Over Hand (Farrall)

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The Problems with Hand-Over-Hand v2.0 – Jane Farrall Consulting

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Hand-over-hand as a teaching strategy is increasingly being defined as restrictive practice. However, I still find that many people working in this area use hand-over-hand as a teaching strategy without being aware of the problems around it – or the fact that there are other, more effective, teaching strategies.

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Communicating with Partner Assisted Scanning

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Everyone uses Core vocabulary to communicate. There are 2 types of Vocabulary - Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.
People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth.
AAC users should not stop using speech if they are able to do so. The AAC aids and devices are used to enhance their communication.(American Speech-Language-Hearing Association)
When children or adults cannot use speech to communicate effectively in all situations, there are options.
This includes different forms of communication that is used to express thoughts, needs, wants, and ideas. There are different types of AAC systems (aided and unaided) along with different levels of technology: low-tech (paper-based) and high-tech (electronic).

Unaided Systems rely on the person's body to convey messages. Examples include gestures, body language, and/or sign language. Aided Systems require the use of tools or equipment in addition to the person's body. Aided communication has different ranges: from paper and pencil → communication books and boards → devices that produce voice output (speech generating devices). Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages. core and fringe.

Core vocabulary is a small set of commonly used words (high-frequency words) that support communication and language learning. It refers to words that speakers use frequently across multiple settings, such as the park, school, and home. These high-frequency words bridge topics and environments, and children can easily combine them to form meaningful phrases and sentences. They are often small, commonly used words (e.g. I, have, the, want, on..etc) and are typically pronouns, verbs, and demonstratives, such as it, go, want, eat, I, this, and no.
Core words are going to be more flexible to use across environments and communication partners.
- High frequency words that can be used in a variety of situations and with various communication partners
- Make up about 80% of the words we use everyday
- You cannot form a sentence without using core words
- You can create a sentence using only core words
- Often more difficult to visualize
- Usually includes pronouns, helping verbs, prepositions, articles, and common verbs
- Examples include - I, he/she, like, play, have, on, open, help, more, can, do, it
- Sentences using only core vocabulary - "I like to play", "I need help"

Fringe vocabulary is more situation specific (words that occur infrequently). Fringe words refer to a specific set of low frequency words that are specific to a particular person or activity. Their importance changes from context to context and from person to person (e.g., evaporation, museum, funny, etc.).They are often easier to teach because they are typically nouns -you can picture the item in your mind.
Since we don't just speak using fringe vocabulary, it is imperative that we focus on teaching the core words even though it can be more challenging.
- Words more specific to a situation - mostly nouns
- Cannot be used across a variety of situations
- Cannot form a sentence with only fridge words
- Can visualize the fringe vocabulary words
- Examples include: "pig", "school", "teacher", "pizza", "TV", "dinosaurs"
Core Vocabulary are those words used with high frequency and make up about 75-80% of the words we use everyday. Core vocabulary should be a main part of all AAC systems because it allows for most flexibility across most situations.
It is import to teach these core words because it allows the student to communicate his/her wants/needs. This will decrease frustration. It is easier for the student to touch the icon or say "more" to request the desired item then learning each noun or trying to navigate a device through various categories to find that specific desired item. For example, if a student points/says "more" or "want" I allows for us to understand what the student is trying to communicate within the given text/situation. This helps reduce those behaviors of frustration due to communication struggles.
Researchers who've developed the Dynamic Learning Maps (DLM) have identified a basic core 40 words that are a beginning word set to meet needs of emerging communicators.
- Gain true understanding of words and their meanings
- Develop basic communication language
- Increase diversity of application of words
- Communicate in more contexts
- Achieve active and independent communication
- Teaching communication for life
- Vocabulary, concepts, symbols or locations become familiar and known
- Focus is on learning new information / content
- Can learn to say what they want to say on a variety of topics in a variety of settings
- Express wants and needs

When using aided AAC Systems - core vocabulary should be the main focus because it allows for more flexibility. It is important to have the most frequently used vocabulary or core words easily accessible so it can be utilized efficiently. Fringe vocabulary are not used as often so they can be placed to the side or top of core boards (or programmed on further back pages in their AAC device).
Having the core words easily accessible and in the same place on the communication system is it allows the students to learn the motor planning patterns on the system which allows the student to also communicate quicker.
No student will be able to use core vocabulary without teaching and modeling.

