Building Successful AAC Outcomes: Language Goals and Communication Partner Instruction
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Building Successful AAC Outcomes: Language Goals and Communication
Partner Instruction
Cathy Binger, Ph.D., CCC-SLP
University of New Mexico
ArSHA 2013
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Overview
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Role of AAC in Communication
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Role of AAC in Communication
AAC is a TOOL◦GOAL = Improved daily life
communication◦TOOL = AAC
◦GOAL ≠≠ Using Using AAC
AAC is about COMMUNICATION
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Role of AAC in Communication
AAC use is never an outcome in and of itself
Devices cannot accomplish anything in and of themselves◦ Nothing magical about using AAC
Devices are TOOLS to reach the same goals as clients who rely on speech ◦ Increase/improve
Participation Academic/employment outcomes Social skills Language skills ArSHA Binger 2013
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Role of AAC in Communication
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AAC is much less intimidating when viewed this way!
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Language Goals for Children who use AAC
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Language Goals for Children who use AAC
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Our research has focused on:
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Receptive-Expressive Gaps
• Test receptive language formally May need to make adaptations for physical limitations
• Use standardized, normed tests that require NO verbal output from child; e.g.,
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Do NOT use the PLS: Requires verbal output
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Receptive-Expressive Gaps
• Determine age-equivalent score on test
• This is the age to aim for expressively. E.g.,
– Child’s age = 5;0– Receptive age = 3;0– Expressive expectations = ???
• What are your expectations for language for a child who is 3 years old?
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Receptive-Expressive Gaps
• Even if there is a big gap between chronological age and receptive ageYou may be underestimating expressive capability
• Many children simply lack:
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There are (many) exceptions, of course Low level symbolism; pre-symbolic communicators
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Vocabulary Selection Techniques (Beukelman & Mirenda, 2005)
• Environmental inventory– Observe and document what peers are saying
during that activity– Analyze and document vocabulary needed for
activities• Books, other curricular materials• Recipes • Etc.
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Environmental Inventory Example
• Provide the person using AAC with this same vocabulary
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Additional Techniques
• Aided AAC ModelingWhen you model using AAC, you will quickly
figure out what vocabulary is missing• Core vocabulary lists
http://aac.unl.edu/vocabulary.html
• Fringe vocabulary questionnaires• Fallon & Light, 2001; http://ajslp.asha.org/cgi/content/abstract/10/1/81
• Analysis of materials & activitiesIEP goals, curriculum, daily/classroom activities
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Example Goals: Pragmatics
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Increase turn-taking
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Pragmatic Goals, con’t
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Ask partner-focused questions
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Example Goals: Semantics
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Increase expressive vocabulary
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Example Goals: Syntax
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Increase sentence length
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Examples of Page-Based Communication Boards
Facilitating Syntax
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Simple Grids• Use grids as soon as the
client can!
• Enables the client to build simple sentences
• Can color code by morphemes or concepts In English: by words
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More Complex Grid
• This one is for a storybook
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Another Moderately Complex Grid
• This one is for a 4 year old who loves to play with dolls
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Picture WordPowerTM Grid
• A more complex grid for someone learning to spell
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Providing Communication Opportunities
Case Studies
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Providing Communication Opportunities
• Let’s start by looking at two videos
• Notice differences with – What the teacher is doing– What the child is doing
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What’s Different in the 2nd Video?
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Necessary but not Sufficient Conditions
• Even in the first video, we hadIdentified motivating contexts for communicationDeveloped appropriate communication boards
Selected appropriate vocabularyOrganized vocabulary appropriately
These steps are necessary but not sufficient for communicative success Communication partners must change how they
interact with AAC clients
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What is “Timmy” Doing and Not Doing, Communication-Wise?
Timmy is doing a lot pragmaticallyTaking communicative turnsPointing to what he wantsUsing gestures to communicateAnswering questionsVocalizing
Timmy is notUsing words to communicate
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False Assumptions
• Many clinicians would assume that we should start with very basic goals
• Using single symbols to communicate
• However, his receptive language abilities are strong
• 3 year old range He understands many linguistic structures If his speech were not impaired, he would be using full
sentences Don’t aim too low!
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Differences between the 1st and Last 2 Videos
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Lessons from Timmy
• Don’t hold your clients back
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Ray’s Choice Book & Schedule Board
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Lessons from Ray
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Providing Communication Opportunities: Summary
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Multiple steps are involved in creating meaningful communication opportunities