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TIP #5:
Connecting Core Words, Aided Language Modeling, and Literacy

Introduction

Building communicative competence for students with significant communications needs enables them to thrive in inclusive contexts. The use of core words and aided language modeling with these students not only increases augmentative alternative communication (AAC) use, but also forms a connection with literacy instruction.

Evidence

Aided language modeling combined with core vocabulary approaches is useful for increasing receptive and expressive language for students with complex communication needs. It also increases AAC use by these students (Erikson & Geist, 2016; O'Neil, Light, & Pope; 2018). The core vocabulary approach represents language in a way that promotes the formation of phrases and sentences, which creates a natural literacy connection (Binger, & Light, 2007; Harris & Reichle, 2004; Romski, Sevcik, Cheslock, & Barton, 2006).

Definitions

Aided language modeling is modeling the use of a student's AAC system by individuals in the environment who do not have significant communications needs. Best practice involves the use of an evidence-based strategy that utilizes a communications partner to model the use of AAC with an AAC user. The communication partner uses the AAC device to model language using complete sentences, fixed position symbols/words for motor planning, slow speech, and waiting for engagement.

Augmentative alternative communication (AAC) refers to communication methods (other than oral speech) used to express thoughts, needs, wants, and ideas (Kleinert, Holman, McSheehan, & Kearns, 2010).

Core words are words (e.g. verbs, adjectives/adverbs, and pronouns) used for a variety of communicative intents (e.g. requesting - "want"; commenting - "love"; refusing "stop"). These are the words that comprise most of the content used in a typical conversation. There are a relatively small set of core words, which individuals can successfully use in a range of communicative opportunities and interactions using them.

Expressive language refers to the ways that an individual indicates their wants and needs.

Fringe words are nouns that are specific to persons, places, or things that are highly specific or unique to the user and/or an activity in which they are involved.

Motor planning refers to planning, and carrying out a motor activity (in this case, ones that are supportive of communication) in the correct sequence.

Receptive language refers to how an individual understands information received from others.

Slow speech refers to the slowing down of a partner's speech as part of aided language modeling. The slowing down of the partner's speech allows the student using AAC to have time to process the partner's message.

Implementation

The combination of core words and fringe words allows a student with significant communication needs to have a robust vocabulary using AAC. In the image, the fringe words for the core word "do" include words related to activities that the student does at home such as play ball, play with a friend, play in the snow, play outside, go to the store, ride the motorcycle, watch TV, and feed the chickens. It is easy to see the level of specificity that is unique to this user - not everyone has chickens. This robust vocabulary allows them to participate meaningfully in academic and social activities including telling, writing, spelling, etc.

Strategies for connecting core words, aided language modeling, and literacy can be found below:

Create Core Vocabulary Arrangements. Selection of the core vocabulary arrangement allows the student to access highly flexible words used most often across the day. Core vocabulary arrangements can include any number of symbols/words from a minimum of four for those students who are unable to point to symbols/words and need an alternate means of access to many more. An alternate means of access might be the use of eye gaze, partner assisted scanning, or access to 3-D/tactile symbols due to vision. The teachers should be modeling from the 36 words on the Universal Core (see Project Core information in the Resources), and larger arrays can be used as appropriate for the student. The array should be organized with pronouns on the left, verbs in the middle, and adjectives/adverbs to the right. The array in the image uses Boardmaker© symbols in a 45-word array which fits on a tablet screen. Nouns (i.e., fringe words) represent highly individualized words located by links on a device or as a tab in printed models.

Use Aided Language Modeling. Aided language modeling requires communication partners to use sentences, but not every word in the sentence will have a symbol/word on the communication display, The communication partner should:

Speak slowly and point to the symbols/words,

Vocally emphasize the key symbols/words,

Pause frequently,

Wait for the student to engage.

Make the Literacy Connection. Connecting core vocabulary and aided language modeling to literacy occurs when the student and educators use core vocabulary arrangements in academic activities involving vocabulary development such as reading, writing, and spelling in literacy activities with some simple adaptations. Creating content specific fringe vocabulary can help the student participate in literacy activities. These may be separate from the student's device or there may be a reading folder where specific fringe vocabulary for reading is located. It is important to be thoughtful and strategic about what fringe vocabulary to include. The core arrangement itself may also be used to describe what happened in the book although not all needed words may be available. The verbs and adverbs are placed to make it easier for the student to participate. Nouns primarily make up the fringe vocabulary.

The image shows a fringe arrangement for the book, The Giving Tree (Silverstein, 1964), using Boardmaker© symbols. The nouns highlighted by yellow backgrounds include the words "boy," "tree," "leaves," "branches," "apple," "tree trunk," "house," "money," and "boat." Verbs are highlighted in pink backgrounds include "hide & seek," "sleep," "grow-up, and "sit." Adverbs are highlighted in blue include the words "happy," "sad," and "old."

Spelling is also important for literacy. Adding a letter arrangement provides the opportunity for students to embed spelling as a part of the lesson. The folder in the image includes a 45-word core array, numbers and their numeric representations, colors, and the alphabet for spelling.

Summary

A key to successful inclusion, and better outcomes, for students with significant communications needs is getting a communications system in place in a timely manner. AAC using core vocabulary words and fringe words, combined with aided language modeling, connects well with literacy activities. This provides support for both language and literacy skills development.

PrAACtical AAC Project Core

TIPS Series: Tip #5, January, 2020

All rights reserved. Any or all portions of this document may be reproduced without prior permission, provided the source is cited as:

Kearns, J., & Kleinert, J. (2020). Connecting core words, aided language modeling, and literacy (TIPS Series: Tip #5). Minneapolis, MN: University of Minnesota, TIES Center.

TIES Center is supported through a cooperative agreement between the University of Minnesota (# H326Y170004) and the Research to Practice Division, Office of Special Education Programs, U.S. Department of Education. The Center is affiliated with the National Center on Educational Outcomes (NCEO) which is affiliated with the Institute on Community Integration (ICI) at the College of Education and Human Development, University of Minnesota. The contents of this report were developed under the Cooperative Agreement from the U.S. Department of Education, but do not necessarily represent the policy or opinions of the U.S. Department of Education or Offices within it. Readers should not assume endorsement by the federal government. Project Officer: Susan Weigert

The National Center on Educational Outcomes (NCEO) leads the TIES Center partnership. There are six additional collaborating partners: Arizona Department of Education, CAST, University of Cincinnati, University of Kentucky, University of North-Carolina-Charlotte, and University of North Carolina-Greensboro.

TIES Center

University of Minnesota

215 Pattee Hall

150 Pillsbury Dr. SE

Minneapolis, MN 55455

Phone: 612-626-1530
www.tiescenter.org
This document is available in alternate formats upon request.

The University of Minnesota is an equal opportunity employer and educator.

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TIES TIPS | Communicative Competence | TIP #5: Connecting Core Words, Aided Language Modeling, and Literacy

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Building communicative competence for students with significant communications needs enables them to thrive in inclusive contexts. The use of core words and aided language modeling with these students not only increases augmentative alternative communication (AAC) use, but also forms a connection with literacy instruction.

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Using an Aided Language Board to Help Non-Verbal Students Tell a Story

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Link to access adapted, interactive texts

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Link to access adapted, interactive texts

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Because of their flexibility and malleability, digital technologies - especially web-based tools - dramatically expand options for providing Universal Design for Learning (UDL) supports as compared with exclusively print-based media.

Created in partnership with the Google Literacy Project and Carnegie Corporation of New York to celebrate World Book Day in 2008, CAST launched UDL Editions of classic public domain texts, including a short story, sonnet, speech, and more, from world literature to demonstrate the power of technology to transform texts in a way that responds to the needs of all kinds of learners.

UDL Editions brought seven classic texts into a scaffolded digital reading environment with flexible supports for three facets of learning: understanding content, building skills, and having fun. Six of the texts could be viewed in English, and one in Spanish.

The tool reached a target audience of users 10 years of age or older. To incorporate UDL, readers chose their text and level of support desired: minimal, moderate, or maximum, and accessed multimedia resources for background information and enrichment activities for further learning.

Supports included:

Glossary words

In-context explanations of idioms and literary devices

Stop-and-think prompts

Animated coaches providing hints and support

Image descriptions

"Build-your-own" activities to understand the authors' craft

Interactive maps

Teacher resources

In addition, a toolbar contributed by Texthelp offered:

Text-to-speech read-aloud

Dictionary and encyclopedia links

Highlight-and-gather

Translations between English and Spanish

Varied literature was selected to show how a UDL-supported and scaffolded environment can support content across the curriculum and across grade levels. With powerful new technologies and UDL principles, old classics became smart, reader-friendly texts that opened up a new world of reading to learners with diverse abilities, interests, and skills.

UDL Editions and other literacy research project work conducted by CAST informed the development of UDL Studio, which guides and supports educators to build their own UDL-supported materials.

For more information about UDL Editions, contact Kristin Robinson.

UDL Editions in Research

Universal Design for Learning in the Classroom: Practical Applications, published in 2012, uses UDL Editions as a case study to discuss how the principles of UDL apply to reading comprehension, teaching, and learning in Chapter 3: Reading Strategy Instruction, Universal Design for Learning, and Digital Texts: Examples of an Integrated Approach.

In particular, it addresses the what, how, and why of reading:

What: What are the words on the page/screen, and what do they mean?

How: How does the reader make sense of the text?

Why: Why should the reader care about the text?

Learn more & order the book

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Publicized by Google around the world, UDL Editions was a model for presenting classic texts from world literature in a flexible online interface with just-in-time, individualized supports for struggling and expert readers alike.

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Link to bookbuilder for creating adapted digital texts

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Link to bookbuilder for creating adapted digital texts

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Message to our Loyal Users of CAST UDL Book Builder, UDL Exchange, and UDL Studio

On January 15, 2024, we will retire this website, along with a few others. We know it has many devoted followers who will be sad to see it go. We're sad, too.

Making these creative tools and offering them free-of-charge to educators, parents, and learners at no charge the past decade-plus has been our joy, we also know that usage is way down, funding for the tools ran out years ago, and their underlying technologies are no longer contemporary.

To ensure a smooth transition, we're providing a three-month sunset period so you have sufficient time to download any stored materials you may have on the sites and to find alternative tools. After January 15, we will also close all user accounts.

Thank you again for your understanding and be sure to visit www.cast.org to learn more about the exciting innovations we are pursuing today and tomorrow! Questions: questions@cast.org

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Message to our Loyal Users of CAST UDL Book Builder, UDL Exchange, and UDL Studio On January 15, 2024, we will retire this website, along with a few others. We know it has many devoted followers who will be sad to see it go. We're sad, too.

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An overview of the multi-year, iterative development project to create the Project Core implementation model for teachers and classroom staff.

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Core Word of the Week Planners

The AssistiveWare Core Word Classroom has planners that can help you give your classrooms the WOW factor! The Core Word of the Week Planners are specifically designed to support teams in modeling a set of core words throughout the day, across all activities. Used in conjunction with the Core Word of the Week Displays - printable displays that show the location of the core words - you can get core words happening with WOW!

Like many of our resources in the AssistiveWare Core Word Classroom, we focus on the 3W's - the words, whys and ways. And while in the Core Word of the Week Planner, the WORD is more obvious, it is still important to use that word to communicate for different reasons (whys) and to combine that word with other words to communicate in different ways.

We currently have 30 different core words (or pairs of words such as here & there, in & out), and have plans to expand to more core words in time. We have an even mix of pronouns, verbs/actions, describing words, questions and prepositions, all of which are highly functional core words. The words are chosen based on the core words used to create the Proloquo2Go Crescendo Core Word vocabulary.

What will you find in a Core Word of the Week Planner?

Each Core Word of the Week Planner consists of the following four categories: - Whys & Ways table - Specific grammar - Extension ideas - Literacy suggestions You can find an explanation of each below. Download the Core Word Planner for "Like"(PDF) as an example of what a Core Word Planner looks like. On the AssistiveWare Core Word Classroom you can find more Core Word Planners.

Whys & Ways Table

This table gives suggestions for ways to model the core words to your students. These ways are split into the different reasons to communicate, or whys. Sentences are in order of increasing length and complexity, to give you ideas you can use with students of different language skill levels.

For example, in the "different" Core Word of the Week Planner, the suggestions in the "Asking for Information" cell start with a simple "what is different?" and end with a six word sentence:

What is different?

Where is the different one?

Who wants a different one?

Why is it different?

How is this different from that?

When can we do something different?

Specific grammar

This section gives you some specific ideas for how you may support the grammatical learning of the core word for those students that are ready, eg. teaching past tense of "go" > "went".

Extension ideas

Extension ideas give you some extra ideas you may like to try to extend language and create more opportunities to model the core word/s throughout the day.

Literacy suggestions

We also have given some brief starting points and suggestions for extending the activity to include a literacy component. The suggestions are not comprehensive and you should use alongside your current comprehensive literacy program.

Getting started with Core of the Week Planners

Explore the Whys & Ways table to help you in planning your modeling. Use copy/paste to grab sentences you want to be sure to use with your students. You can make a cheat sheet for your classroom staff in this way. You can choose between making a single cheat sheet for use with all your students, or a customized sheet for each teacher or aide with whys & ways that target the specific needs of the group of students they will be working with.

Explore the Extension ideas to find suggestions to extend use of the words of the week throughout the day.