Make a plan:
- Choose the new words
- Combine new words and symbols with known words and symbols to generate - - - Phrases Sentence illustrations
- Teach the words in the set you select
- Teach the symbols in the set you select
- Ask students to demonstrate meaning of word and symbol in sentence
- Assist students in creating their own sentences with target word(s)

All AAC learners need to see what it looks like to communicate using their AAC systems in real conversations.
- You don't need to model every single word you say, especially to start with. This would likely be overwhelming to all concerned. Instead, model one step above the AAC learner's current skill level. So if the AAC learner is not yet using the system to communicate in single words, model at the single word level. For example, if you're leaving the classroom to go to the cafeteria, you can verbally say "It's time to go to the cafeteria" and press the "go" button on the AAC system when you say the word "go". Once the AAC learner is at the one word level, you can step up your game - add a word when you model. So if you're leaving the house to go to see grandmother, you can verbally say "Let's go see Granny" and press "go" and "Granny" while you're speaking these words. - To support receptive language (Receptive input using the system is critical)
- To teach new words and combine known words
- To demonstrate a variety of communicative functions
- Model the use of the vocabulary during instructional activities and all other communication activities
- To support the understanding of words and their varied uses in a variety of environments
- Create multiple systems encouraging peer and adult supports

When designing a communication board for a student with complex communication needs, a consideration of a range of issues related to the person's ability is involved. Key factors to consider when designing a board focus around: mobility, vision, access, cognition, and language. Using person-centered questions help determine the best design for the student.
Because a single page on a device or board contains a limited amount of space, Special Educators and parents must carefully choose vocabulary. A student can use core vocabulary words to talk about a variety of topics for different purposes. For example, a student may have no, you, I, want, go, and more programmed on his device. How many messages can this student make? The student can combine words to make requests, such as "I want more," or "I want it." The student may also combine words to make rejections, such as "No more." Finally, a student can attempt to make directives, like "You go."
The context of a core vocabulary word determines the meaning of the message. If a student says "I want to go" in the context of a board game, he is indicating that he would like a turn to play. The same message in the context of a conversation regarding the grocery store indicates that the student physically wants to go to the store. In the context of a non-preferred activity, a student might use the same phrase to indicate that he is ready to leave. A communication device/board that contains mostly fringe vocabulary may include words such as paper, pencil, crayon, and glue. How many messages can this student produce? This vocabulary set severely limits the child to making one-word requests and labeling objects. When programming an AAC device or creating a communication board, it is important to find a balance between flexible core vocabulary words and appropriate fringe vocabulary words. By meaningfully and carefully selecting both core and fringe words for a device or board, parents and Special Educators open the door to strong communication skills.

In the world of AAC there are many icon families to choose from. Boardmaker icon, Pixons and Symbolstix, etc. to name a few. Choose a set that works well for you and your students. You may want to keep the future in mind - - - are you choosing a symbol set that will transfer well from a low-tech device to mid or high-tech?

There is a such thing as too many words. Don't start with too many words! To demonstrate beginning the teaching process with core words, here are a sample of a possible first 12.

- - - - "
Page (single or multi-page repeated core)
Symbol location (consistent location on page)
Access (physical, visual or portability & availability)
- Motor Automaticity - makes communication faster & easier
Location Learning" vs " Symbol Discrimination" (requires consistent layout - symbols always remain in that location.
- Develop motor patterns with specific symbols such as "I want" or "please go home"

- - -
Core words - select based on frequency of use (lists) and include range of parts of speech: pronouns, verbs, adjectives, adverbs, prepositions, social/interjections Extended Vocabulary:
Personal core - key people, key places, key things/objects
Generic school core - letters, numbers, colors, shape, calendar, etc
Grammatical markers - prepositions, add -ing to a verb, add 's' to plurals, possessives, articles, etc.
Binders - "of" "with" "by" "for"
Word altering strategies - "same as" "opposite of" "add to the front" "part of " "Sounds like" "Starts with" "same group/family" "join words"

