Early Intervention-Preschool Conference Everyone Communicates! Strategies for Young Children with Multiple Disabilities and Sensory Loss Deborah Chen, Ph.D. deborah.chen@csun.edu October 25, 2016 Early Intervention-Preschool Conference Montgomery, Alabama

Communication Value and belief: Everyone communicates May be intentional or unintentional Occurs through multiple means Communication is a basic human right

Questions to Gather Information Receptive communication Expressive communication Social interaction Vision, hearing , motor skills Preferences Temperament Strengths Learning needs

EBP Promoting Communication Use of preference inventory Identify motivating items and activities Provide means (switch, communication boards, object symbols, adapted PECS, gestures, signs, speech) Teach child to request Provide wait time Embed in daily routines Fade prompts (Banda et al., 2014; Brady et al., 2016; Johnson & Parker, 2013;Parker et al, 2008; Pinto & Bakken, 2009)

Assessment Practices High preference inventory Observations of routine activities Structured or communication temptations Forms and functions of communication acts (e.g., Communication Matrix) http://www.communicationmatrix.org/

Communication Modes Output (Expressive) General body movements Input (Receptive) Touch cues Object cues Tangible symbols Gestures Vocalizations Manual signs Speech Output (Expressive) General body movements Object cues Tangible symbols Gestures Vocalizations Manual signs Speech

Output: Early Communication Functions Behavior regulation refuse or request action or object Social interaction greet, request social routine, comfort, or permission, show off Joint attention comment or request information

Considerations Demonstrates intentional communication? Look toward, reach for or point to objects or people Take someone’s hand and leads to location When do these behaviors occur and with whom? Imitate any actions? Use any gestures?

Progressively Matched Turn-taking Child does not communicate intentionally- adult imitates sounds and actions Child uses gestures and sounds - adult imitates and provides words Child uses words – adult provides standard form and adds a bit more information (MacDonald & Gillette, 1986)

Interrupted Routine Strategy Identify a favorite activity Engage child in activity Pause or interrupt the activity Wait for child’s response Interpret child’s request behavior and “speak for the child” Resume the activity

Delay Procedure Set up the situation for a familiar and favorite activity Wait for the child to signal anticipation of the activity Interpret the child’s request behavior and “speak for the child” Begin the activity

Offering choices 1. High preference object 2. Foil & high preference 3. Two of equal preference

Benefits of Signing Key Words Accessible language input Specific labels Repetition Appropriate pacing Provides a means of communication output Supports language development

Considerations for using Key Word Signs Output Motivation Efficiency Motor ability Physical assistance Communication modes Input Family priorities Frequency Access Adaptations Communication modes

Initial Sign Vocabulary Motivation: want to use Function: need to use Complexity: easy to produce Iconicity: easy to understand Family culture and comfort level

Adaptations Coactive signs Tactile signs Visual Distance from child Position and placement Size and amount of movements Rate or speed Sign on body- birthday party http://www.youtube.com/watch?v=c-fyNqTLj8o

Strategies Sign name of object when child is focused on object Produce sign on referent Make sign on child’s body Sign action words just before action begins Help child produce sign (coactive) Have child feel the signer’s hands (tactile)

Creating Conversations Pause and wait/interrupted routines Inadequate portions Need for assistance Silly situations/planned mistakes Making choices Interesting materials and events Memorable activities Upping the ante