Thursday, October 23, 2014

TBT: The Limitations of Sign Language for Children With Speech Delays



I was prompted to write this post by the many conversations that I've had with parents who say that they don't want to pursue AAC but that they are working (usually working hard) to teach their child sign language. I put this post together to have an easy link to share about some points to consider before choosing sign language as a child's primary method of communication.

Will stars in a tiny video clip that really drives the point home :) (Ironically, in the clip he's discussing watching a sign language video!)

It should be noted, of course, that I think signing is a great communication tool for a child to have as part of their total communication toolbox---it just shouldn't be taught at the exclusion of AAC that would let them independently communicate with any communication partner about any topic.

Wednesday, October 22, 2014

One Size (with some tailoring) Fits Many: Key Considerations in AAC Selection

“There is no one-size-fits-all approach to AAC.”

In my part-time non-paying job (AAC advocating online) I’ve heard this a lot. I’ve said it a few times myself, but always halfheartedly, because I’ll tell you a secret: while one size doesn’t fit all, I believe that there are nearly universal principles that must be considered and incorporated when setting up an AAC system for any person.

Nearly universal. As in, applying to nearly all people. Not one-size-fits-all, I guess, but one-size-(appropriately tailored)-fits-many.  I’m not going to suggest a specific device/app/system, but I’m going to provide you with organizational/planning points that you may want to carefully consider as you purchase a system, or configure and personalize a system that you already own.

Please note that I am not suggesting you overhaul your system overnight. If you feel like your current AAC system is a great fit and working well, this post probably isn't for you.  I don’t suggest switching things up (unless in reading this, you realize that even their “proficiency” leaves them unable to communicate many things).

An AAC user deserves a system that will provide them with the maximum amount of language (referred to as SNUG---spontaneous novel utterance generation—the ability to put together an utterance that says exactly what they want it to say) with the minimum amount of time and effort. They need to be able to say exactly what they want to say, to whomever they want to talk to, whenever they want . . . and in a way that can happen as quickly and automatically as possible.

In order to help make this happen, here are the things that you need to think through:

1. Context-based communication pages are not the best idea. A context-based page groups together “all of the words” that you would need to communicate in a certain context. For example, an art page might contain these words (with icons):

I
paint
crayon
glitter
yellow
want
you
draw
marker
pencil
green
need
more
cut
brush
red
blue
like
all done
glue
scissors
orange
purple
bathroom

Why this is used: For someone new to AAC, this seems to make sense. Think of words that relate to art, put them all on a board, pull the board out during art. This board allows the user to request certain colors or items, to comment on the colors, to indicate what they like, to direct their communication partner “you draw,” and to also have a few commonly used words (more, all done, bathroom).

Limitations: Spontaneous novel utterance generation is low. Sure, the user can request red paint. But they can’t tell anyone that what they painted is a red school bus. They can’t ask to mix colors together, or request that the teacher draw a space shuttle so that they can paint stars next to it. They can’t point to their scribble and say “That’s my dad!” or tell their teacher “My pencil isn’t sharp enough” or “I don’t like the paint under my fingernails.” They can’t say “I’m thirsty!” They can’t comment on a friend’s painting or ask questions about what someone is drawing. They can’t say that they stopped painting because “my belly hurts” or “I feel tired” or “I don’t want to sit next to Sam because he keeps sticking his tongue out at me when you’re not looking.”

All of the words. When you wake up in the morning, you have the ability to use all of the words that you’ve ever heard. Your AAC user needs to be on a system that gives them access to all of the words, all of the time---not just food words at the dinner table and art words at the art table. 

2. Motor planning needs to be a part of the system. It just needs to be.  “Motor planning” is what happens when you need to make your body do something, like step up onto a ladder. You think about what you want to do (lift your foot to step up) and (very, very quickly) your nerves and muscles zap information around: contract this muscle, relax that muscle, shift your balance back a little, change the angle of your foot, lift, lean forward, move at hip and knee joint, lower foot down at the appropriate speed, contact!. The more that you execute a given motor plan, the better your body does it---it becomes automatic. A good example of this is typing the password on your computer. When you have a new password, you type it slowly for a few days, as your fingers learn the motor pattern of the new word. If you have an old password your fingers probably do it automatically, zipping through the letters without you even paying attention. That’s motor planning. (I wrote a whole post on it, with pictures and videos, here.)