Explore the Literacy suggestions and remember that literacy is the ultimate AAC, as it allows you to say anything without waiting for someone to program in the words! Every student can benefit from literacy instruction, regardless of the level of literacy they eventually reach.

Core Word of the Week Displays

These Displays were designed to support a Core Word of the Week approach, by giving you printable and easy to read posters that can be displayed prominently in the classroom and around the school. They could even be shared with parents for use at home!

Page 1 of the WOW Display provides visuals, with both the symbol for the core word, as well as showing where the word can be found on the Proloquo2Go Crescendo core word board. If you are using a different AAC system, you could take a screen capture of your core word screen to create a similar page to this.

Page 2 of the WOW Display, provides sentence examples for using the target core word. These have been organised into 3 main communication functions:

Needs & Wants (eg. like it, like that, not like, I would like to __, etc)

Giving/Getting Information (eg. you like it, what like?, he will like, etc.)

Social Interaction (eg. I like to see you, etc.)

Not sure?

Are you not sure what approach to take for teaching and modeling core words? Do you teach the core words within an activity, or teach a core word of the week? While there is no right or wrong, we will be sharing some things to think about and consider in an upcoming blog. Keep an eye out for it!

Join the AssistiveWare Core Word Classroom now!

Our Core Word of the Week Planners are loaded with ideas, and ready to help you to teach and model core words all day, everyday! Why not join up and try them out today?

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Wonderful (Core) Words of the Week - AssistiveWare

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AssistiveWare's SLPs Amanda and Jennifer look at the Core Word of the Week Planners, one of the resources of the AssistiveWare Core Word Classroom, which help with focused modeling and teaching of a specific core word.

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An Amazing Core Vocabulary Board You Don’t Want to Miss!!!

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Visual Schedule Template am pm 10 blocks

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Curricular Adaptation Decision Questions 2015

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This blog uses affiliate links. Basically, I make a small commission when you use these links, at no additional cost to you.

A collection of free social stories about using an AAC device or iPad to communicate. Printable and video social stories for kids are included below.

Some people don't use mouth words to speak. They might be considered nonspeaking or minimally speaking. Or they might just like to supplement with alternative forms of communication in certain situations and it's a supplement to their verbal speech or mouth words.

Instead, they might rely on other forms of communication other than oral speech, such as sign language, letter boards, technology, and/or something else entirely. These other forms of communication are called augmentative and alternative communication or AAC.

Below you will find a variety of free social stories about using an AAC device. You can use these stories to introduce your child (or client, if you're a therapist) to using AAC to communicate.

Or you might even use a social story or two from this list with a child's siblings or classmates to explain different forms of communication to them.

Whatever the reason, I hope you find these AAC social stories useful, no matter who your target audience is.

Free Social Stories About Using an AAC Device

Have you been looking for a social story about using an AAC device? Then look no further than these free printable social stories about AAC device use. Some require you to have a Teachers Pay Teachers account (which is free!) before you can download them.

I've rounded up some options for you to explore. That way you can find the best AAC related social story for you and your child. Or you can simply use ideas from different stories below to write your own custom story ( free social story templates here to help).

Please note that just because a social story is listed here does not mean I endorse its content. After all, many social stories tend to be poorly written and/or teach autistic masking. Besides, I haven't read all of these stories word for word myself. So please read through the stories carefully before using them with your child.

It's also worth noting that there seems to be lots of really great paid options out there as well. The focus here, however, is purely on free social stories.

1. I Use my Device to Talk Social Story from AT4Kids on TPT - This story talks about rules for using the device and include things like not throwing it. There is also a built-in communication board to practice modeling AAC skills. This story uses colorful clipart.

2. Using AAC Device Social Story from Kate O'Malley on TPT - This story highlights that people can communicate and talk in different ways and then explains what an AAC device is. It includes colorful clipart.

3. AAC Device Care Social Story from AAC Hub on TPT - It looks like this story is available as a PowerPoint so you should be able to edit it. Which might be a good thing because this story looks very busy visually and some of the text in the preview images isn't great. But it does include a mix of clipart and photos.

4. AAC Core Word Social Story (Like/Don't Like) from Stephanie Zapata on TPT - Here's a story that focuses on teaching core words/concepts. It uses boardmaker symbols and full color photos. It apparently comes as a Word document so you should be able to edit it too.

5. What are Talkers For? An AAC Communication Device Social Story from ESE AAC on TPT - This story uses a mix of clipart and photos to discuss why some people use an AAC device or talker. It's a Word document so, again, you should be able to edit it.

6. Social Story: Using Your AAC Device from Divergent DeafEd on TPT - This story uses symbols and some simple text. It looks like a pretty basic story.

7. Simple iPad Social Story from Korynn a SLP on TPT - Here's a super simple one page social story about iPad/AAC ownership. It covers what it's for, how to carry it, and where to take it. There is a mix of clipart, symbols, and photos used to accompany the text.

8. Using My AAC Device Social Story on Boardmaker Online - I'm not sure if you can actually download a PDF version on this website or not. However, you can preview all the slides and read the full story directly on the website.

9. I Can Take My Device Home Social Story on Boardmaker Online - Again, not sure if you can actually download this story or not, but you can read the full story directly on the website.

10. Social Story: Taking Care of My Speech Device from Talk to Me Technologies - You have to subscribe to get this free social story, but it looks like it might be a good one. It uses nice colorful clipart.

Video Social Stories About AAC Device Use

Here are a few video social stories about using an AAC device. You can use these in teletherapy sessions, social skills groups, classroom settings, and/or at home. Videos are always a great alternative to printing off a story.

Like the stories above, some of the wording in these videos aren't always great. But I wanted to make sure you had lots of different options for teaching your child about AAC devices.

I usually opt for stories with text already included in the video (to support hyperlexic learners), but I thought this video about a classmate's use of AAC was too important not to include. Just remember to turn on the closed captions for our hyperlexic learners.

Finally, I thought this story might be a good one to include here as well. You could share it with a child's friends or extended family members about how they can get involved in the modeling process.

A Note on AAC Use for Gestalt Language Processors

Remember, hyperlexic learners are gestalt language processors so they learn language differently. So you will have to set up and use their AAC devices a bit differently. That might also mean that you have to modify the above social stories to factor in this different way of developing language.
Learn more about the Gestalt Language Processing Handbook & Course
And speaking of AAC use for gestalt language processors, you might be interested to know that the Meaningful Speech team is releasing a course all about AAC and gestalt language processing in February 2023.

This Canadian muggle might be a no-laugher (despite her energy vampire husband's jokesies), but Dyan's a fierce advocate for her two boys and passionate about all things hyperlexia and autism.

She's an avid book reader, lifelong learner, and former piano teacher. She likes Toad as her Mario Kart driver and prefers to listen to audiobooks and podcasts at a minimum of 2.5x speed. Her idea of a perfect lunch is nachos. You can frequently catch her saying, "It's Dyan, not Dylan. There's no L."

She has a B.A.H. in Psychology, an ATCL diploma in Recital for Solo Piano, an RCM Grade 10 Piano certificate, and an RCM History & Theory: Intermediate certificate.

Connect with Dyan on: Instagram - Pinterest - Facebook or Join The Hyperlexia Hub community!

If you haven't already done so, I highly recommend checking out the Meaningful Speech course and their Gestalt Language Processing Handbook and getting on their waitlist for this new AAC course. Use coupon code DYAN to save 5% on the handbook or course.

Either way, I hope you found this collection of free social stories about using an AAC device helpful. They're a great way to start introducing your child or client to using AAC to communicate.

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Free Social Stories About Using an AAC Device

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This blog uses affiliate links. Basically, I make a small commission when you use these links, at no additional cost to you. A collection of free social stories about using an AAC device or iPad to communicate. Printable and video social stories for kids are included below.

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Making Core Count_ Core Vocabulary in Activity-Based Instruction [360p]

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Aided Language Stimulation: description of utilizing modeling strategies for teaching device use

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Aided Language Stimulation Explained [360p]

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In a previous post, I discussed the strategy of conducting an Animated Step-by-Step™ activity such asBanana-Berry Shakes across two consecutive days. Day one is conducted as a literacy activity with the additional benefit of introducing the event sequence and the symbols that will be necessary for Day 2. Day two is devoted exclusively to communication training. A communication display (simple or complex depending upon need) is projected on the Interactive Whiteboard and is used by the Primary Facilitator (person leading the group) to conduct Aided Language Stimulation (ALgS).

By definition, Aided Language Stimulation is a clinical strategy in which the Facilitator highlights symbols in conjunction with her ongoing verbal language stimulation. 'Highlighting' can be achieved in numerous ways: pointing to symbols, shining a light on symbols or showing hand-held symbols. At this point in the discussion, you are probably wondering what is the difference between ALgS and just plain AAC modeling?

I think of Aided Language Stimulation as being a sub component of overall modeling. If you view the modeling of symbols as a continuum reflecting occasional modeled use (on the left) to frequent and/or complete modeled use (on the right), Aided Language Stimulation would be positioned toward the right on this continuum.

Even within ALgS, there is a continuum of use.On the far left we have ALgS that highlights just the main content words e.g., ANDREA is POURing the MILK INTO our BLENDER. On the far right we have ALgS that models both content, function words, and word endings (a, the, possessive 's, plural s, -ing, -ed, pronouns etc.) e.g., "ANDREA ... IS ... POUR ... ING ... THE ... MILK ... IN ... TO .... OUR ... BLENDER." Obviously, the former would be used with students that are cognitively young and/or students with significant comprehension issues while the more complex version might be introduced with students who are functioning at a higher level linguistically.

The complexity of your ALgS will also depend upon the situation. If performing ALgS in a conversational exchange you might use less complex modeling in an attempt to ensure more efficient conversational exchange. When conducting a lesson (recipe, craft, science project) where your primary focus is modeling the use of language (information that you hope will ultimately be reflected in their writing ability) greater levels of complexity may be in order.

It is important to note that ALgS is not just a matter of pointing out symbols as you provide verbal language stimulation. The Primary Facilitator also needs to create communication opportunities throughout the group activity ... opportunities that the Secondary Facilitators help their assigned students, recognize and capitalize on using their AAC communication systems. The Shadow Light Cuing hierarchyis an excellent strategy for helping students recognize communicative opportunities while unobtrusively guiding students toward proficient use of their AAC systems. Shadow Light Cuing will be the topic of the next post! http://bit.ly/shadowlightcue

... 'til the next post ... (new posts every Monday; consider becoming a follower of my blog)

© 2015 Carol Goossens', Ph.D.

Augmentative Communication Specialist

Speech-Language Pathologist

http://animatedstepbysteps.blogspot.com

http://teacherspayteachers.com/Store/Bloom

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Is Aided Language Stimulation Different than AAC Modeling?

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In a previous post, I discussed the strategy of conducting an Animated Step-by-Step™ activity such asBanana-Berry Shakes across two consecutive days. Day one is conducted as a literacy activity with the additional benefit of introducing the event sequence and the symbols that will be necessary for Day 2.

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Everyone has something to say. Working closely with the AAC community, we build apps and share best practice to help you communicate with the world.

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Augmentative and Alternative Communication: Modeling, Prompting, & Responding

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Role Play and Scripting: description of targeting vocabulary and communicative interaction around specific scenarios

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5 Thoughts on Using Scripts in AAC Therapy

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As we all know, it’s a big leap from having an AAC system to being able to use it functionally. For many of our prAACtical friends, one of the areas in which they struggle is conversation. It is no…

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Descriptive Teaching Model: description of utilizing open-ended questions and teaching concepts with device specific vocabulary

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TIES TIPS | Communicative Competence | TIP #17 What is Communicative Competence for and with Augmentative and Alternative Communication (AAC) Users?

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This TIP provides information about what competence in communication means for all students but also the additional competencies required of students who use AAC. It is important that communication partners (e.g. teachers, peers) demonstrate competence by understanding the additional skills required of an AAC user.

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Today, we welcome Dr. Kimberly Ho, SLP and Director of Speech, Language and AAC Services at Confidence Connection in Needham, Massachusetts. In this post, she discusses how professionals in her org…

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This article describes simple tools and strategies to support every person to understand, compare and express their preferences as they make decisions. These strategies apply even if they are still learning to use words or Augmentative and Alternative Communication (AAC) to fully express themselves.

What does supported decision-making include?

In ' Real choices, real control: support for decision-making when you cannot speak ' we explain the process of supported decision-making. It aims to help AAC users to discover and share:

Who they are as an individual and what makes them unique;

What is important to them, what is not negotiable and what they prioritize in their life above all else;

Who they want help from to make decisions;

What communication partners need to know about how the person communicates so that they can respond in a way that is respectful and acted upon;

What support is needed so they fully understand the information and choices given to them;

What decisions they can make for themselves, and which decisions they need support with;

When they need this support, e.g. regularly and daily, or occasional?

Three steps

Supported decision-making focuses on giving a person more autonomy, i.e. choice and control. It can be divided into three steps: expressing preferences, prioritizing them, and taking action.

Step 1: Expressing preferences

Discovery

Supported decision-making starts with discovering how the person expresses what they like, don't like, and what is most important to them. This ensures the person is heard when they express preferences, positive or negative: I like this, I don't like that. Every person expresses preferences, but sometimes very subtly. The more subtle and unique a person is in their communication, the more likely it is that others will make decisions for them instead of with them.

Some people may not yet express preferences using words or AAC, but in other ways:

sounds and vocalizations, like a happy squeal for joy or a groan for discomfort

gestures, such as reaching for what they want or pushing away what they don't

facial expressions, such as a smile or grimace

body movements, such as turning towards/away from what interests/disinterests them, or walking away from an unpleasant environment.

