1. Applying AAC Strategies Everett Public Schools Discovery Ridge Barb Lark, SLP, ATP 3/24, 4/7, 4/21/09

2. Class Agenda Night 1 How to get the most out of online participation Sharing the same AAC lingo Definition of AAC Components of AAC Continuum of Communication for AAC users Who uses AAC Ultimate goal – start with the end in mind Assignment

3. Class Agenda Night 2 Purposes of Communication ala Janice Light and Beukelman & Mirenda Vocabulary, Vocabulary, Vocabulary Strategies, Strategies, Strategies Assignment

4. Class Agenda Night 3 Finally, AAC Systems Low tech Mid tech High tech Strategies, strategies, strategies

5. So many different needs, so little time… A lot of different participants in this class A lot of different students represented Cerebral palsy - dysarthria Cognitive delays Apraxia of speech Autism Cover some basics about AAC tonight Hopefully give you some different things to think about Focus on strategies the following nights, built on this framework

6. Definition of AAC  An area of research, clinical and educational practice. AAC involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of persons with severe disorders of speech- language production and/or comprehension, including spoken and written modes of communication. (ASHA Div. 12, 2005)

7. Important aspects of AAC Augmentative Alternative Compensate Participation

8. How might we apply that definition specific to our educational setting? What functional activities should students participate in while at school? Greet people they know; meet people they don’t know Make choices Tell what they know; indicate when they don’t understand Protest, refuse, negate, negotiate Ask for things; ask for help Share feelings; express health needs

9. How might we apply that definition specific to our educational setting? What functional activities should students participate in while at school? Joke around; make people laugh; compliment others, accept compliments Ask questions to gain information, share what is learned Give directions; ask for clarification Gain attention, establish identity Organize oneself This is not an exhaustive list

10. When you look at this list, how would you prioritize these activities for yourself? Greet people you know; meet people you don’t know Make choices Tell what you know; indicate when you don’t understand Protest, refuse, negate, negotiate Ask for things; ask for help Share feelings, health needs Joke around; make people laugh; compliment others, accept compliments Ask questions to gain information, share what is learned Give directions; ask for clarification Gain attention, establish identity Organize oneself

11. Let’s think about some common activities in our classrooms Activities What communication do you need to participate in each activity?

12. The ultimate goal of AAC is… Not to find a technical solution to communication problems To enable individuals to Efficiently and effectively engage in a variety of interactions, and Participate in activities of their choice

13. AAC has 4 primary components Symbols Aids Techniques Strategies

14. Symbols Different symbol types for different AAC users: Graphic (words, numbers, pictures, objects) Auditory (spoken word) Textured or tactile symbols (objects or learned tactile/textures symbols signs gestures facial expressions

15. Aids A device or system used to either transmit or receive messages Why are we talking about receiving messages too, rather than just “expressing”? Aids = Devices – but they don’t need to be electronic to be considered a device Some examples of Aids? Electronic Non-electronic

16. Techniques Techniques = the way messages are transmitted Direct selection Pointing, touching, exchanging Joystick use Head pointing, eye gaze, eye pointing Scanning Single switch auto scan 2 switch step scanning

17. Strategies Refers to the ways messages are conveyed, by the most effective and efficient means possible Enhance message timing Support grammatical formulation Enhance rate of communication

18. A special note to SLPs: When you are looking at recommending a device for a specific user, you will need to look at these 4 components to support your recommendation. Symbols (what type and why, including need for spelling) Aids (often, no, always need non-electronic along with electronic) Techniques (i.e. physical access) Strategies (rate enhancement, message timing, grammar strategies)

19. Continuum of AAC Independence A continuum, not discrete categories. No pre-requisites for AAC use Can’t assume why a person is at a level – need to rule out possible contributing factors Knowing a student’s general functioning level on the continuum helps you determine appropriate goals.

20. Continuum of Communication Independence EmergentContext Dependent Independent Patricia Dowden, Ph.D., CCC-Sp(L) http://depts.washington.edu/ augcomm/ http://depts.washington.edu/ augcomm/ Has no reliable means of symbolic communication. Probably: Uses non-symbolic methods May: have severe sensori- motor impairments, be very young, hasn’t received appropriate AAC technologies, techniques or strategies. Can talk to some people about some things. Many partners = need for additional training Many contexts = need for additional vocabulary*. May not have received appropriate training, strategies, technology Can communicate anything to anyone. Can interact with familiar and unfamiliar partners on any topic. Has strong literacy skills, so can use spelling.

22. What does this continuum mean in terms of selecting appropriate intervention goals? Emergent Communicator: identify that 1st method of symbolic communication Context Dependent Communicator: expand vocabulary and partners and contexts Independent Communicator: Use their goals and desires for improved communication

23. Remember The ultimate goal of AAC is… Not to find a technical solution to communication problems To enable individuals to Efficiently and effectively engage in a variety of interactions, and Participate in activities of their choice

24. Communication is not "independent" if.. utterances can only be understood by some people, or... other people have to preprogram all vocabulary in a device, or... he cannot spell well enough to compose novel utterances, or... she is given no opportunity to communicate what she wants to say, or... his communication system doesn't match his motor skills making it difficult to control, or... her communication system doesn't match her communication needs, or... there are partners who influence communication through cueing, or... he has hidden vision impairments making it hard to see the symbols, or... she has a hidden hearing impairment making it difficult to hear what is said, or... he has been given insufficient training and time to learn to use his AAC system, or... she has no access to a communication system at times, or... he cannot see the display on his system in some light conditions, or... no one believes she has anything worth listening to....etc

25. A case for communication independence This was best articulated by Bob Williams, former U.S. Deputy Assistant Secretary, and himself an AAC user. "Every person, regardless of the severity of his/her disabilities, has the right…to communicate with others, express everyday preferences and exercise at least some control over his or her daily life. Each individual, therefore, should be given the chance, training, technology, respect and encouragement to do so." Vermont Communication Resource Guide (2002)Vermont Communication Resource Guide (2002) Sources: http://www.state.vt.us/dmh/ddscommunicationresourceguide.pdf and http://biz.yahoo.com/bw/020508/82364_2.html http://biz.yahoo.com/bw/020508/82364_2.html And http://depts.washington.edu/augcomm/03_cimodel/commind1_intro.htmhttp://depts.washington.edu/augcomm/03_cimodel/commind1_intro.htm

26. Assignment - Think about a student you work with now, or have worked with in the past. Where do you think that student is on the continuum of communication independence? Why? Come prepared to share at our next class. To learn more about this continuum, visit Pat Dowden’s (UW) website: http://depts.washington.edu/augcomm/03_ci model/commind1_intro.htm http://depts.washington.edu/augcomm/03_ci model/commind1_intro.htm