Communication Matters 2014 Development of LAMP in the UK Andrea McGuinness Hayley Power

Aims of Today To feedback on facts and figures to date regarding LAMP in the UK Discuss demographical information on clients using LAMP Data around implementation What has worked most successfully and hypotheses as to why Short case study of individuals using the LAMP approach.

Why we got involved… It made sense… Had great results… High expectations….. Solid theory….. Good clinical practice

Reminder - What is LAMP? LAMP is a therapeutic approach based on sensory integration principles The goal is to give individuals who are nonverbal or have limited verbal abilities a method of independently and spontaneously expressing themselves in any setting LAMP focuses on giving the individual independent access to vocabulary on voice output AAC devices that use consistent motor plans for accessing vocabulary.

Components of LAMP Readiness to Learn Joint Engagement Consistent & Unique Motor Plans Auditory Signals Natural Consequences

Waiver…!!! All data collected from activity of centre for AAC and autism UK (CAA UK) Other assessment centres / suppliers / individuals will have trialled and recommended LAMP

LAMP Trainings 17 two day courses across the UK (12 by us) Format is day one working with a selected number of students and their team including where possible parents. Day two is the theory behind LAMP, implementation and setting of aims Trial period and review of progress

LAMP Training Sessions UK

Format of Day One Sessions with student and their team- all sessions videoed. Included a variety of items known to be motivating to the child. Following the child’s lead, the therapist engaged in play with the child centred around item(s) of their choice. Communication opportunities created, vocabulary use modelled. Core vocabulary was modelled either in single words, or in short phrases according to each child’s language abilities.

Format of Day One No verbal prompting, but clear verbal models of target words given Physical prompting faded as quickly as possible All communication attempts responded to with natural consequences Students chosen by the host

LCP Scheme LAMP certified professionals 2 qualified 9 in development LAMP certified practitioners 1 in development and 2 expressions of interest

Location of LCPs

LCP applications Most come from personal contacts Most of the northern trainings have been organised through CAA UK ◦ Work with at least one person ◦ Share videos for feedback and evidence ◦ Pre and post LAMP use communication profile ◦ Case History ◦ Ongoing support, equipment

How many individuals have trialled LAMP? Liberator figures June 2011 – July 2014 – 363 known trials Outcomes Full device 20% Decision making stage 10% Seeking funding 8% Ongoing trials 14% On hold 6% Apps/ low tech/ other42%

CAA UK Information January 2012 – July 2014 Figures on a much smaller scale Numbers 12 training days Have kept in contact with 8 locations following training Contact maintained on request - limited

From those 8 follow ups Figures based on ◦ Individuals seen on day 1 of the training ◦ Individuals supported through LCP scheme ◦ Ongoing individuals from therapists own case load 42 individuals 62% of these gone on to use LAMP approach for expressive communication Clinical approach

CAA UK Device21% Unity App32% Words for Life3% Seeking Funding6% Other38%

From 8 follow ups

Without and with support

Communication level Early communication level Individuals using other methods ◦ Stuck ◦ Not meeting their needs Individuals with some spoken expressive language Good non verbal communicators

Communication level Difficult one to call Standardised assessment to fit all those students not practical VERY rough analysis Biographical data from LCPs Informal observation

Communication level Figures show a mix Majority of people put forward for LAMP trials to CAA are at an early level of communication Can’t draw any definite conclusions Hypothesis – language level does not affect success Try...

Sensory levels Does this make a difference? Maintaining sensory levels is important to the success of the interaction Over / under ◦ Difficult to engage the individual

LAMP Can we make any hypotheses? Any patterns emerging?

Success criteria Support ◦ Therapy ◦ Home ◦ School Motivation Sensory levels Training - understanding approach

Alex Alex – aged 11 Dual diagnoses ASD and CP Used 4 Talk 4 Used iPad with Words for Life app since Oct 2012

Alex’s “LAMP” 4 Talk 4LAMP One hit one messageUsing for approx. 18 months Up to 4 messagesApprox 100 words Words for Life app on iPad Adult changed overlaysSequenced 84 location Keyguard and case Gross motor movementFine motor with index finger RequestRequest, greet, negate, direct, comment, give information, describe Challenging, self injurious behaviourMuch reduced Some mis-hits Pre-recorded phrasesNovel utterances, e.g. ‘down bike’ Up to 5 words per utterance Increased positive vocalisation, word approximations for ‘more’, ‘hi’ + names

Joel Joel – aged 7 Diagnosed ASD Before LAMP, no verbal communication, no effective AAC Used Vantage Lite since October 2012

Joel’s “LAMP” Communication pre LAMPLAMP Take adult to desired itemProgressed to verbal communication – short utterances No verbal communication2-4 word level phrases 84 sequenced Unity on Vantage Lite Frustration and self injuryStill frustrated, screams, no self injury Non verbal communication to requestRequest, greet, negate, direct, comment, express emotion Closed questions – is it this – or this?Open questions- what do you want? Spontaneous language generation – not all taught

Alex video Choosing TV programme Novel utterances Communication partner training ◦ Vocabulary choice ◦ Respond ◦ Error free ◦ Modelling

Developments More one day trainings followed by support for those interested in taking it further Survey Monkey – follow up after 3 months of initial training session New research – segmentation / auditory signals Support further research

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Conclusion  Research is ongoing in UK and USA  For more information    Contact: ◦ ◦