Combining a manual communication board (core board) and a communication device (speech generating device or mobile technology app) is not unusual. Sometimes a manual board is a back-up system. Sometimes a manual board is a supplemental system when the device is a limited device or when the device can't be used in all environments (e.g., on the playground, at the pool, at the beach, etc.) When people are using core boards with a device, I would want them to define for me the role of the core board and the role of the device. If the person needs a manual board (core board) as a back-up system , I would want there to be a relationship between the board and the device/app (e.g., same arrangement, same pictures, same vocabulary) so that there isn't a great need to learn 2 totally different systems. If the board is a SUPPLEMENT to a device/app, then the core board would be providing additional words not available in the device/app.

1. If a student has a communication dedicated device that was purchased by their district, this device should be taught as the primary mode. Talk with SLP and AT Team about adding Core Vocabulary to the device, how to access Core Vocabulary, etc to work through CV challenges. It is important for the team to define the role of the board and the role of the device and include the district representative in the conversation to determine if the student has outgrown the device or app or what other needs exist.

2. Take screenshots of the device screens, email to the teacher or yourself, print, laminate and put together for the student in the event the device is broken or the student exits the program and the device remains with the district.

Once the student starts to perseverate or touch all the icons, I suggest several things:
(1) use visual masking so that ONLY the key/target words are available.
(2) try a board with more white space (if visual perception/clutter is an issue).
(3) use some hand-over-hand to restrict the random movements - Focus on core vocabulary
- Frequent opportunities to practice
- Activities appropriate for students of different ability levels
- Different AAC tools and strategies
- Group and individual activities
- Use in Natural contexts
- Direct instruction in symbol/concept meaning
- Involve families

- -
One way of structuring the process of teaching and modeling core words is to schedule a set of words to focus on each week or month. This makes the modeling more manageable, and as long as you keep modeling words from previous weeks, you will end up teaching a robust vocabulary with many core words.
Focus on 3-6 new words each week & continue to consistently use the previously learned words.

Repeated reading of books * Daily reading of the book of the week
* Say words of the week using AAC when they happen in the story
* Character poster

Predictable chart writing activities
* Students use their AAC system to complete a sentence that starts with core words
* Using words of the week during school activities Such as: "I like to" and "I can"
* The sentences can be combined with photos to create a book the students can re-read
- Typical classroom routines

* Modeling words of the week whenever possible using large core word displays located throughout the classroom as well as on students' AAC systems
Such as: circle time, snack, cooking, art, music, dramatic play centers and outside play - Centers & Work Time - Home Connection
* Practice at home by sending home information to families about the words currently being learned and how to model them using the students' systems

These strategies teach core words in natural contexts. Through repeated modeling of the words to communicate during real, fun activities, students learn the meaning of non-picturable words and how to use them to communicate. A wonderful program for teaching core words using this method has been developed by Carole Zangari, Gloria Soto, and Lori Wise. The program is called TELL-ME (Teaching Early Language and Literacy through Multimodal Expression). Yes, there can be a lot of new icons to learn and it is okay to teach one icon at a time! Maybe even spend an entire day using the icon "go" in as many situations and circumstances as you can.
Tell-Me through Multimodal Expression Model
(Link Above)
You might be surprised how many there are!

- "Go" to the bathroom / "Go" sit down
- Take time to "go" eat lunch
- Indicate it's another person's turn by saying "go"
- Ask for a walk by saying "go"
- "Go" away
- Indicate you want a video to play by saying "go"
Think about the world in terms of core vocabulary and how you can express yourself using it.

Commands: "sit down," "listen," "wait," "look," "stop," "all done." Games: "Your turn," "my turn," "go," "stop." Projects: "Same," "different," "look," "like it."

