1. Early Language Development & AAC
Tuesday, June 7, 2016

2. Agenda Typical Language Development
How to Classify Language in Students with Complex Communication Needs (CCN)
Level of Symbolism
Reasons to Communicate
AAC Considerations
Agenda

3. Aspects of Language Semantics (Vocabulary) Syntax (sentences, grammar)
Pragmatics (social interaction)
Articulation and Phonology (sounds)
Paul (2001) Language Disorders textbook

4. Semantics (Paul, 2001) Age Milestones 8-12 months
Understand 3-50 words, first spoken words for familiar objects and people
12-18 months
Average expressive vocabulary of words, need context for understanding
18-24 months
Average expressive vocabulary of words, putting two words together
24-30 months
Understand and ask questions using What, Who & Where about objects, people and basic events
30-36 months
Understand and use Why questions and basic spatial terms (prepositions)

5. Two Word Combos (Brown, 1973)
Agent-Action (Daddy go)
Agent-Object (Daddy ball)
Action-Object (Hit ball)
Entity-Location (Mommy chair)
Possessor-Possession (Mommy ball)
Demonstrative-Entity (That ball)
Attribute-Entity (Big chair)

6. Syntax (Paul, 2001) Age Milestones 8-12 months 12-18 months
Brown’s Stage 1: “telegraphic” utterances, using intonation to ask yes/no questions
24-30 months
Brown’s Stage 2: use of in/on, add -ing to verbs, plural /s/, use of no, not, can’t, don’t
30-36 months
Brown’s Stage 3: starting to use past tense in overgeneralized way, interrogative reversals

7. Grammatical Morphemes
Begin to appear around the time of 3 word utterances
Takes about a year for all to be used consistently
Similar order of acquisition across children, rates differ
Brown (1973)
Present Progressive
6. Possessive /s/
11. Third person irregular
2. In
7. Uncontractible copula (am, is was)
12. Uncontractible auxiliary (am, is, are)
3. On
8. Articles (a, the)
13. Contractible copula (‘m)
4. Plural /s/
9. Past Regular (ed)
14. Contractible auxiliary (‘m, ‘s + -ing)
5. Past Irregular (came)
10. Third person regular

8. Syntax
Mean Length of Utterance (MLU): how many words are typically in a child’s utterances during free play
Often used as a measure of syntax development but not often reliable for students with more severe disabilities
(This is relevant to AAC choices when we discuss phrase or sentence based vocabulary on voice output devices)

9. Syntax
Typical Language Development with syntax involves building up words like Legos into sentences
Gestalt Learners (many children with autism) tend to learn language in phrases and then break down the phrases into the individual Lego blocks
Gestalt Learners and those who use echolalia will have inflated MLU that does not correspond to the level of development

10. Pragmatics (Paul, 2001) Age Milestones 8-12 months
Intentional requesting, refusing, commenting and turn-taking using gestures and vocalizations
12-18 months
Express the same intents, but now using words; 5 communicative acts displayed per minute of free play
18-24 months
Spoken words increase over gestures; now requesting information, answering questions, acknowledging
24-30 months
Narratives include labels and descriptions; symbolic play; talking about absent items
30-36 months
Narratives have some sequence; use of more language while playing; adding new information to topics

11. Dore: Primitive Speech Acts
Behavior
Speech Act 1
Child touches doll’s eye, says “eye”
Labeling 2
Overhears a word and repeats it
Repeating 3
Mom asks “who’s this?” Child says “Daddy”
Answering 4
Child needs help, says “uh uh uh”
Requesting Action 5
Child points to milk, says “milk?”
Requesting 6
Calls “mama” and wait for response
Calling 7
Says “hi” when parent enters a room
Greeting 8
Screams and resists when mom tries to put on his shoe
Protesting 9
Says “Daddy” when father is not present, doesn’t address an adult or await a response
Practicing (Babbling)

12. Referencing typical development helps understand sequence of skills to target for teaching or intervention

14. Considerations for Students with CCN

15. AAC: Augmentative & Alternative Communication
Low tech to high tech
For both RECEPTIVE and EXPRESSIVE language
While a child may need to master some skills in order to be a competent high tech device user, there are NO PREREQUISITES to AAC