Many individuals who are in need of AAC systems also have issues with muscle movements and motor planning, so the ability to organize a system in a way that allows for movements to access words to become automatic is essential. Imagine how much time and cognitive energy can be saved when an AAC  user’s hand just knows what little path to tap to say the word “go” instead of having to scan pages or search through folders because that word might be in a different spot.

AAC systems that honored and fostered motor planning principles used to be hard to find (limited to one company, really), but more and more companies are realizing how essential it is and attempting to allow their products to be configured in a way that will allow for the automaticity that following a motor plan to find a word can bring.

Here are some examples of when motor planning is not incorporated:


Motor Planning Foil #1: Movement of words with increasing vocabulary size.

GRID 1:

red


orange

yellow

green


blue

purple

black


brown

grey

GRID 2:

red


orange

yellow

green

blue


purple

black

brown

grey


white

paint

brush


pencil


glue

scissors

glitter

In Grid 1, each word has a spot. The user learns the motor plan to say these words. Then, the vocabulary increases (Grid 2) and the user is left having to scan and search for words (or images). And every time the vocabulary increases, the words move. Not good.

Ideally, a grid should have as many buttons as possible (a lot---even for people with fine motor challenges)  and the ones that aren’t currently in use could be blacked out (which will make the motor learning and target hitting more possible for people with motor challenges as well), reserved to hold more words later.

As a simple example, this would be a revision of Grid 1, which holds all of the same words but can grow to become Grid 2 without changing the motor plan for the original words:


red


orange

yellow

green

blue


purple

black

brown

grey


          
















-Motor Planning Foil #2: Predictive Text.  Predictive text walks a user through a sentence by “predicting” the type of things that a user might want to say. One issue with apps that use predictive text is that the app is not fully able to predict the types of spontaneous, novel things a person might want to say.


                                                                                         to
                                                                       want          (people)
                                                          I   à      like   à     (toys)
                                                                       feel            (food)


For example, if you type the choices like, want, and feel might appear. Tapping like might lead you to categories toys, food, people, and probably the word to, which could connect to other verbs (to eat, to drink, etc). But what if the user wanted to say “I like jumping on my bed” or “I like the smell of farts” (I mean, you never know).  That’s one problem with predictive text.

Another problem with predicative text is that, because the screen reloads after each selection, everything is always moving. If the word moves around (in the upper left corner if you get to it this way, but down at the bottom if you get to it a different way), then the user can never internalize the motor plan to get to a word, and they have to spend a lot of time scanning and searching. It’s a waste of energy.  The last issue with predictive text is that it's sometimes difficult to find a word if you’re not walked to it (if you wanted to start a sentence with the word caterpillar, it might be dicey). There are typically “category” folders in these systems that you can also access, but they may have many layers (which means many button pushes to find a word) or require scrolling (which wastes time and can present a challenge to those with fine motor impairment).

-Motor Planning Foil #3: Putting one word on a bunch of screens. When you say a word with your mouth (like “cut”) your muscles always move in exactly the same way to produce that word, no matter what the context is. You can “cut an apple” or “cut down a tree” or “cut that deck of cards”, but cut = cut = cut. If your system is made of a lot of screens that could function as context boards, then you may have one word in a lot of places (“want” on the eat screen, the drink screen, the art screen, the toy screen, etc). This is a lot of clutter and potential confusion (especially if the screens don’t have duplicate words in the same exact place, which should be the minimum requirement for duplicating words within a system).


3. Minimal work for maximum SNUG An AAC user shouldn’t have to navigate through multiple layers of folders to find a word. One of my favorite sentences that Maya ever said on her device was “Lightening---scary!” as the thunder cracked outside of our window. I loved it because it was exactly what she wanted to say, and she was able to quickly get to those two words, lightening and scary, which could easily have been buried in layers in another system. In one system the default to find the word lightening would require this navigation:

(more) --- (school) --- (weather) --- (more) --- lightening

No user should have to think their way through multiple categories to find a word. By the time Maya reached “lightening” in that example (if she managed to get there without giving up) the moment would have been long gone. And that’s only a two word sentence! It would take a very long time to say something more substantial. Systems need to be organized in a way that will minimize the amount of navigation that it will take to get to each word. Each additional step of navigation takes extra time and cognitive energy. 