How to increase expressions of preference

Maximize opportunities for the person to express preference across the day. Set goals that the person will express preferences (likes and dislikes) more times across the day. Ask the person to reflect on their different activities and experiences, indicating LIKE or NOT LIKE. Carefully observe the person in these activities: what were they expressing?

Support the person to become more transparent and consistent in how they express preferences. Use the person's AAC to describe how you interpreted their actions. Model what words they could use to express their preferences. "You laughed during the show, I think you LIKED it."

Keep a chart or log on what the person responded to so that it can be used to develop a more detailed profile of preferences.

Support more communication partners to interpret this behavior as an expression of preference. Tools include communication passports, gesture dictionaries, and communication charts.

Model the person's AAC to reflect what they are expressing: "I see your smile and I hear your laugh. I think you LIKE this. I THINK you LIKE this a LOT!"

Introduce a ranking scale. Model the use of a ranking scale when talking about preferred and non-preferred activities. Provide visuals to help the person indicate MOST and LEAST. A simple "thumbs up/thumbs down", or ranking 1, 2, or 3 stars, can help set priorities and clarify preferences.

Maximize opportunities to express preference and rank the options. The person with communication disabilities can be encouraged to regularly reflect on each part of their day. Ask them what they thought of different activities: if they LIKED it or NOT and what they liked MOST and LEAST.

Build the infrastructure that allows this person to understand, compare, and express choices. Create a framework, chart or other aid to support the decision-making and to document the choices.

Sara expresses preferences
During the school holiday concert, Sara fussed and covered her ears. Her support staff used Sara's AAC to model "I think you DO NOT LIKE this, it is too LOUD" on her AAC. Sara vocalized, which her aide interpreted as agreement. The aide then offered Sara the choice to STAY at the concert or GO to the library. The aide indicated both "STAY" and "GO" on Sara's AAC, then waited for Sara to respond. Sara smiled and got up to leave the concert. The aide modeled, "You have decided to GO" as they left for the library. The aide noticed a trend that Sara was becoming more expressive about how she feels in noisy locations.

Step 2: Prioritizing

Ranking preferences

It is crucial that we support the ability to rank preferences: expressing concepts such as MOST and LEAST, or FAVOURITE. Ranking activities allow people to compare one decision against another. It helps involve the person in choice-making and establish priorities.

Strategies that support ranking preferences include:

Model the person's AAC to reflect what they are expressing: "I see your smile and I hear your laugh. I think you LIKE this. I THINK you LIKE this a LOT!"

Introduce a ranking scale. Model the use of a ranking scale when talking about preferred and non preferred activities. Provide visuals to help the person indicate MOST and LEAST. A simple "thumbs up/thumbs down", or ranking 1, 2, or 3 stars, can help set priorities and clarify preferences.

Maximize opportunities to express preference and rank the options. The person with communication disabilities can be encouraged to regularly reflect on each part of their day. Ask them what they thought of different activities: if they LIKED it or NOT and what they liked MOST and LEAST.

Build the infrastructure that allows this person to understand, compare, and express choices. Create a framework, chart or other aid to support the decision-making and to document the choices.

Anna rank orders what is important to her
Anna was faced with the decision of where to live after her stroke. She had always assumed she would age in her own home. However, after her stroke, she could no longer drive. She was frustrated living far away from friends and the activities she most enjoyed. Anna's speech therapist helped Anna and her loved ones use a prioritizing procedure. The goal was to identify what is important to Anna, which is somewhat important, and what is not important.

Supporting comprehension
Anna was provided with line drawings that represented everything from eating and cooking to noise levels and personal care. She indicated which specific items were very important to her, or were somewhat important to her, or were not important to her at all. Anna found that the visuals helped her retain her focus on the idea and helped her rank items more easily.
This process helped Anna's family decide that Anna was likely looking for a quiet assisted living facility where paid staff could provide care and meals, and where Anna could join in a range of activities with other seniors.

Step 3: Taking action

Create a framework

The final essential step of supported decision-making is to turn preferences into actions. One tool is to document them in a decision-making agreement: this is simply a framework that explains how the person will be involved in decisions about their life. In Anna's case above, deciding where she would live was a shared decision. The decision-making agreement illustrated how Anna would participate and what support she needed. Below, the example of Samuel shows how he uses his decision-making agreement to develop his personal support plan. This plan will ensure that the staff person who supports Samuel in school will respect the decisions that Samuel will make for himself.

Samuel takes action
Samuel is preparing for life after school. Like many of his classmates, Samuel hopes to attend college. He is excited for a traditional student experience. He wants to live in a dorm and attend classes with friends. Samuel knows he will need support with daily living. He wants his college support person to be more like a peer or employee than the educational assistant who supported him in high school. It is important to Samuel that the future support person does not infringe on Samuel's right to experience daily college life. Together with his school transition team, Samuel prepares a daily support plan and decision-making agreement. His support person will help him get dressed and bathed each day, but Samuel will select his own clothes and the foods he will eat. His support person or a peer will accompany him to class and ensure his AAC is in reach, but Samuel will decide when, where, and how he communicates with it. He is very clear: he does not want to be prompted to use his device. That decision is now his alone. Samuel's transition team even goes so far as to write the job description and hiring announcement for Samuel's future support person. These documents make it clear: Samuel's staff must respect the boundaries between supporting Samuel and directing him.

Links and references:

Auckland Disability Law, Supported Decision-Making in Action (PDF), New Zealand

CALL Scotland. Create personal communication passports and Passports book. [Resources & templates]

Funk & Drew (2017). Realizing supported decision-making and advance planning: pilot training for people with disabilities, their supporters, and service providers. World Health Organization.

Helen Sanderson & Associates. Communication Charts. Includes a simple PDF template to make your own chart.

James & Watts, (2014). UNDERSTANDING THE LIVED EXPERIENCES OF SUPPORTED DECISION-MAKING IN CANADA: Legal Capacity, Decision-Making and Guardianship (PDF), Law Review of Canada.

Sinclair, Field, Williams, Blake, Bucks, Auret, Clayton, & Currie (2018) Supported Decision-Making for People with Dementia (PDF), a manual that is relevant to any disability group.

Zangari, C. (2018). On the Same Page: Helping Team Members Recognize and Respond to Unconventional Communication Signals. [Blog post that includes a template to create "How I Communicate" Books].

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3 strategies to support choice and control for AAC users - AssistiveWare

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All people who struggle with communication can be supported to make their own decisions. Discover tools and strategies that can help with this.

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When you're learning something new, it's likely that you'll need some help along the way. The same is true for our AAC learners. Here are some of the things we've been thinking about lately regarding prompts and cues.

1. Sometimes, actually MANY times, a 'perfect pause' is all that's needed. Stop the action, look expectantly at the learner, and wait quietly. How long? It depends on the individual and the situation, but 10 or 15 seconds is in the ballpark for most AAC learners.

2. It's important to consider both the type of prompt (e,g., gestural, verbal, physical) and how much information that prompt provides to the learner. We hear lots of SLPs say that they prefer verbal prompts because they are less helpful than, say a physical prompt, and, thus, require more from learner. Not always. Here's an example: "Jason, tell me, 'More milk.'" Vs. Gesturing over the message on the SGD. In that example, it's the opposite. The verbal prompt makes it easier on the learner. If he doesn't need that much help, we'd be better off using the gestural prompt.

3. Prompt hierarchies are essential elements of any clinical toolkit. Good SLPs use them fluently, moving fluidly up and down the hierarchy in response to the learner's response. If you target one thing to strengthen, make it this.

4. Not sure where to start with prompt hierarchies? In general,

Most-to-least for a new skill, device, or page set

Least-to-most for an emerging skill that is inconsistent

5. In the hands of a skillful clinician, prompts can speed up the learning process. But, as soon as we begin using them, we should develop a plan to fade them so that the AAC learner becomes progressively more independent.

This post was written by Carole Zangari

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5 Things to Consider About Prompts in Teaching AAC

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When you're learning something new, it's likely that you'll need some help along the way. The same is true for our AAC learners. Here are some of the things we've been thinking about lately regarding prompts and cues. 1. Sometimes, actually MANY times, a 'perfect pause' is all that's needed.

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35+ Simple (and FREE) Ideas for Beginning Core Word Users

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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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Aided Language Stimulation (It's just modeling)

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Strategies for AAC apps to reality

Without a doubt, the key strategy that is discussed and promoted as best practice for AAC is Modeling or Aided Language Stimulation. We can all understand the concept that AAC users may not learn how to effectively use their AAC system for communication if they do not see it used regularly and reliably by others in their world.

However, although we talk frequently about the importance of modeling, there is often not as much discussion into the "nitty-gritty" of HOW we model.

The first part is always to boldly step in and have a go, remembering that any modeling is better than none!

Modeling augmentative and alternative communication

When we are just starting to model AAC with individuals, how you model words and language is important. So consider today's DO and DON'T....

Do focus on key words when modeling AND

Don't think you need to always model grammatically complete sentences

When we focus on modelling the key words in a sentence, it makes us target the most important words needed to convey the meaning of the message. If I model this sentence : " I GO SHOP GET BANANAS", even though it is not grammatically complete, the general message of my sentence can be understood. Especially if it is modeled in context as I am telling my friend about what I had done this morning.

Key words is a powerful way to demonstrate how we start combining words to build sentences and language, without the demands of having to know/understand the grammar. Unfortunately many of us are grammar warriors. We hate seeing incorrect grammar all around us and the idea that we might model sentences that are not actually grammatically correct, makes us feel anxious! But it is okay - we all need to let that go!

Logically, modeling key words before full grammatical sentences should make sense - this is probably how the AAC user will develop their language. They are likely to say and communicate to us in key words, before they start composing sentences, much the same as all children develop language! Everywhere I have ever been, we have always celebrated an individual's success at combining key words and not stopped to criticise their incorrect grammar.

There are a few problems with focusing on modeling fully grammatically correct and complete sentences on an AAC System:

We can get so hung up on getting all the grammar right and all the little words in there, that that small window, that wonderful teachable moment can be lost.

It can also lead to frustration for us; especially when we can't find the right words on the AAC system to make the sentence correctly. Modeling every word is overwhelming!

And often that is not real life - does everyone have to time to fully compose a long complex sentence every time? Often we say one or two words in an effort to get our message across quickly and efficiently, which is super important for AAC users too.

These can become barriers to us becoming good modeling communication partners! We give up! We feel that we are no good at modeling! We think modeling is too hard! Now if we take away the pressure to model grammatically, and instead think about the key words, we can make a start now and build our language modeling as we get more familiar with the AAC system and as the AAC user starts using it more.

Key things to remember for augmentative communication apps:

When you are modeling on the AAC system, it is totally okay to use the AAC system to model 1-2 words (or however many are needed), whilst saying verbally the complete sentence. For example, I could model on my AAC system "I GO SHOP GET BANANAS", while saying verbally "I went to the shops to get the bananas".

It is also okay to model the correct grammar at the right time for the individual. For example, if the individual uses his AAC system to say "I GO SHOPS" when asked what he did, then this may be a perfect opportunity to model and show him how he can use grammar supports to find the word "WENT", or to model little words like "TO" and "THE" on his AAC system.

How many words should we model?

As a good rule of thumb, it is often recommended that you model words and language that is 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 library, you can verbally say "It's time to go to the library" 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 Nanna" and press "GO" and "NANNA" while you're speaking these words. Keep building your modelling of word combinations to match the language of the AAC user.

What kinds of words should we model?

It is important to provide lots of modeling of the core building blocks of language - those core words. Showing individuals how they use these core words in different ways, in different word combinations to communicate different things is very powerful!
It is important to model that we use different words for different reasons - it is okay to model how to request things ("I want"), but it is really so important to model the language needed to make comments, ask questions, give opinions, describe things, tell news and stories, start conversations and much more.

Your turn

Think of an activity that you like doing with your AAC user/s... what are the KEY WORDS that can be said and modeled during that activity? What kinds of ways will you combine these words when you are modeling? Do you know how to find them in your core word vocabulary? What different kinds of communication reasons (functions) can you model? If they are ready, is there specific grammar that you would like to model and/or teach during the activity?

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Do's and Don'ts of AAC - Modeling - AssistiveWare

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We all know that the best practice for teaching AAC is Modelling or Aided Language Stimulation. We can all understand that AAC users will learn how to effectively use their AAC system when they see it used regularly and reliably by others in their world. So how do we model?

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Using an Aided Language Support During Direct Instruction

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Introduction

The inclusive classroom has the distinct advantage of the constant presence of peers who are competent communicators. Encouraging peers to use Augmentative and Alternative Communication (AAC) with students with significant cognitive disabiliites who also have complex communication needs increases access to repeated, interactive, and generative language opportunities across environments.

Evidence

A recent review of the literature (Kleinert & Kearns, in preparation) found that peer-mediated supports were a significant factor in increasing AAC use among students with significant communication needs. Peer-mediated supports "substantially increase" social interactions among students who use AAC, which in turn increases the use of AAC (Biggs, Carter, & Gustafson, 2017; Biggs, Carter, Mazur, Barnes, & Bumble, in press).

Definitions

Augmentative and alternative communication (AAC) refers to communication methods (other than oral speech) used to express thoughts, needs, wants, and ideas (Kleinert, Holman, McSheehan, & Kearns, 2010).