17. To Determine Where to Start
Does the student have Intentional Communication?
Does the student understand that s/he can have an effect on others? Or are their wants and needs inferred?
To Determine Where to Start
Question 1:

18. To Determine Where to Start
Does the student understand Symbolic Language?
Does the student understand and/or use pictures, manual signs, photographs, written or spoken words for communication?
To Determine Where to Start
Question 2:

19. Four Stages:
No Intentional Communication; Not Symbolic
Intentional, Emergent Symbolic
Intentional & Symbolic- Single word/Short Phrases
Intentional & Symbolic- Multi-word Utterances

20. No Intentional Communication; Not Symbolic

21. No Intentional Communication, Not Symbolic
How does this student communicate?
Crying
Eye gaze
Vocalizations
Reaching (not pointing)
May react to stimuli

22. No Intentional Communication, Not Symbolic
What does the student communicate?
Hunger
Fatigue
Happiness
Discomfort
Need for attention

23. No Intentional Communication, Not Symbolic
Why does the student communicate?
Behavior Regulation
Requesting object
Requesting action
Protest

24. No Intentional Communication, Not Symbolic
AAC Considerations:
Use single message voice output switches and access switches (if needed) to address cause/effect development
NEED to respond in a timely manner to unintentional and intentional switch activations to develop this
Adults create communication dictionary to make sure all working with this student know unconventional but consistent communication methods
May make more progress with protesting than requesting- “no” or “go away”

26. 2. Intentional Communicator; Emerging Symbolic
Also referred to as Emergent Language Stage; students have a clear understanding of cause-effect

27. Intentional Communicator, Emergent Symbolic
How does the child communicate?
Crying
Eye gaze
Vocalizations (word or two from songs)
Pulling, grabbing
Pointing
Some manual signs/consistent gestures
Picture exchange

28. Intentional Communicator, Emergent Symbolic
What/Why does the student communicate?
Hunger/fatigue/discomfort
Happiness/enjoyment/affection
Need for attention
Desire for more of an item or activity
Desire to stop an activity
Express an opinion or preference- make a choice

29. Intentional Communicator, Emergent Symbolic
AAC Considerations:
Refine gestures for conventionality/greater range of communication partners
Communication boards
PECS (Picture Exchange Communication System)
Static display voice output with careful choice of words/messages

31. 3. Intentional & Symbolic- Single Word/Short Phrase
Also called Context-Dependent- these students typically use a wide variety of communication methods & do best in routines about familiar topics with familiar communication partners

32. Intentional & Symbolic- Single Word/Short Phrases
How does this student communicate?
Speech/some words
Photos/picture symbols
Gestures
Manual signs
Single message voice output switches for routines
Static display voice output

33. Intentional & Symbolic- Single Word/Short Phrases
What/Why does the student communicate?
Hunger/fatigue/discomfort
Happiness/enjoyment/affection
Need for attention
Desire for more of an item or activity
Desire to stop an activity
Express an opinion or preference-make a choice
Share information about others and activities

34. Intentional & Symbolic- Single Word/Short Phrases
AAC Considerations:
Communication boards allowing opportunities for word combinations & modeling expansions
Static display voice output allowing word combinations
May be a candidate for a dynamic display device
Continued exposure to core vocabulary symbols to generate own utterances
PECS, adding categories and verbs

35. 4. Intentional & Symbolic- Multiword Utterances
Also called Independent, although that does not mean purely verbal as the student may be independent via AAC. These students will persist in getting their message through

36. Intentional & Symbolic- Multiword Utterances
How does this student communicate?
Speech
Photos, picture symbols
Gestures
Manual signs
Voice output device, usually dynamic display
May type words and use text-to-speech
Writing

37. Intentional & Symbolic- Multiword Utterances
What/Why does the student communicate?
For a wide range of information, feelings, opinions and intentions

38. Intentional & Symbolic- Multiword Utterances
AAC Considerations:
Should have dynamic display device(s) with linked boards to plenty of vocabulary
Should be able to use core vocabulary fluently to be efficient
May use some spelling/typing and text-to-speech
Often use a variety of AAC to meet the needs of different environments

39. Geo or Lost Voice guy?

40. Assessment We’ll discuss this much more in the fall, but for now:
Communication Matrix:
Communication Sampling & Analysis tool:
Every Move Counts, Clicks & Chats