- - - -
Book Activities - Touch different core words on the core vocabulary board or AAC device as you read a book.
Hang a large portable core board in the room. You can use the core board during small group instruction or throughout the day to help teach those core words and concepts. Student can practice using their boards during this time through teacher modeling. Teachers should focus on modeling and encouraging the use core vocabulary during all activities throughout the day.
Practicing word order: loose symbols from the wall chart you can move around into different word combinations
Asking for help when you are supposed to be working independently: help picture card on the stick placed on the student's desk to remind him/her to ask for help, when needed
- Asking questions in a social language group: 2-word phrases, core phrases, and sentence strips of possible things to say which can be ordered into a social script
- Cooking in a small group: phrase cards (put in, get more, turn on, turn off, take out) to hold up to prompt vocabulary use
- Writing 3 sentences about the book: wall chart of the 200+ core words as a word bank
Add your ideas for using functional core words for describing common school, classroom, and community objects.
Post visual symbols on the objects:

Stairs - go, up, down, help, move, left, right
Trampoline - on, off, help, jump, my turn, go
Bathroom- in, out, turn on, turn off, open, close, push
Door - open, close, shut, in, out, push, pull
Door Handle/Knob - turn, pull
Fridge - in, out, open
Lockers - open, close, in, out, hang up,
Mailboxes -put in, take out

We need to take the time to model speech and language for children BEFORE we expect them to demonstrate that output of their words. Focus on modeling, modeling, and modeling for your students! Don't stress about beginning AAC learners who isn't touching their communication device often. Be the model that they need and deserve. Before you know it those little learners will be following that model.
So your AAC learners are starting to use core words on their own, but you still need to teach academic lessons! Teach nouns for academic lessons - nouns you know your AAC learners will not use once the lesson is over. The student uses core words to describe the concepts in the lesson instead of asking the student to memorize specific nouns to answer academic questions.

There are several bonuses to the descriptive teaching method:
- It gives the student more practice retrieving core words and combining them into meaningful sentences
- It requires the student to think more deeply and creatively about a concept in order to describe it his own words
It saves time spent programming and learning how to retrieve infrequently used words

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Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write. People with severe speech or language problems rely on...

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Teaching Verbs in Speech Therapy: MORE, Not Less

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When it comes to teaching verbs, less is not more. It’s important, when teaching verbs in speech therapy, to utilize evidence based practices and materials that

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It's really exciting when children begin talking. If you have your own child or have had the opportunity to watch a young child develop, you may have noticed that a child's first words are usually the names of people or things (nouns), such as Mama, Dada, ball, car, or bear. But by the age of two, young children should also be saying verbs. Verbs are words for actions like go, come, wash, eat, or words for states like want, like, love, see.

Examples of verbs that young children tend to learn first [1]:

bite, blow, break, bring, bump, clean, close, cry, dance, draw, drink, drive, eat, fall, feed, finish, get, give, go, help, hit, hug, hurry, jump, kick, kiss, look, love, open, play, pull, push, put, read, ride, run, say, see, show, sing, sleep, smile, splash, stop, swim, swing, take, throw, tickle, touch, walk, wash, watch, wipe, write

Why Are Verbs Important?

A recent study showed that 2-year-old children who use more verbs have more advanced grammatical skills six months later.

Verbs are very important for language development because they allow children to start building early sentences. Every sentence needs a verb. And the choice of verb determines many of the grammatical forms in a sentence. In fact, a recent study showed that 2-year-old children who use more verbs have more advanced grammatical skills six months later [2].

When Should Children Start Using Verbs?

There is a lot of variability when it comes to how many verbs children use when they are toddlers. But children should say at least a few verbs by 24 months. Many children can say at least 40 verbs by 24 months [3]. A child with only three or four verbs at 24 months would be at the low end of the average range [2]. This would not be cause for concern as long as the child continues to learn several new verbs every month for the next six months.

But children with no verbs at 24 months who don't start to speed up in the rate at which they learn new verbs between 24 and 30 months may be at risk for problems with language development [2]. These children will not be able to produce short sentences yet, as they can't build sentences without verbs. If they have any other risk factors for a long-term language difficulty, it may be wise to seek advice from a speech language pathologist who can determine whether they need help building their vocabulary. See our article "How to Tell if Your Child is a Late Talker - And What to Do about It" for more information and a list of risk factors.