Peer-mediated support involves peers as communication partners directly in the use of the AAC device.

Implementation

Use Peer Support Arrangements

Educators can use peer support arrangements to establish supports for academic learning and AAC use in general education or inclusive education arrangements (Biggs, Carter, & Gustafson, 2017). Peers in an inclusive pre-school class can support an AAC user in a variety of academic and social activities that increase the opportunities for the AAC user to communicate.

Peers use the student's AAC system when communicating with the student. This is called aided language modeling. In addition, as they get to know the AAC user, peers can learn a variety of other communication strategies including partner-assisted scanning, sign language, acknowledge/interpret body language, eye-gaze, or facial expressions that may be unique to the AAC user. In the photo on the left, a peer uses an eye-gaze system made from a sports card page. Peers can also help other classmates communicate with the AAC user. Inclusive education can provide optimal opportunities for beginning AAC users to communicate, especially in cooperative learning groups.

Use Peer Support Networks

Additionally, educators can use peer support networks to establish social opportunities that lead to friendships, and to develop social and communication skills in extra-curricular activities beyond the classroom (Biggs, Carter, Mazur, Barnes, & Bumble, in press). This strategy has fewer opportunities than the peer support arrangements that occur in inclusive classrooms.

Peer support networks often focus on high interest areas such as school technology teams, sports teams, music/newspaper/yearbook/drama groups, and morning message. In the absence of formal peer support networks, informal groups established for social purposes can also be used, including greeter groups, lunch buddies, and gym workout buddies. To support communication in these types of arrangements, special communication devices with high interest topics added to the student's device are essential to support AAC use. As in the peer arrangements, teaching peers the strategies for successfully communicating with the AAC user with or without the device remains an essential element of the strategy.

Pay Attention to Valued Social Roles

In any of these groups, it is important that ALL group members, including the AAC users, become known for their unique contributions to the group. This allows healthy friendships to grow, gives the AAC user a voice, and ensures new skills for all the participating students.

Summary

Inclusion, friendship, and communication ensure valued social roles and life-long learning. Peer- mediated supports combined with training are essential for supporting AAC users. Embedding simple, evidence-based strategies that involve peers will serve to increase success in inclusive settings for students with significant cognitive disabilities who have complex communication needs.

Communicating with Partner-Assisted Scanning . This video from Cincinnati Children's Hospital Medical Center demonstrates partner-assisted scanning, a communication technique that can be used with children who are nonverbal. It is a useful strategy to let a child make choices and to enable the child to express his or her wants and needs. It can be a useful tool for building skills that allow the child to use a more sophisticated communication system.

Kentucky Peer Support Network . This professional learning project focuses on developing peer support networks and peer support arrangement in Kentucky classrooms.

TIPS Series: Tip #1, June 2019

All rights reserved. Any or all portions of this document may be reproduced without prior permission, provided the source is cited as:

Kearns, J., & Kleinert, J. (2019). How peers can support AAC use by students with significant communication needs (TIPS Series: Tip #1). Minneapolis, MN: University of Minnesota, TIES Center.

TIES Center is supported through a cooperative agreement between the University of Minnesota and the Research to Practice Division, Office of Special Education Programs, U.S. Department of Education (# H326Y170004). The Center is affiliated with the National Center on Educational Outcomes (NCEO) which is affiliated with the Institute on Community Integration (ICI) at the College of Education and Human Development, University of Minnesota. The contents of this report were developed under the Cooperative Agreement from the U.S. Department of Education, but do not necessarily represent the policy or opinions of the U.S. Department of Education or Offices within it. Readers should not assume endorsement by the federal government. Project Officer: Susan Weigert

The National Center on Educational Outcomes (NCEO) leads the TIES Center partnership. Collaborating partners are: Arizona Department of Education, CAST, University of Cincinnati, University of Kentucky, University of North-Carolina-Charlotte, and University of North Carolina-Greensboro.

TIES Center

University of Minnesota

Institute on Community Integration

2025 East River Parkway

Minneapolis, MN 55414

Phone: 612-626-1530
www.tiescenter.org
This document is available in alternate formats upon request.

The University of Minnesota is an equal opportunity employer and educator.

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TIES TIPS | Communicative Competence | TIP #1: How Peers Can Support AAC Use by Students with Significant Communication Needs

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The inclusive classroom has the distinct advantage of the constant presence of peers who are competent communicators. Encouraging peers to use Augmentative and Alternative Communication (AAC) with students with significant cognitive disabiliites who also have complex communication needs increases access to repeated, interactive, and generative language opportunities across environments.

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TIES Inclusive Practice Series (TIPS) are designed to share practical information, ideas, and strategies on specific topics and practices to support inclusive education.

You're viewing Communicative Competence TIPS, we also have Foundations of Inclusion TIPS.

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TIES TIPS | Communicative Competence | Communicative Supports TIPS

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TIES Inclusive Practice Series (TIPS) are designed to share practical information, ideas, and strategies on specific topics and practices to support inclusive education. You're viewing Communicative Competence TIPS, we also have Foundations of Inclusion TIPS.

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AAC helps Kendal understand me and it helps me understand him. We call the NovaChat his “translator box.” Thanks to AAC we can have conversations that make s...

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Vocabulary Inventory

Tools for planning and collecting vocabulary needed by the user across contexts, partners, and environment

Visual Supports

Tools for visual representation of targeted vocabulary

Adapting Books description goes here...

visual support that shows buttons sequence(s) for navigating to a specific word/phrase/sentence

Collection of new or targeted words/symbols that are displayed within the environment for the user/partner to refer to

Set of pictures/words that communicate a series of activities or steps of a specific activity

Visual supports posted in the environment to encourage communicative participation

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Tools for planning and collecting vocabulary needed by the user across contexts, partners, and environment Tools for visual representation of targeted vocabulary Adapting Books description goes here...

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The Richard West Assistive Technology Advocacy Center (ATAC)

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Advancing Opportunities has resumed all new loans for assistive technology devices. Devices currently out on loan are expected back on the due date and will be cleaned to ensure no transmission of the COVID-19 virus. ATAC and Advancing Opportunities have worked together to develop a stronger procedure for cleaning and distribution of devices for loan.
ATAC, through its network of contractors, provides a library of devices for temporary short term loan. Borrowing a device for a short period of time is a good way for a person with a disability to determine whether a given device will meet their needs.

ATAC partners with Advancing Opportunities in lending devices to individuals, family members, advocates, etc to trial devices before you go out and buy an expensive piece of equipment that does not work.

Technology Lending Center is now a free service for New Jersey residents. Anyone with a disability who would like to trial assistive technology can contact us, sign up for free, and begin borrowing right away.

Through the lending center you are able to:

Browse their inventory by category.

You can call them- they will give you suggestions! 888-322-1918, x 536, or email

Ask them to stock a specific item. If enough people ask, they will add it!

Join the Technology Lending Center by visiting Advancing Opportunities registration page

Technology is not just a tool. It can give learners a voice that they may not have had before.
George Couros

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COVID-19 UPDATE from ATAC / Advancing Opportunities regarding AT Loans Advancing Opportunities has resumed all new loans for assistive technology devices. Devices currently out on loan are expected back on the due date and will be cleaned to ensure no transmission of the COVID-19 virus. ATAC and Advancing Opportunities have worked together to develop a...

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Medicare Coverage Policy on Speech-Generating Devices

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Medicare recognizes speech-generating devices (SGDs) as Durable Medical Equipment (DME), which is a covered benefit for Medicare beneficiaries under the Social Security Act (Section 1861). On July 29, 2015, the Centers for Medicare & Medicaid Services (CMS) issued changes to the SGD benefit in a Fin…

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Effective communication is a fundamental element of life. Relationships, choice, employment, and so much more are severely limited by an inability to communicate. Let's make effective communication a reality for people with disabilities. Join TASH's new campaign, Join the Communication for All. The campaign was created to promote life-long communication for people with disabilities through awareness, professional development, access to communication technologies, instruction, and support. campaign group (members-only) to promote life-long communication for all!

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Communication for All Campaign - Tash.org

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Effective communication is a fundamental element of life. Relationships, choice, employment, and so much more are severely limited by an inability to communicate. Let's make effective communication a reality for people with disabilities. Join TASH's new campaign, Communication for All.

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A7503

Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each

A7504

Filter for use in a tracheostoma heat and moisture exchange system, each

A7505

Housing, reusable without adhesive, for use in heat and moisture exchange system and/or with a tracheostoma valve, each

A7506

Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, and type, each

A7507

Filter holder and integrated filter without adhesive, for use in a tracheostoma health and moisture exchange system, each

A7508

Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each

A7509

Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each

A7520

Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each

A7521

Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each

A7522

Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each

A7523

Tracheostomy shower protector, each

A7524

Tracheostoma stent/stud/button, each

A7525

Tracheostomy mask, each

A7526

Tracheostomy tube collar/holder, each

A7527

Tracheostomy/laryngectomy tube plug/stop, each

A9900

Miscellaneous dme supply, accessory, and/or service component of another hcpcs code

A9901

Dme delivery, set up, and/or dispensing service component of another hcpcs code

A9999

Miscellaneous dme supply or accessory, not otherwise specified

E1902

Communication board, nonelectronic augmentative or alternative communication device

E2500

Speech generating device, digitized speech, using prerecorded messages, less than or equal to 8 minutes recording time

E2502

Speech generating device, digitized speech, using prerecorded messages, greater than 8 minutes but less than or equal to 20 minutes of recording time

E2504

Speech generating device, digitized speech, using prerecorded messages, greater than 20 minutes but less than or equal to 40 minutes of recording time

E2506

Speech generating device, digitized speech, using prerecorded messages, greater than 40 minutes of recording time

E2508

Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device

E2510

Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access

E2511

Speech generating software program, for personal computer or personal digital assistant

E2512

Accessory for speech generating device, mounting system

E2599

Accessory for speech generating device, not otherwise specified

Services performed by a qualified speech-language pathologist, in the home health setting, in the establishment or delivery of a safe and effective speech-language pathology maintenance program, each 15 minutes

Developmental testing with interpretation and report, per standardized instrument

L8499

Unlisted procedure for miscellaneous prosthetic services

L8500

Artificial larynx, any type

L8501

Tracheostomy speaking valve

L8505

Artificial larynx replacement battery/accessory, any type

L8507

Tracheo-esophageal voice prosthesis, patient inserted, any type, each

L8509

Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type

L8511

Insert for indwelling tracheoesophageal prosthesis, with our without valve, replacement only, each

L8512

Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10

L8513

Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each

L8514

Tracheoesophageal puncture dilator, replacement only, each

L8515

Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each

S9128

Speech therapy, in the home, per diem

S9152

Speech therapy, re-evaluation

S9986

Not medically necessary service (patient is aware that service not medically necessary)

School-based individualized education program (iep) services, bundled

V5008

Hearing screening

V5336

Repair/modification of augmentative communicative system or device (excludes adaptive hearing aid)

V5362

Speech screening

V5363

Language screening

V5364

Dysphagia screening

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Speech-Language Pathology HCPCS Level II Codes

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A7503 Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each A7504 Filter for use in a tracheostoma heat and moisture exchange system, each A7505 Housing, reusable without adhesive, for use in heat and moisture exchange system and/or with a tracheostoma valve, each

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When

About the workshops

Learning objectives

Target audience

Workshop 1: Communication Access: Understanding where to start and taking the first step

Thursday, May 13, 2021 - 4:00-5:30 PM Eastern / 3:00-4:30 PM Central / 2:00-3:30 PM Mountain / 1:00-2:30 PM Pacific

Regardless of the age of the individual, communication access is critical for community involvement, connections with others, and control in one's own life. This workshop will address key strategies for overcoming barriers and tailoring communication support to the unique needs of each individual. Presenters will share a problem-solving process for increasing communication access, and will engage with participants in smaller group discussions related to beginning steps.

Presenters
Register for this Session
Workshop 2: Understanding Communication Vulnerability and Being an Empathetic Ally

Thursday, May 20, 2021 - 4:00-5:30 PM Eastern / 3:00-4:30 PM Central / 2:00-3:30 PM Mountain / 1:00-2:30 PM Pacific

Individuals who use augmentative and alternative forms of communication are often dismissed, discounted, and even dehumanized throughout their lives. These experiences result in trauma for the individual, and are a product of ableist thinking and systems within our culture. In this session, AAC users will share their personal experiences with communication privilege and communication vulnerability, with an emphasis on how these impact individuals and what actions we can take to address these issues. Following a presentation, smaller groups will have an opportunity for discussion.

Presenters
Register for this Session
Workshop 3: Supportive and Responsive Communication Partners: How to be one and how to develop them

Thursday, May 27, 2021 - 4:00-5:30 PM Eastern / 3:00-4:30 PM Central / 2:00-3:30 PM Mountain / 1:00-2:30 PM Pacific

How do we create interactions, environments, and situations that promote trust and welcome individuals who communicate differently? In this workshop, participants will gain insights from AAC users on the qualities they need in a communication partner, whether the person is a paid support, a family member, a co-worker, or a friend. Presenters will share practical ways that communication partners can notice and address barriers to communication as well as strategies to establish mutual trust and a mindset of support.

Presenters

Grant Blasko

Ryan Duncanwood

Cynthia Blasko

Adie Buchinsky

Additional presenters forthcoming

Register for this Session
Workshop 4: Communication Access and Support in the Digital Age

Thursday, June 3, 2021 - 4:00-5:30 PM Eastern / 3:00-4:30 PM Central / 2:00-3:30 PM Mountain / 1:00-2:30 PM Pacific

Throughout the global coronavirus pandemic, many individuals who use augmentative and alternative forms of communication have both struggled, and succeeded, in finding new ways to interact in the virtual world. In this workshop we will discuss the ways in which digital literacy is becoming critical for all individuals, and in particular for individuals with complex communication needs. AAC users will share their own access strategies, as well as ways to make online environments more accessible. Smaller breakout room discussion will provide an opportunity for discussion and problem-solving.

Presenters
Register for this Session
How to participate

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TASH Workshop Series: Increasing Communication Access and Improving Communication Support - Tash.org

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When A four-part workshop series on Thursdays from May 13th to June 3rd 2021 at 4:00-5:30 PM Eastern / 3:00-4:30 PM Central / 2:00-3:30 PM Mountain / 1:00-2:30 PM Pacific.

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Does communication stop when you get home from work or school? No!

Should AAC only happen at work or school? No!

Successful communication happens when people with communication difficulties can use their Augmentative and Alternative Communication (AAC) system in all environments. And families are so important in this process.

In this blog post you will find some general strategies for getting AAC happening at home, as well as some practical ideas to try out and get you started.

General strategies for home

Your home is a busy active place, with many comings and goings. But two things need to stay consistent for your child who uses AAC. Firstly, your child needs to have easy access to their AAC system. And secondly, your child needs to see their AAC system being used by people at home to communicate real messages in real situations (aka "modeling").
Always available
Is your home set up for AAC? Can you grab the AAC system ready to communicate quickly and easily? Can your child access their AAC system independently? It's important to give your child access to an AAC system all the time. It needs to be in easy reach and/or always in the same place.

If your child uses a high-tech AAC system (such as Proloquo2Go on an iPad), it can be a great idea to have light-tech (or paper-based) version of it in places around the house. Could you stick laminated boards to places such as the mirror in the bathroom, cupboard doors or table tops? This means that the AAC can be grabbed and used easily! Having a light-tech or paper based backup of the AAC system is also useful if something happens to the AAC device. Follow the steps here to get yours started.

You can also download and print quick communication boards. These give you access to lots of words that can be used anytime.
AssistiveWare Core Word Classroom
The Proloquo2Go Crescendo core word boards are available in the AssistiveWare Core Word Classroom. The Core Word Classroom offers a large collection of learning resources, which are designed to support implementation of any AAC system that is based on core words. Learn more about the AssistiveWare Core Word Classroom.

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Language opportunities for using AAC at home - AssistiveWare

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Communication does not stop at home or at school. Successful communication happens when people with communication difficulties can use their AAC system in all environments. Find strategies for using AAC at home in this blog post.

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Augmentative and Alternative Communication (AAC) - AAC Calendar

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TIES TIPS | Communicative Competence | TIP #23: Supporting the Communication Needs of Augmentative Alternative Communication (AAC) Users who are also English Learners

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Core words are useful in a variety of situations. They aren't just nouns; they can be adjectives, verbs, prepositions... words that are high frequency, easy to combined into sentences and they can be used all the time across lots of different routines and settings.

Click here to read my full blog post about how to use core words with your child.

Work with core words! Click here to access my resources.

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Core Words - Rachel Madel Speech Therapy Inc.

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Core words are useful in a variety of situations. They aren't just nouns; they can be adjectives, verbs, prepositions... words that are high frequency, easy to combined into sentences and they can be used all the time across lots of different routines and settings.

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Augmentative and Alternative Communication (AAC) - Teaching AAC

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Augmentative and Alternative Communication (AAC)

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Predictive Chart Writing with Erin Sheldon

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Tactile books are a great way to foster the development of literacy skills with any child who is visually impaired, including children with other significant disabilities. These can be used at home for enjoyment, to support understanding and anticipation of activities or as an independent leisure skill.

At school tactile books are a must for supporting literacy instruction, for use in developing concepts and honing sensory efficiency skills.

Here are some of the different types of tactile books you can create:

Experience Books:

An experience book is a book based on an experience the child had (i.e. trip to zoo, grocery store). The book is then used to retrieve memories of that experience and assists the child in the language development around the experience; can also become an experience book if the experience will be repeated.

Object Books:

"An object book is a book containing real objects. These objects should be taken from the student's activities and experiences, so they will be meaningful. This is the first type of book that should be used to introduce a tactual learner into the wonderful world of reading."

Routine Books:

A routine book is a book that organizes a student's day or activity set; a book version of the calendar box. When the activity or step is done, the student will turn the page.

Story Boxes (book bags): "A story box is a way for young children with visual impairments to experience a story. When selecting a story for the child, choose one that is simple and tells about familiar objects and concepts. Collect corresponding items in a box or bag. As you read the story to the child, allow him/her to hold the item. The number of items and complexity of the story should be suited to the child. Often, simple is better."

Theme Books:

A theme book is a book that focuses on a topic (i.e. transportation, restaurant, demographic information). The books are then used to supplement the instruction of that topic.

Whenever possible, it is always a good idea to make the book with the child.

Create the book based on the child's level related to the type of tactile material the child will understand (i.e. if still using real objects, book should be made with real objects that have meaning to the child).

If including text, compose the text with the child and/or get help from the speech-language therapist.

If using pictures or tactile drawings, keep the graphic as simple as possible without losing meaning.

Glue one object per page to begin with, and then increase the number of objects as skill level increases.

Glue envelopes or Ziploc bags to pages or the back of book to hold items inside.

Use textures the child tolerates.

Use a progression in moving from the concrete to the abstract: start with solid objects, then go to raised line figures, then to embossed figures, and then braille figures.

When using symbols, remain consistent in the way you make the symbol (so not to confuse the reader) - collaborate with speech therapist, classroom teacher, teacher of the deaf and hard of hearing, and/or the parent.

When finishing the book...bind it with rings or in binder if you are planning on adding additional pages at a later date or reordering the pages once child is familiar with the order.

Change the location of where book is bound (i.e. instead of left side, use top) to prepare child for other books bound differently.

Tag the cover of the book with an object, large print, picture, or braille that is specific to the book to aid child in identifying the book.

The cover should be either a different kind of paper or larger than the "text" pages. Card stock, poster board, braille paper, plastic are some examples of possible items to use for pages...depends on the need of the student and items being used

Keep page numbering system consistent, for example, print page number top right, braille page number bottom right.

For a child with CVI, color should drive the selection of objects, outline of pictures, or background page. For example, if you are using Boardmaker, outline the picture in the child's preferred color: use the option of color or black and white.

Books should be tactilely FUNCTIONAL, and may not be visually appealing. That is okay!

Books should be loved, and therefore may have a short life span....much like "The Velveteen Rabbit."

Here are some examples of materials made by Texas teachers at a workshop held at Region 4 Education Service Center in Houston that was presented during the summer of 2015 by Liz Eagan, TVI from Bastrop, TX:

This concept card was part of a set to show the growth of a tree. Roots are displayed. The image is created by store bought items as well as things found in nature.

This is an interactive card for the student to work on matching. This teacher made additional cards in different order as well as a simple AB pattern cards where the final object in the pattern the student completes.

This is a board book on color. Each page focuses on a different color and has different shades of the color included.

This is an interactive book designed to work on positional concepts.

Creating Books Using Microsoft Word

You can use Microsoft Word to create books that can be shared between the student with visual impairments and sighted peers or teachers.

When creating a book using Microsoft Word as the foundation for the book you are creating, consider the audience for whom you are creating the book :

Student with low vision

Student with little or no vision

Educational team working with student (this includes the parent/guardian)

It is important to make sure you meet all their visual and tactile needs within the single document.

Import Boardmaker Pictures into a MS Word Document

1. Open a Boardmaker template that has pictures about the size you want

2. Place picture(s) on template

3. Close symbol finder window

4. Click on picture (so you get orange dotted box around symbol) you want

5. Click on EDIT then CUT or COPY

6. Open document you want picture in, find location where you want to place picture click on EDIT then PASTE

Insert Clipart or Pictures into an MS Word Document

1. Open you Word document and draft the text of the book.

2. Determine which visual images you want to illustrate the book.

3. Find the text block for a specific image and place you cursor where you want the image to appear.

4. Using the "Insert" tab on your toolbar, select "clipart".

5. When the Clip Art dialog box opens, enter a search term for the object you want to help you find an appropriate image.

6. Click on the image you choose and it should appear in the appropriate place in your document.

7. Click on the image, then go to the "Picture Tools - Format Picture" tab. Here you can adjust the size and alignment of the picture to suit your needs. You may also want to compress the image so that the file is not so large.

8. You can use the same process with photos, except you choose "photo" under the "Insert" tab to add photos from your collection.

Once you have your book laid out with the text and images, print out your book on appropriate size and weight of paper. Then you can determine how to add tactile features and or braille to the book.

Here are some examples of materials shared with Texas teachers at a workshop held at Region 4 Education Service Center in Houston that was presented during the summer of 2015 by Liz Eagan, TVI from Bastrop, TX. These were to aid the teachers as they go back to their districts create their own for their students.

Sample IEP Book - Often times I've created books to help students with a particular goal. This book is based on demographic information. In this type of book, I typically ask parents for a photo of the phone in the home (or cell phone), a picture of their house, etc. to help the student learn their information. Yes, that is a 5-year old me in the first picture and my childhood home in the snow (old photo, I know) as I didn't have permission to share one that contained an actual student.

Peanut Butter Sandwich - This is an experience book to help my student and her family repeat the experience for homework. After the book was made, braille was added to the pages to help my student read the book. Print was for the parents.

White Cane Day 2013 - This is another experience book to help my student verbalize what all she did that day and share her experience with others. Braille was also added to the bottom of the pages.

Creating Tactile Posters

A tactile poster can be nice way to create a collection of things that can be found in a particular setting. For example, you might make a poster of things you can find in a flower garden or under water. The student can explore the poster as a prompt to create a story or to discuss other things that might be found in a specific location.

These could be used before and after an experience, somewhat like an experience book or bag. For example you might make a poster about a walk on the playground including things you find along the way. Before the next walk on the playground, review the items you found before and then look for new items as well as the objects you already found.

It might also be something that the student could create with a sighted peer: figuring out what should be on the poster and describing what it material each thing is made of how that thing feels.

A tactile poster might also be a nice leisure activity for some individuals in the same way you or I might enjoy looking at a coffee-table book of images. This is also a nice way to encourage tactile exploration with a child. See more at: Tactile Posters

Tactile posters are a nice way to create materials to:

adapt currently used materials

enhance the curricular materials

expand on the concept/skill

teach a new concept/skill

Tactile Poster Tips

Use lots of glue!

Keep areas open to secure to the wall (pins or staples)

Try to keep the items light in weight (not always possible)

No sharp objects

Use a variety of realistic textures

Here are some examples of materials made by Texas teachers at a workshop held at Region 4 Education Service Center in Houston that was presented during the summer of 2015 by Liz Eagan, TVI from Bastrop, TX.

This is a poster designed for a science lesson on insects. The plant life helps show the insects in their 'natural' environment.

This poster is designed to aid in the describing of fall and its changes.

Tactile Materials

Student with visual impairments generally benefit from the use of tactile materials to support learning. Though some of these materials may be purchased from sources like American Printing House, many (if not most) of these are homemade.

Here are some ideas of where to go to get ideas and find the necessary raw materials you will need to make tactile materials and what to do with left over materials.

Economic Advantage Stores

Hancock Fabrics

Jo-Ann Fabric and Craft Stores

Crystal Teacher Supply

Lakeshore Learning Store

Southwest Teacher Supply

Human Life Forms

Art Teachers

Family

Friends

Student's family

Janitors

Nature walks

Neighbors

Yard / Garage Sales

For stickers or shapes that can be made easily into stickers, put in labeled envelope

Then store envelopes alphabetically in a filing cabinet for easy retrieval

Place smaller pieces (i.e. beads) in plastic bags

Store bags in a plastic tote, drawer, cabinet, etc.

Organize however it makes sense to you

When you start to make tactile graphics there are some key questions that should guide you.

Why is this picture/map figure important?

Not every image in a book or material needs to become a tactile graphic. Some images are simply included to make the overall document or material visually interesting. You should always ask yourself why this image is important. Does the student need this image to make a concept understandable? Is this image something that the child will need to reference to respond to questions or participate in a discussion? Understanding why this image is important will also help you determine key elements to highlight and those that may be ignored. For example, if you are trying to teach a child facial features, including wrinkles in an image is not important.

What are the most important elements to communicate?

This is similar to figuring out why a picture or map is important; what aspect(s) of the image is most important for the student to discriminate. The fewer tactile details in an image, the easier it is for the student to access. For example, if you are learning about the rivers in Texas, an outline of the state and the rivers might be all that you need to be feature. However, if you are also trying to help the student know what major cities are on rivers, then you would need to include that information tactilely.

Who will use this material?

The type of tactile materials a toddler might need is very different from the type of material you will use with a high school student. Younger students generally benefit from simpler images and tactile materials. As a student ages and has more experience with tactile materials, more complex tactile materials can be created.

Mental and physical condition

Individuals with mental or physical conditions that might limit the use of hands and fingers probably need simpler tactile materials. These materials may also need to be a bit sturdier.

Ability or experience with reading graphics

Of course, students who are just being introduced to reading graphics will need much easier to read tactile materials than a student who has been using tactile materials for many years.

How will this figure be used?