How to Help Your Child Learn New Verbs

Keep a list of the verbs your child understands and says. Children have to understand a word before they can begin using it. Knowing what verbs your child understands will help you know which verbs you might repeat regularly to help him learn to say them. And keeping track of the verbs your child already says will help you know if he or she is learning new verbs each month.

Think about things your child likes to do. By identifying toys, foods, and activities your child enjoys, you will be able to think of action words (verbs) associated with these things. For example, if your child enjoys bath time, you could repeat verbs like "pour", "wash", or "splash" when he has a bath. If your child likes to play with cars, you could use verbs like "push", "crash", or "go" when you play cars together.

Show your child what the verb means. Verbs are action words, so whenever possible, try to do the action while you say the verb in a short sentence. For example, if you are helping your child learn the verb "push", make sure you push the toy car while you say "I'm pushing the car". This helps your child remember the new word and what it means.

Repeat, repeat, and repeat some more! Children need to hear new words many times before they start to use them themselves. When interacting with your child, try to use a new verb several times during the activity. Then use it again the next time you do that same activity. And then use it again when you do a different activity with your child. For example, if you've been emphasizing the verb "pour" every night at bath time, remember to use it at meal times when you pour a glass of milk. In this way, your child will have many opportunities to hear the new verb in a variety of situations.

In Summary

Children need to learn all kinds of words in order to talk. Verbs are especially important because they help children communicate about events in the world by combining words into sentences. Using some of the tips above, you can help your child learn verbs and pave the way for his language to develop.

Many of the tips above come from Target Word™, The Hanen Program for Parents of Children Who are Late Talkers. Learn more about Target Word™.

References

1. Fenson, L., Marchman, V. A., Thal, D. J., Dale, P.S., Reznick, J. S., & Bates, E. (2007). MacArthur-Bates Communicative Development Inventories (CDI): Words and Gestures. Brookes Publishing: Baltimore, MD.

2. Hadley, P. A., Rispoli, M., & Hsua, N. (2016). Toddlers' Verb Lexicon Diversity and Grammatical Outcomes. Language, Speech, and Hearing Services in Schools, 47, 44-58.

3. Center for Child Language and the CDI Advisory Board. (2013). Cross Linguistic Lexical Norm website. http://www.cdi-clex.org/.

The Hanen Centre is a Canadian not-for-profit charitable organization with a global reach. Its mission is to provide parents, caregivers, early childhood educators and speech-language pathologists with the knowledge and training they need to help young children develop the best possible language, social and literacy skills. This includes children who have or are at risk for language delays, those with developmental challenges such as autism, and those who are developing typically.
Click on the links below to learn more about how Hanen can help you help children communicate:

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Verbs Pave the Way for Language Development

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You may have noticed that a child's first words are usually the names of people or things, like "Mama", "Dada", "ball" or "car". But by the age of two, young children should also be saying verbs. In fact, verb use at this age has been linked to more advanced grammatical skills six months later.

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Bridge School - First Author Writing Measures

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Bridge School - First Author Writing Measures

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The Sherlock Center is committed to helping students with complex disabilities to participate in the general curriculum. As resources permit, the Sherlock Center creates adapted versions of popular literature for use by students, teachers and families.

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Well, the school year is all of 3 days old and already we've had plenty of questions about AAC apps. Sigh. We've had our ups and downs with AAC on mobile devices, but there is no sense rehashing all of that here. Instead, we'll focus on some of the tools we use when helping to determine which, if any, are a good fit for a particular communicator.

AAC App Lists:
Feature Match Checklists & Forms:
Our Rubric for Evaluating the Language Aspects of the AAC App
Other Helpful Sources

Filed under: PrAACtical Thinking

This post was written by Carole Zangari

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Comparing AAC Apps: A Look at the Language & Other Features

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Well, the school year is all of 3 days old and already we've had plenty of questions about AAC apps. Sigh. We've had our ups and downs with AAC on mobile devices, but there is no sense rehashing all of that here.