With or without help from a sighted teacher or peer

If a sighted teacher is going to be using this material with the child, then they need to also be accessible to the teacher. Make sure tactile materials include print images or words to help the teacher know what the image is all about.

With other children who are blind

If two children are using the tactile materials, both of the students' needs and abilities must be considered when developing the materials. Otherwise you may need to develop materials that are similar, but tailored to each child's individual needs. You may also want to create materials that can be modified easily for each child's use. For example, one child might have a face with only eyes, nose, and lips while another child might also have eyebrows, eyelashes, and teeth.

With actual concrete objects

Often times pairing tactile materials with real objects is important. For example, a tactile symbol of a cup might be paired with an actual cup in a story. It is important that the features of the tactile symbol also reflect the features of the real object, unless the child is so familiar with the symbol that it can be paired with any cup and still convey meaning.

Where will the material be used?

Some thought should be given to where the material will be used. If materials are going to be used as part of a test instrument, there may be some strict guidelines on what can be conveyed. A child who is learning to travel independently around campus using a map, needs a good bit of precision and thought to detail. Think about the setting and purpose of the materials being used.

How will the map be produced?

Since a map or tactile material may be used one time or many times, should guide you in thinking about how the material will be produced. Of course, it is always better if you can produce materials that can be used over and over again. But sometimes you need to create something that will only be used once and trashed. Don't spend too much time creating materials that are "use and lose" items. If a material will need to be used many times put your energy into creating a master that can easily be copied or reused.

Source: American Foundation for the Blind Braille Literacy Mentors in Training: The Next Generation - Teaching Special Codes: Nemeth, CBC, and Tactile Graphics -Workshop in Fremont, California (August 7-9 1997) and Atlanta, Georgie (September 11-13, 1997). Diane Spence and Susan A. Osterhaus

Have fun with it!! Make it a party or a workshop in your area.

I got some really good ideas from these teachers who came out that day!

Want to learn more about tactile materials and tactile graphics? Check out these resources!

Bohling, Terry (2003) Alphabet Help. http://www.tsbvi.edu/early-childhood/1924-alphabet-help

Crawford, Jackie and others (1994). Please! Teach All of Me: Multisensory Activities for Preschoolers. Sopris West: Longmont, Colorado.

Drezek, Wendy (2003). Move, Touch, Read! http://www.tsbvi.edu/early-childhood/1926-move-touch-read

Drissel, Norma (1997). What is a Story Box? http://www.pathstoliteracy.org/storybox-ideas-norma-drissel

Lewis, S and Tolla, J (2003). Creating and Using Tactile Experience Books for Young Children with Visual Impairments.

Project Slate (2002). Ideas for Adapting Books. (For Parents) [No longer available online.]

Smith, Millie and others (2002). Object Books. http://www.tsbvi.edu/component/content/article/1736-object-books

Wright, Suzette (2008). Guide to Designing Tactile Illustrations for Children's Books. https://sites.aph.org/files/research/illustrations/

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Tactile Books for Students with Visual Impairments - Paths to Literacy

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Paths to Literacy Tactile Books for Students with Visual Impairments. For teachers, families, and others interested in literacy for children and youth with visual impairments

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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: December 21, 2018

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

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Name writing is a classic goal that sometimes stays on the IEP for decades! Students typically practice name writing by copying and tracing, which leads to little or no generalization. Signing our name is a very important goal, as it is a part of who we are, so it is very important - but we need to address it using strategies that work! This series of tips suggests several strategies that are interactive, motivating . . . and successful!

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'Sign In' refers to have students sign in each day, and tracking their name writing as data across a semester or year. Students can sign in for: school, therapy, afterschool activity, Scouts, etc.

February 2014

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'Sign Up' refers to having students sign up for desired activities or materials. This can be more motivating than signing in, especially when signing up for exciting events. Use actual sheets or PostIts so that students understand the POWER of signing up!

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'Sign Off' refers to having students sign off when leaving or signing off on their personal work. This can be more motivating than signing in, especially when signing work to be shared or celebrated. Use actual materials (cards, artwork), so that students understand the power of signing off!

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This rating scale is an attempt to help capture and quantify the progress students make with name writing before their name is spelled correctly.
**Based on assessing the students' errors. Students' errors are very valuable as they offer a window in to what they know.
*This rating scale was developed by informally looking at a group of students name writing samples across a year. Patterns and features that were seen across students' attempts were identified as possible indicators for this rating scale.

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Here's a super fun 'barrier communication' game to play with students using AAC devices (or speech).

'Barrier Games' are activities that teach students to share information across a boundary. In this case the two girls were on opposite sides of the table, and couldn't see each others' cookies!
June 2014

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Before Writing: getting the right tool, which will often be an alternative pencil

Setting a Topic: writing for a real reason

After Writing: giving informative feedback

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This tip provides background information for:

WHY we should read familiar texts over and over with children

WHO is especially in need of hearing multiple re-readings

HOW we can make this happen

Repeated read alouds are fun for both children and adults - so jump in and read it again . . . and again . . . and again!August 2014

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This tip shares strategies to support emergent readers in 'practice' reading to their siblings, cousins, pets, stuffed animals, or dolls! This practice reading supports students in:

Feeling like a reader

Practicing concepts about print

Developing fluency

This can be helpful for students who are emergent readers and early conventional readers. The tip also includes what NOT to do when practicing.

September 201 4

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This tip describes approaches to writing using

Word banks

Core + Content (Communication system)

Alphabet

Samples are provided, and the importance of increasing use of the alphabet and core plus content for writing is emphasized.

Letter of the Week is a common preschool and special education practice. This tip advices against that practice, and suggests alternatives.

This tip provides background information for:

WHY we should stop doing letter of the week

WHO this tip is for

HOW we can do alternative activities that help students compare letters

November 2014

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Alphabet books are a staple of preschool education. This tip shares ideas for finding and using alphabet books with older students.

This tip provides background information for:

WHY we should share alphabet books with older students

WHO this tip is for

WHERE to find alphabet books that will engage and support older students who are emergent readers

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Our little idea guy marks the tip attachments. They are posted in pdf format. On the few occasions where there was more than one document to attach, we have "zipped" the files.

PDF File Information
If you don't have Acrobat Reader on your computer, go to the following site:
http://get.adobe.com/reader/

Contact us if you need tips in another format.

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tools for communication with special needs kids

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Name writing is a classic goal that sometimes stays on the IEP for decades! Students typically practice name writing by copying and tracing, which leads to little or no generalization. Signing our name is a very important goal, as it is a part of who we are, so it is very important - but we need to address it using strategies that work!

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Did you know that we use the same 'high frequency' words for the majority of our communications? These high-frequency words are also called "core vocabulary". These are words that come up time and time again in day-to-day communications.

If you're looking for ways to teach core vocabulary, try using stories! In this example, we're sharing a story to aid in teaching the core vocabulary word, "more".

In many parts of the world, winter has arrived, and with it comes the possibility of snow! Read through the story, "More Snow", with your students. This story provides a variety of examples, both good and bad, of what it means when there is more snow.

When you're finished, ask them if they would like to read 'more'. Model for them how to say "want more" or "no more".

Reinforce the meaning of "more" through classroom activities that relate to the story. For this example, you could try these related activities:

Bring in a snow globe and show your student how the snow swirls when it's shaken. Prompt them to ask for "more" to see the snow swirl again.

Place paper snowflakes around your classroom with the words "more snow" written on them. Ask your student to find all of the snowflakes.

Ask a student to pass out art materials for a snowflake activity to the other students. Encourage your students to ask for "more" as they work on the activity.

Teaching core vocabulary may seem like an overwhelming process, but it doesn't have to be! Try using vocabulary stories in your classroom and check out the "More Snow" story and activity guide to get started!

The special education resources on this page were authored by Watson Institute's special education consultants and faculty.

Lesson:

Story:
book more-snow
If you have questions or concerns about the Watson Institute's use of this information, please contact us.

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Teaching Core Vocabulary - Watson Institute

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Did you know that we use the same 'high frequency' words for the majority of our communications? These high-frequency words are also called "core vocabulary". These are words that come up time and time again in day-to-day communications. If you're looking for ways to teach core vocabulary, try using stories!

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Impact | Winter 2018/19 Volume 31, Number 2

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From the Editors

In the past, students with the most significant cognitive disabilities were often taught only functional skills in our K-12 schools - how to do self-care, tell time, use money, carry out routine daily tasks. Today, growing numbers of families, educators, and students are advocating for higher expectations and a more inclusive educational experience.

What does it look like when schools transition to more inclusive and rigorous education for students with the most significant cognitive disabilities? In this Impact issue inclusive K-8 education is viewed from a variety of perspectives - researchers, classroom teachers, education administrators, students with and without disabilities, and families. They explore inclusion from the classroom to the school-wide community, and beyond.

The learning curve for adults is sometimes steep when more inclusive practices are introduced in schools. However, students - both those with cognitive disabilities and their peers without - often make the shift more easily. The key is for the needed and appropriate supports to be in place for students. And for the special and general education teachers, and school administrators who support them, to have the knowledge, skills, and quality curricular resources they need to confidently instruct all students. In these pages we share examples of such knowledge, skills, and resources from across the country with the hope that they can help K-8 schools increasingly support the learning of all students in inclusive settings.

Subscribe

For a free subscription to Impact, visit ici.umn.edu/products/impact/subscribe.html or call 612/624-4512. Provide your contact information and let us know whether you'd like a print or digital subscription, or both.

Inclusive Education: Additional Resources of Interest

Resources from National Centers

National Center on Accessible Educational Materials
( aem.cast.org)
Accessible educational materials or AEM are specialized formats of curricular content that can be used by and with students who are unable to read or use standard print materials. The AEM Center provides resources, training, and technical assistance for educators, parents, students, and others interested in learning more about and implementing AEM and the National Instructional Materials Accessibility Standard (NIMAS). In addition to the large collection of resources and information on its website, the center invites K-12 educators (especially those in their first three years of teaching) to participate in a free professional development course delivered online to improve the accessibility of the materials their students use for learning (for more information see http://aem.cast.org/about/new-educator-training.html#. XBwfVi2ZPMU). The AEM Center is based at CAST, Inc. (cast.org).

The ALTELLA Project
( altella.wceruw.org/resources.html)
The Alternate English Language Learner Assessment (ALTELLA) project at the Wisconsin Center for Education Research, University of Wisconsin, Madison, applies lessons learned from research on successful instructional practices, accommodations, and assessments for English learners (ELs) and students with cognitive disabilities to inform alternate English language proficiency assessments. On its website are reports, briefs, and conference presentations for educators, including the recently-released briefs, Individualized Education Programs for English Learners with Significant Cognitive Disabilities and Nonverbal Communication in Diverse Classrooms: Intercultural Competence Considerations for Supporting English Learners with Significant Cognitive Disabilities.

National Center on Educational Outcomes
( NCEO.info)
This technical assistance center at the University of Minnesota, Institute on Community Integration, publishes over 200 resources online for educators, policymakers, and families focusing on assessments and accommodations. Among its reports, briefs, presentations, and tools are the recent report, Alternate Assessments for Students with Significant Cognitive Disabilities: Participation Guidelines and Definitions (Report #406) and the White Paper, Developing an Alternate ELPA21 for English Learners with the Most Significant Cognitive Disabilities.

Resources for Families

Resources for Schools, Districts, States

Supporting Inclusive Schools for the Success of Each Child: A Guide for States on Principal Leadership
( ccssoinclusiveprincipalsguide.org)
Principal development is a critical lever to drive school improvement efforts, achieve states' equity goals, and ultimately improve outcomes for each student, especially those with disabilities. The Council of Chief State School Officers has developed this online guide to help states establish a vision for, and advance policies and practices that support principals to lead, inclusive schools where each student excels and feels safe, supported, and valued

Volume 31 * Number 2
Winter 2018/19
Managing Editor: Vicki Gaylord

Issue Editors:

Terri Vandercook, Assistant Director, TIES Center, Institute on Community Integration (ICI), University of Minnesota (UMN)

Harold Kleinert, Director Emeritus, Human Development Institute, University of Kentucky, Lexington

Cheryl M. Jorgensen, Inclusive Education Consultant, South Acworth, New Hampshire

Sheryl Lazarus, Director, TIES Center, ICI, UMN

Kristin Liu, Co-Principal Investigator, TIES Center, ICI, UMN

Martha Thurlow, Director, National Center on Educational Outcomes, ICI, UMN

Graphic Designers: Sarah Hollerich

Web Developers: Shawn Lawler, Jonathon Walz

Impact is published by the Institute on Community Integration ( UCEDD), and the Research and Training Center on Community Living and Employment ( RTC), College of Education and Human Development, University of Minnesota. It is supported, in part, by Grant #90DDUC0070 from the Administration on Intellectual and Developmental Disabilities, US Department of Health and Human Services (HHS), to the Institute; and Grant #90RTCP0003 from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), HHS, to the RTC. Additional support for this issue was provided by the TIES Center through Cooperative Agreement #H326Y170004 from the Research to Practice Division, Office of Special Education Programs, US Department of Education; and by Grant #T73MC12835 from the Maternal and Child Health Bureau, HHS, to the Minnesota LEND.

The views expressed are those of the authors and do not necessarily reflect the views of the Institute, Centers or University. The content does not necessarily represent the policy of the US Department of Health and Human Services, or Department of Education, and endorsement by the Federal Government should not be assumed.