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The CALL Scotland 'wheel' of Apps provides a categorised guide to iPad Apps for individuals with complex communication support needs, who may need to use Augmentative and Alternative Communication (AAC). First published in 2014, I'm pleased to share now that it has had it's 2020 refresh and update.

The process of updating has taken a while, but this has resulted in the most significant update yet and the outcome is a resource that maintains the usability and usefulness of its previous versions.

Of the Apps included, many have been tried and tested by us or have been recommended by others. We have included a range of Apps for supporting different communication needs and included those which are more or less expensive to buy.

Other key principles in our selection process are:

the Apps stand out in their category in some way, due to their features, ease of use and reliability

there is evidence of continuing support from the developer for the App, by way of recent updated versions and a website or other web-based presence

user information is provided through a guide or similar resource on how to use the App

The following changes have been made -

A total of 17 Apps have been added to this version 2.0

Speech Assistant AAC, Jabberwocky AAC, Sesame Talking Keyboard, SayIt!, BRIDGE Communication Pro, SymboTalk, GoVisual Experience, iSpeak Button Collection, Make a Choice - AAC Buttons, Verbal Me, Smooth Talker AAC, Yes/No, Special Stories, See Me Talk, PODD with Compass (PCS), simPODD, Pathways for Core First

A total of 20 Apps which appeared in the previous version 1.7, have been removed

Word aaccess, Assistive Express, TotalTalk AAC, Tobii Dynavox Compass Connect, AAC Speak, Able AAC, image2talk, iSpeak Button Series, TapSpeak Button, Use2Talk, TapSpeak Sequence, Our Story, Speakall, PictureCanTalk, So Much 2 Say, Board Communicator, Bitsboard Preschool, MobileSign2, BSL Education, British Sign Language - Finger Spelling

Further indicators showing alternative access options, have been included:

Switch access (previously included) is now shown as a red border around the App image

Head Tracking (Face ID/Attention) is shown as an H, next to the App image

Where there is free versions of an App, there is a red * next to the App name

The BSL section has been removed and a PODD section added

Some app images and symbol sets have been updated

During the update process this year, information was collected through conducting two surveys, one focussing on text-based Apps and the other on symbol-based Apps. Comments and views were sought on App use, features and preferences. I am most grateful to all those who participated in either survey and will provide a summary of the responses in a subsequent blog.
download the wheel
Please get in touch with your feedback and any suggestions for further revisions.

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Updated Aac Ipad App Wheel Available Now

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The CALL Scotland 'wheel' of Apps provides a categorised guide to iPad Apps for individuals with complex communication support needs, who may need to use Augmentative and Alternative Communication (AAC). First published in 2014, I'm pleased to share now that it has had it's 2020 refresh and update.

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The Most Popular AAC Devices | TherapyWorks

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AAC can teach and reinforce a child to communicate with others. Here's a list of the most popular AAC devices and the features that put them on our list!

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See this post for the newest update. A 12th app has been added: https://omazingkidsllc.com/2022/01/29/updated-expanded-feature-matching-chart-for-the-top-12-robust-ios-symbol-based-aac-apps/
This major update adds an 11th app (Talk Suite Pro) to the AAC feature matching chart
This chart includes an in-depth comparison of features & support resources across 11 robust iOS symbol-based AAC apps:

* Avaz AAC - Lifetime Edition

* Clicker Communicator: AAC

* CoughDrop

* GoTalk Now / GoTalk Now Plus

* Grid for iPad VPP

* LAMP Words for Life

* Proloquo2Go

* Speak for Yourself

* Talk Suite Pro

* TD Snap (formerly known as Snap Core First)

* TouchChat HD with WordPower
Preview:

This product also now includes free exclusive access to an unlisted YouTube video (58:32) with time-stamped sections highlighting the unique features in each app.

Thanks SO much to Lauren S. Enders for this shout out for my AAC Feature Matching Chart in her presentation on 6/24/21 at AAC in the Cloud! See the whole presentation and get her handouts for "Personalizing AAC - A Deep Dive into Vocabulary Customization": https://presenters.aacconference.com/videos/UVRRd1FUSXg=?. Be sure to also check out her Waklet with links to resources: https://wke.lt/w/s/7ldtJE.