For print copies contact: Institute on Community Integration, University of Minnesota, 109 Pattee Hall, 150 Pillsbury Dr. SE, Minneapolis, MN 55455 * 612/624-4512 * icipub@umn.edu.

Impact is available in alternate formats upon request. The University of Minnesota is an equal opportunity employer and educator.

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Strategies for Supporting AAC Use in Inclusive General Education Classrooms by Jacqueline Kearns, Jane Kleinert, and Karen Erickson

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In the past, students with the most significant cognitive disabilities were often taught only functional skills in our K-12 schools - how to do self-care, tell time, use money, carry out routine daily tasks. Today, growing numbers of families, educators, and students are advocating for higher expectations and a more inclusive educational experience.

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With the right support, students who cannot rely on natural speech to communicate can do well in integrated classrooms.

Thad Alton / The Capitol-Journal / AP Photo

My first exposure to a student who used augmentative and alternative communication (AAC) was when I taught in a self-contained disability-specific special education classroom. The student, Ringo, had a device like a small laptop that he used to type words and sentences, which were spoken aloud by the device. When Ringo received the device, I didn't get much training other than a few consultations with the speech and language pathologist and a pat on the back for good luck.

After 13 years in the classroom, I realize now what I wish I knew then: Students who cannot rely on speech to be understood don't have to be educated in segregated classrooms. And for educators who have students who require communication supports, training or preparation doesn't have to be complex.

Here are four ways educators can prepare for students who need AAC.

1. Get Familiar With AAC

According to the nonprofit Communication First, AAC is any method of communication used by people with speech or communication disabilities to supplement or take the place of verbal speech. This can include no-tech aids (like pointing, gesturing, or signing), low-tech options (such as a paper board with words, letters, and symbols on it), or high-tech solutions (such as a computer with text-to-speech software).

Some students will use AAC all the time, others only in certain situations. And while some people think that the use of AAC may limit students, using a communication system only empowers people who would not otherwise express themselves reliably.

2. Watch AAC in Action

There are examples in TV and movies of people using AAC that the disability community has universally panned, but fortunately there are also some authentic portrayals. One of the best ways to learn more about people with disabilities is to hear directly from them or interact with media heavily influenced by their voice. Here are a few movies and short films to get you started.

Listen (2021): A short film made by and with nonspeaking autistic people.

The Reason I Jump (2021): A feature-length film based on the biography of Naoki Higashida, who is autistic and nonspeaking.

Loop (2020): A short film by Pixar and Disney highlights Renee, a nonspeaking autistic girl who makes friends with Marcus, a speaking boy, when the two go canoeing together at camp.

Thasya (2012): This powerful short film is a profile of Thasya Lumingkewas, an 8-year-old autistic girl.

Carr Brackett (2008): In this short film, Carr, a young man with Down syndrome, uses his AAC to support his communication needs in a general education classroom.

3. Use the Communication Bill of Rights as a Guide

First published in 2016, the Communication Bill of Rights from the National Joint Committee for the Communication Needs of Persons with Severe Disabilities states that "all people with a disability of any extent or severity have a basic right to affect, through communication, the conditions of their existence." The list of rights, which consists of 15 points for educators to consider, focuses on the dignity and respect of the person with communication support needs.
Reproduced with permission from Tobii Dynavox, LLC ©2020 Tobii Dynavox. All rights reserved.
The first point, "to interact socially, maintain social closeness, and build relationships," is an important one for teachers to implement. Teachers can be intentional about including AAC users in groups where there are students accepting of differences to help facilitate friendships.

If you include planned interactions in lessons where the AAC user can "make comments and share opinions," you can align with the bill of rights' goals. For example, during a class review of a reading passage, give the AAC user time to craft their answer to a question and call on them at a predetermined time. When you give them time to process, they can be prepared with their answer. Wait time benefits all students, so this is a good idea in any classroom.

Another critical thing to consider is a student's right to "refuse or reject undesired objects, actions, events, or choices." Like students who use natural speech, if an AAC user refuses to participate in a class activity, there's typically a reason. Educators can make an effort to ask the student directly about how they can be more comfortable participating in the activity.

Students should always have access to their communication systems.

Students are more likely to communicate and participate when activities are motivating or connect with their passions and interests.

Frequent opportunities to practice using their AAC helps children learn to communicate in various contexts and with various people.

People who use AAC may require more wait time to prepare a response, so make sure to be patient.

When teachers honor students' communication, it teaches them and the other students that we respect them and their voice.

Talk directly to the AAC user, not to their support person (if they have one). And if students work in groups, guide everyone in the group to talk directly to the person using AAC.

4. Practice Strategies for Promoting Communication for All Students

Students who cannot rely primarily on speech to communicate are often the first to be placed in segregated special education classrooms. But what I learned from Ringo is that supporting communication can happen in the general education setting-it just takes a willingness to listen.

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Students With Limited Verbal Capabilities Can Thrive in Inclusive Classrooms

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With the right support, students who cannot rely on natural speech to communicate can do well in integrated classrooms. Thad Alton / The Capitol-Journal / AP Photo My first exposure to a student who used augmentative and alternative communication (AAC) was when I taught in a self-contained disability-specific special education classroom.

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Augmentative and alternative communication (AAC) devices help to create inclusion within a classroom. Learn how these devices empower users to initiate communication, rather than just respond to questions.
Stephanie Taymuree has witnessed huge advances in augmentative and alternative communication (AAC) during her nearly 40 years as a speech-language pathologist (SLP) and special educator, and her implementation of AAC technology in the classroom is unrivaled. But she still finds it thrilling when a student embraces AAC to express a novel thought or idea.

"My very best days are those when an AAC user calls my name and is then able to successfully communicate a message to me about something of which I have no previous knowledge or context," she says. "The happiness and laughter that ensues with those connections is my absolute reward!"

Taymuree teaches 3rd-5th graders at Redwood Heights Elementary School in Oakland, CA. Her students have cerebral palsy, severe verbal apraxia, traumatic brain injury, ASD, and various syndromes that affect speech and language development.

"Our Technology & Augmentative Communication for Learning Enhancement (T.A.C.L.E.) program is a special day class program for students with complex communication needs," she says of the program she was selected to launch in the early 1990s. "My students require multimodal communication strategies, including the use of high-tech speech-generating devices (SGDs), to communicate within their environment and access the academic curriculum."

Modifying the Curriculum for Expression and Engagement

Taymuree works diligently with other school staff members to support her students' success in school. "Some of the students in my program are included in general education classes for academic subjects. Those students generally need modifications to the way curriculum is represented, the way they can express their knowledge, and options of engagement."

Modifying the curriculum presentation for special needs students could include "using enlarged text, having textbooks and grade-level literature read aloud with text highlighting, symbolated text for students who continue to need graphic support, teacher-created Smart Board lessons, or teacher-created Classroom Suite lessons to enhance a concept being taught," she says.

To enable a student to express their knowledge, Taymuree might recommend interfacing a student's SGD with a computer for writing activities, programming specific "fringe vocabulary" into the device for classroom "academic talk," or teaching several non-disabled classmates to facilitate a student's engagement in cooperative learning tasks. Modification of options to engagement could include programming a "script" into a voice-output communication aid or SGD for participation in a skit, game, or shared reading.

Such modifications are essential to successful inclusion, she says, "and require the collaborative effort and planning of the special education teacher, general education teacher, and supporting paraprofessionals. One afternoon each week, we meet to discuss the need for upcoming modifications/adaptations, device programming, accessibility and transportation planning for field trips, social-emotional learning, and friendships, etc."

Integrating Students into the Academic Community

But for Taymuree, full inclusion goes beyond a classroom's walls. "First and foremost, it is essential to develop a school-wide climate of inclusion and responsibility for all students, along with good working/collaborating relationships with the general education teachers and staff. This requires the special education teacher to be a good 'PR' person!

"My students have always been an integral part of the community here at Redwood Heights School," she continues. "I have made certain that their voices are heard in all aspects of our learning environment. My students participate in the Martin Luther King Oratorical each year, delivering speeches at assemblies, participating in plays or in the school music concerts, delivering messages to the office or other classrooms, and so on."

Her biggest challenge in working with young augmented communicators, she says, "is teaching the functional use of their system as initiators of communication rather than simply as respondents. Many children learn to access the vocabulary needed to communicate basic thoughts but continue to remain on the sidelines of social conversation."

Improving the student's "personal narrative skills" is one way she is overcoming that challenge, using an intervention technique she learned years ago when several of her students participated in a study conducted by Dr. Gloria Soto of San Francisco State University.

"The study explored the effects of a specific intervention technique in improving personal narrative skills of children who use AAC," Taymuree recalls. "Using photographs of memorable family events that were emotionally charged, the students were explicitly taught how to initiate a conversation, vocabulary, techniques of circumlocution when the needed vocabulary was not programmed into the device, sentence construction, elaboration, and attaching emotion to a narrative."

Students would use their devices to talk about the event depicted in the photograph, and their story was programmed into their device. They were then encouraged to initiate a conversation with others and share their personal story.

"This has proven to be a highly successful technique in improving the personal narrative skills of students who use AAC," Taymuree says. "It has also proven to be a successful way of helping students initiate conversation with others."

Sharing Success Tips with Other Teachers

In addition to encouraging the sharing of personal stories, Taymuree offers additional suggestions for teachers working with students who use AAC:

Provide a means to communicate, because every child needs some way to interact with others in his or her environment - eye gaze, gestures, sign language, picture communication systems, voice output aids, or speech generation systems. It is important that families and teachers develop vigilance to the subtleties and nuances of emergent communicators.

Facilitate motivation by engineering the classroom environment with captivating materials, putting some desired objects just out of reach, creating situations of inequity (such as various proportions of snack foods), creating choices, and planning for emotionally charged situations.

Always reward the learner by reacting to their communication attempts. Sometimes that requires waiting with anticipation for a response.

Expectations affect the quality of teaching as well as the behavior of students. Always expect that students can become effective communicators.

Provide support by assisting families in locating appropriate resources, and eliminate blame (such as "the parents don't follow through!").

Collaborate with the other professionals involved with the child on instructional goals and teaching strategies. Creating and building an effective multimodal communication system requires understanding of language development, cognitive function, neurological function/dysfunction, etc. It takes a multidisciplinary team to address each issue to develop an appropriate system.

Reflect and problem-solve. Good teaching is a reflective process which, when thoughtfully and systematically implemented, leads to growth.

Source
Prentke Romich Company

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Using AAC Technology To Create Inclusion in the Classroom - The Orange Effect Foundation

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Augmentative and alternative communication (AAC) devices help to create inclusion within a classroom. Learn how these devices empower users to initiate communication, rather than just respond to questions. Stephanie Taymuree has witnessed huge advances in augmentative and alternative communication (AAC) during her nearly 40 years as a speech-language pathologist (SLP) and special educator, and her implementation of AAC technology in the classroom is unrivaled.

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TIES 101: Communication Supports in the Inclusive Class
https://www.hdilearning.org/courses/ties-101/
This introduction and six-part Communication TIP series followed a systematic review of the literature on communication and inclusive environments. The findings of the literature review concluded that peer supports, aided language modeling, and training and planning for the teaching team were evidence-based practices that improved AAC use among students with complex communication needs.

TIES Communication 101 Learning Series

TIES Communication 101 is an asynchronous professional learning series. A certificate for one hour of credit is available upon completion. One hour of ASHA credit is available for Speech-language pathologists at no charge for the six-part course.

This series includes TIP modules on communication-based on a review of the literature on Communication Competence in Inclusive Environments currently available https://files.tiescenter.org/files/g93yqc4Knm/ties-center-report-103

The findings of the literature review concluded that peer supports, aided language modeling, and training and planning for the teaching team were evidence-based practices that improved AAC use among students with complex communication needs.

The topics in this series include:

1. Peer Supports Communication - defines and describes the importance of peer support and the types of support arrangements that are helpful.

2. Collaborative Team Planning - provides strategies for effective and efficient planning and implementation of AAC.

3. Getting to know the AAC User - highlights the importance of knowing details about the student including unaided communication forms, preferences, hearing/vision/motor concerns as well as the use of AAC across school environments.

4. Successfully Using Communication Strategies in the Inclusive Classroom - highlights strategies that acknowledge communication, insure AAC availability, modeling, and teaching other how the individual communicates.

5. Connecting Core Words, Aided Language Modeling, and Literacy - provides examples connecting core vocabulary word arrays, aided language modeling, and connecting to literacy opportunities.

6. Defining Communicative Competence - describe the additional skills that AAC users must learn including operational and strategic skills in order to communicate effectively.

We hope the series will provide some useful tools and strategies to use with AAC users in inclusive classrooms.

All rights reserved. Any or all portions of this document may be reproduced without prior permission, provided the source is cited as:

TIES Center is the national technical assistance center on inclusive practices and policies. Its purpose is to create sustainable changes in kindergarten-grade 8 school and district educational systems so that students with significant cognitive disabilities can fully engage in the same instructional and non-instructional activities as their general education peers while being instructed in a way that meets individual learning needs. TIES Center is led by the National Center on Educational Outcomes (NCEO) at the Institute on Community Integration, University of Minnesota, and includes the following additional collaborating partners: Arizona Department of Education, CAST, University of Cincinnati, University of Kentucky, University of North Carolina - Charlotte, and University of North Carolina - Greensboro.

TIES Center is supported through a Cooperative Agreement (#H326Y170004) with the Research to Practice Division, Office of Special Education Programs, U.S. Department of Education. Opinions expressed do not necessarily reflect those of the U.S. Department of Education or Offices within it. Project Officer: Susan Weigert.