Thanks Vicki Clarke / Dynamic Therapy Associates Inc (aacchicks)! The shoutout for the AAC feature matching chart in your IG Stories on 7/20/21 made my day 🥰

It's available for purchase on my Teachers Pay Teachers store: https://www.teacherspayteachers.com/Product/Feature-Matching-Chart-for-the-Top-11-Robust-iOS-Symbol-Based-AAC-Apps-6867853.
If you already purchased it be sure to go download the update for free.
Recurring monthly subscribers on Ko-fi can access this as part of their subscription: https://ko-fi.com/post/Feature-Matching-Chart-for-the-Top-11-iOS-Symbol-B-R6R85DVLH

This freebie on my OMazing Kids TPT store has been updated to add the Talk Suite Pro app: https://www.teacherspayteachers.com/Product/How-to-Get-Access-to-the-Top-11-iOS-Symbol-Based-AAC-Apps-TPT-Freebie-6869004

Have questions? The best way to reach me with any questions is via messaging on the OMazing Kids Facebook page: https://www.facebook.com/OMazingKidsAAC/. That way messages don't get lost among the spam in my e-mail.

Angela Moorad, MS, CCC-SLP, Founder of OMazing Kids, LLC, OMazing Kids AAC Consulting

Teachers Pay Teachers Store: https://www.teacherspayteachers.com/Store/Omazing-Kids-Aac-Consulting

Ko-Fi: https://ko-fi.com/omazingkidsaac

Personal Professional Facebook Page (linked to OMazing Kids): https://www.facebook.com/angela.moorad (adding "friends" who have a direct role in AAC or Assistive Technology - AAC / AT app or product developers, AAC / AT consultants, SLPs who specialize in AAC, other professionals who specialize in AAC or AT, etc.)

OMazing Kids AAC Consulting Facebook Page: https://www.facebook.com/OMazingKidsAAC/

AppPeeps Facebook Group: https://www.facebook.com/groups/OMazingKidsAppPeeps/

Instagram: https://www.instagram.com/omazingkidsaac/

Twitter: https://www.twitter.com/amoorad

Pinterest: http://pinterest.com/OMazingKids/

Linktree: https://linktr.ee/amoorad1

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Feature Matching Chart for the Top 11 Robust iOS Symbol-Based AAC Apps

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See this post for the newest update. A 12th app has been added: https://omazingkidsllc.com/2022/01/29/updated-expanded-feature-matching-chart-for-the-top-12-robust-ios-symbol-based-aac-apps/ This major update adds an 11th app (Talk Suite Pro) to the AAC feature matching chart This chart includes an in-depth comparison of features & support resources across 11 robust iOS symbol-based AAC apps: * Avaz AAC - Lifetime Edition *...

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Diagnostic Center, Northern California (DCN) is a sector of the California Department of Education's State Special Schools and Services Division. We provide student assessments, virtual & in-person trainings, and on-site technical assistance projects at no cost to the school or district.

We would like to invite SELPA, district and school staff members to our virtual informational sessions. During this time we will discuss our various programs, answer any questions you may have and brainstorm how our center can be of assistance to your community.

Register for the 2:00 PM session on Wednesday, October 4th, 2023
Register for the 12:00 PM session on Tuesday, October 17th, 2023

Our Services Include...

Comprehensive, state-of-the-art assessment and educational planning services to assist local school districts in determining the needs of their most complex students;

On-site technical assistance and consultation in program and instructional design based on the unique needs of each student;

Professional development opportunities for teachers, administrators and special education staff, including presentations at national, statewide, and local conferences and workshops, provided by specialists with "hands-on" experience;

Family education opportunities, including consultation, referral, and resource information.

There is no cost for assessment services; however, requests for services must be generated by the local school district.

DCN Newsletters

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Diagnostic Center, Northern California (DCN)

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The Diagnostic Center, Northern (DCN) California provides expert, interdisciplinary teams of diagnostic professionals who address the unique educational needs of Northern California's most difficult-to-serve students enrolled in special education programs.