TIES Center University of Minnesota 215 Pattee Hall 150 Pillsbury Dr. SE Minneapolis, MN 55455 Phone: 612-626-1530 www.tiescenter.org

This document is available in alternate formats upon request. The University of Minnesota is an equal opportunity employer and educator. Click the first strategy below to get started.

TIES TIP 1: How Peers can Support the AAC User
[2-12 Minutes]

TIES TIP 5: Connecting Core Words, Aided Language Modeling, and Literacy
[42-52 Minutes]

TIES TIP 6: What is Communicative Competence and Why is it Important for All Learners?
[52-60 Minutes]

J acqueline Kearns, EdD - Dr. Kearns directs a number of Communication Projects at the Human Development Institute at the University of Kentucky. With expertise in serving students with significant disabilities, she supports professional learning for educators in the areas of communication, inclusive education, and assessment and accountability. Projects include the National TIES Center, TAALC (Teaching Academic Age-appropriate Learning via Communication) project, and an initiative with the Ohio Deaf-blind Project. She holds an adjunct faculty appointment in Communication Sciences and Disorders and teaches for SPEAC IT - a personnel-preparation project. As director of the National Alternate Assessment Center (NAAC) 2005- 2010 she collaborated in the development of the Learner Characteristics Inventory for alternate assessment participants.

Disclosures:
Financial: Dr. Kearns receives a salary from the University of Kentucky and support from the Ohio Center for Deafblind Education (OCDBE).
Non-Financial: Dr. Kearns does not have any relevant non-financial relationships to disclose.

Jane Kleinert, PhD., CCC-SLP - Dr. Jane Kleinert, University of Kentucky, is Professor Emeritus in Department of Communication Sciences/Disorders with research, publications, and teaching/training delivery on communication services for persons with severe/multiple disabilities. She has been Co-PI and PI for state and federal grants in this area of specialty. Dr. Kleinert is an ASHA Fellow and was awarded the 2013 ASHA Foundation DiCarlo Award. She has co-authored extensive on-line training materials on communication for students with the most significant disabilities with Dr. Jacqui Kearns and Dr. Judy Page.

Disclosures:
Financial: Dr. Kleinert receives salary and grant funding from the University of Kentucky and the KY Department of Education
Non-Financial: Dr. Kleinert does not have any relevant non-financial relationships to disclose.

J udy Page, PhD, CCC-SLP - Dr. Page is Associate Professor in Communication Sciences and Disorders, College of Health Sciences, at the University of Kentucky. She serves as recent past president of the American Speech and Hearing Association (ASHA). Her primary areas of interest are communication intervention strategies for persons with severe disabilities and augmentative and alternative communication (AAC) systems. Other research interests include early intervention, early literacy development, and interprofessional education and practice.

She is a Fellow of the American Speech-Language-Hearing Association, a Fellow of the National Academies of Practice, a recipient of the Honors of the Kentucky Speech-Language-Hearing Association, and a past nominee for the American Speech-Language-Hearing Foundation's DiCarlo Award for Outstanding Clinical Achievement.

Disclosures:
Financial: Dr. Page receives a salary and grant funding from the University of Kentucky and support from the Ohio Center for Deafblind Education (OCDBE).
Non-Financial: Dr. Page has been active in professional service and advocacy at the state and national levels and was the 2015 President of the American Speech-Language-Hearing Association.

Financial Disclosure:
All authors are employees of the University of Kentucky. Funding for this project is a sub-contract from the University of Minnesota TIES Project. TIES Center is supported through a Cooperative Agreement (#H326Y170004) with the Research to Practice Division, Office of Special Education Programs, U.S. Department of Education. Opinions expressed do not necessarily reflect those of the U.S. Department of Education or Offices within it. Project Officer: Susan Weigert.

Any images of devices or symbol layouts are for illustrative purposes only and no relationship with the authors should be inferred.

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TIES 101: Communication Supports in the Inclusive Class (2 hours)

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TIES 101: Communication Supports in the Inclusive Class https://www.hdilearning.org/courses/ties-101/ This introduction and six-part Communication TIP series followed a systematic review of the literature on communication and inclusive environments. The findings of the literature review concluded that peer supports, aided language modeling, and training and planning for the teaching team were evidence-based practices that improved AAC use among students with complex communication needs.

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At the ASHA Convention last month, I chatted with an SLP about her secret longing: To take a sabbatical and travel the world to see AAC in action. Wouldn't that be exciting?!

In the meantime, we'll have to live vicariously and peek into AAC practices through the words and pictures of dedicated professionals. Angi Pearce, a teacher at Kowhai Special School in Hastings, New Zealand, was kind enough to help us out and share her experiences in increasing AAC use in her classroom. Angi is the team leader for the Junior School classes (ages 5-11) and graciously prepared this post with support from SLP Michelle Roberts. As you'll see, Angi is a highly experienced educator but new to the world of AAC and not afraid to take risks and embrace change.

Let's take a look at how a veteran teacher stretched herself to incorporate more AAC into her classroom.
AAC IN THE CLASSROOM
My journey into the world of AAC (Augmentative and Alternative Communication) began at the beginning of 2015, when I started teaching at a school for children with special needs. Prior to this, I had been teaching in mainstream primary schools for almost 30 years and I had never heard of AAC. Over the years, I have taught many students in mainstream settings who struggled in the whole area of language and communication. I frequently used individual and class visual schedules, as well as some video self-modelling to help direct positive behaviours.

When I began teaching at Kowhai Special School, I immediately discovered that having one or two students in a class who had communication difficulties was totally different from having a whole class of students with communication difficulties! I had to quickly learn alternative methods of communication in order to help them express themselves as well as fully understand what I was saying. So I set myself the following goals:

To learn a minimum of one new Makaton sign a week and use it in the classroom with students.

To encourage my students to use these new signs in their communications.

To have a 'signing buddy' (teacher assistant) to mutually encourage and support each other in learning and using signs.

To gradually increase my use of the core vocabulary board throughout the school day, with support from the speech language therapists.

So there began my learning journey. Initially, I found Makaton the easiest to use and it quickly became a part of my communication toolkit. It got to the stage that when I went out with my husband in the weekends, I would greet people using Makaton Sign - it had become so automatic for me!

I found the core vocabulary board a lot more difficult to master initially. To start with, I had a board with just 50 symbols, but I found this very limiting, as I wanted to be able to say so much more using it, so I changed to a board with 112 symbols. This gave me much more scope for communication. I started by using an A4-sized board, then moved to an A3-sized board. Later, a set fringe vocabulary was added to the top, which significantly widened the scope of language that I could model. The introduction of an A2-sized core board with a robust set of fringe vocabulary in 2016 was the turning point where AAC really took off in my classroom.

For a long time, though, my most commonly used pathways using the core vocabulary board were, "Your turn next", "Finished", "Sit," "Look, "Wait" and "Stop." The modelling was all by me and none of the students used it at the early stages, although they did respond to my communication using the board. I also only tended to use it during circle time in the mornings, neglecting it the rest of the day.

Towards the end of 2015, some of my students got their own core vocabulary boards - to start with, they just had the core vocabulary and no fringes. As with the large board used in circle time, it was mainly used for teacher modelling and not used much by the students. To help teachers learn where symbols are on the board and to use the board more frequently, the speech language therapists developed "Core Word Calendars" which encouraged staff to focus on one core word and Makaton sign per week, along with suggested phrases.

2016 arrived, and with it I had a new resolve to accelerate the use of AAC in my classroom in order to promote an inclusive and language-rich environment, where aided language stimulation is used throughout the day. An expectation of teachers in New Zealand is that they carry out teaching inquiries in order to keep their own teaching and learning constantly moving forward. I decided to investigate how I could foster and embed a team approach to total communication in my classroom. I decided that the steps I needed to take to achieve this were as follows:

Make an expectation that any staff working in my room use the communication tools that are available e.g. Core vocabulary board, Makaton.

Seek out tools that can be used in a range of settings with the support of the speech language therapists.

Use the target CVB and Makaton weekly word charts from the SLT....encourage staff to use the word/sign of the week, as well as the ones from previous weeks.

Research how other schools have brought their classroom staff on-board with the total communication approach.

I aimed for the students to be exposed to constant modelling of the strategies and tools, regardless of who they were working with. They would be encouraged and supported to use the tools as well, which would give them a greater ability to express themselves and understand others.

At the beginning of the year, the speech-language therapists gave me and my teacher assistants each a lanyard with 11 core symbols to support receptive language and behaviour management. I immediately introduced the expectation that all staff in my room were to wear their core vocabulary lanyards at all times. Initially, this was met with resistance, but change came as I continued to model its use and the students started to interact with them. A breakthrough came when one student flicked through the symbols on one teacher assistant's lanyard to find the symbol for 'toilet' and pointed to it, indicating he wanted to go. This was the beginning of students using the symbols for expressive communication and encouraged the teacher assistants to persevere with modelling and using the lanyard symbols. We also added a mini core vocabulary board to the lanyard - it had 30 core symbols and a fringe with yes, no, hello, goodbye, please and toilet on it.

The lanyard symbols were useful for interactions with the students in the playground. We would use it, for example, with students on the swings we could point to the symbols, 'big' and 'little' to ask them, "Do you want a big push or a little push?"

In Term 2, one of the students in my class started to trial a PODD (Pragmatic Organisation Dynamic Display). This presented a whole new challenge with its introduction - how to work with two different AAC tools at the same time in the classroom (or three, if you count Makaton Sign as well). We struggled our way through the term, with little success beyond using a few symbols such as "Hello" and "Your turn." We found there were so many pages, we didn't know where to start! The speech language therapists came to the rescue and produced a weekly pathway calendar for us to use with her, much like the core vocabulary calendars. This was a help for us and aided us in beginning to learn some of the most commonly used pathways. A copy of the pathway calendar was sent home for her family to use as well. Whomever was working with her for her literacy and numeracy would also have the PODD with them to support communications. The PODD is an ongoing learning journey for us, as we have found its use quite challenging. One teacher assistant sat with her at circle time and modeled with the PODD, while I modeled the large core vocabulary board. Each of the students had individual core vocabulary boards, which were modeled by teacher assistants.

At the same time, we were given our A2-sized core vocabulary board, with a complete fringe set. It was from here that I saw an exponential growth in student communication in my room. This large-sized core vocabulary board became the focus of communications any time we had mat time. The students also had their personal core boards beside them and were encouraged to use them as the large one was being used. So, when I modeled "Good morning" at the start of the day, the students would respond by pointing to the same symbol on their core board, as well as vocalising the greeting if they were able. After circle time, the core vocabulary boards were scattered around the room so that one was accessible to anyone at any time. This encouraged staff to use them when working with individuals in literacy and numeracy times. During literacy, we used them to support comprehension....we gave them choices related to the story, e.g. "Did the boy have a dog or a cat?" For writing, the students used the core vocabulary board or PODD to indicate what they want to write in their story. In numeracy, we used them to support number recognition, counting, shapes, colours etc. An exciting moment was when one of my boys with autism, who only spoke in one or two word utterances, started to independently use the core vocabulary board to create 5-6 word utterances, both verbally and pointing to the symbols. The team of occupational therapists and speech language therapists used them whenever they took students for sessions, which worked really well for continuing the expectation that students would use AAC in all settings.

Out in the playground, staff started to carry around either the PODD or the A4 core vocabulary board and lanyards with them. They used them in their interactions with students as they played. We found that the more we modelled their use, the more students started to point to symbols - for example, one non-verbal boy started to point to the symbols, "I - want - big - " and then sign the word 'push', when he wanted someone to push him on the swing.

Staff and students in my class this year have grown so much in their use of AAC and it has been exciting to observe the resulting 'communication explosion' in the students. These tools have given them a voice - their own voice. Just recently, the realisation hit me that students go through the 'babbling stage' when using AAC, just as babies learning to talk also babble before producing meaningful words. This means that students in the early stages of using AAC would point randomly to symbols, and we would attribute meaning to their 'babbling.'

Looking forward, the speech language therapists are in the process of developing A5-sized core boards with fringe vocabulary. These will be able to be worn by teaching staff so that wherever we are, we are able to communicate with students who require alternative ways of communicating. We are also considering ways to permanently have access to aided language systems in the playground, for example, a large, painted core board available to students and staff.

All of us still have a long way to go on the AAC journey, but with each new sign or symbol we use and each new interaction we use them in, it is becoming the culture of our classroom - and, indeed, our school. It's our hope that every student develops a way to express themselves in a purposeful and meaningful way.

This post was written by Carole Zangari

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How We Do It: AAC in the Special Education Classroom

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At the ASHA Convention last month, I chatted with an SLP about her secret longing: To take a sabbatical and travel the world to see AAC in action. Wouldn't that be exciting?! In the meantime, we'll have to live vicariously and peek into AAC practices through the words and pictures of dedicated professionals.

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A printable book with text at the bottom of the page and picture above. Based on the book "Taking Care of My Device" by Talk To Me Technologies. Feel free to use whatever term (device, talker, voice) you use to refer to an AAC system and to swap out the images with ones that look more like your AAC users.

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A printable book with text at the bottom of the page and picture above. Based on the book "Taking Care of My Device" by Talk To Me Technologies. Feel free to use whatever term (device, talker, voice) you use to refer to an AAC system and to swap out the images with ones that look more like your AAC users.