A word of warning, though: notice that I said the goal is maximum spontaneous novel utterance generation----not maximum words. Programming each button to say several words (“I want” “I like” “I see” “I like that” “Pick up” “put down” etc) is not actually increasing language. It’s just relabeling buttons. It makes novel utterances more tricky (what about “You like” or “He likes” or “Mom likes”---do they all get buttons too?).  It might make it faster and easier to say simple things, but this approach will clutter the field (or fill more folders to tap through) and make it more difficult to combine individual words and build new sentences. This multi-word-button approach will also make it difficult to approach instruction about grammar, verb tenses, syntax, etc in a simple, direct way. Another consideration is that for children with some diagnoses, speech segmentation (the spaces where one word stops and a new word begins) is a challenge. This is part of why some children are prone to scripting---using entire sentences “Go to the store now?”  as one “word”, building sentences like “go to the store now yesterday.” Using a single-word vocabulary allows the users to see a word as the smallest unit of language and learn how to manipulate those pieces.

4. There is no “starter” AAC.   Do not waste your time (or money) on a “starter” AAC system, one that you plan to use for a little while until they are ready for a robust system. This is your child’s (or client’s) ability to communicate---it is not fair to waste months of their life teaching them a system that you fully intend on abandoning when/if they become “good enough” at using it to prove that they’re ready for something else. Imagine the uprising that would happen in an office setting if months were spending training on and incorporating a major software system, and just when the employees had all mastered it the boss called them in to congratulate them and introduce them to the “real system that we’re going to use, now that you’ve all proved your competency.” Unfair.

You need to find a system that can grow with the user---and you need to evaluate how the growth will happen in terms of  considerations mentioned above.

  • Will they have access to all of the words easily as it grows? 
  • Will the motor planning remain the same, or very very close to the same? 
  • Will words become buried in layers of folders as the vocabulary increases? 
  • Will predictive text make it difficult to say exactly what they want to say?
  • Can the system hold a massive amount of words, and does it have a solid keyboard to support emergent and conventional spellers who may want to start typing their words?

In my opinion, these are core points to consider as you plan and implement any AAC system. I believe that a system that is organized in a way that takes the above into consideration will offer maximum success and maximum SNUG. If you’ve landed on this page because you’re in the process of selecting an AAC system for your child, I hope that you’ll think through each of these points as you evaluate the options----each one of these things became a bump in the road for us at some point, and I wish that we could get back the months that we wasted figuring all of this out. I wish that we could have heard Maya’s thoughts when she was younger, rather than fumbling through several options that let her effortlessly request milk, or a certain color crayon, and not say much else.




PS: And now, for my preemptive defenses, because I anticipate push back on this:
1. My kid's system doesn't do any of that, and it's perfect for him! That's great! I'm so glad your kid has something that works well for them. This post isn't for you, then, because I would never suggest that you switch a system that is working well for you. However, for most new users, I believe the points above are essential considerations that will maximize success and SNUG.

2. What about kids with vision issues who would struggle with small buttons? Good question, and one that I don't know the answer to. I do believe that the motor planning is especially important for those with vision issues, who should be forced to use their vision to scan for words even less than a user with normal sight. I've seen great use of high contrast symbols and heard about success with visual/tactile markers in the field. When Maya was at the eye doctor she had her eyes dilated, and she was using her talker after the dilation. The doctor said to me: "You know that she can't see those pictures anymore, right? They are just bright blurry squares." I had no idea, but it made sense that the motor plans she had learned for each word, combined with the vague coloring of the icons she knew, was enough to keep her going. (And I'm certainly not saying that my kid's post-dilation blurry vision  is the same as someone with a serious visual impairment . . . it was just interesting for me to see her motor planning in action when her vision was reduced.) I don't know how to create systems for all users, but I believe that the above features can be considered when planning any system.

3. What about kids who struggle to hit small targets? They might need a few words on one page. Again, good question, and one that I don't know the answer to. Access is tricky. One thing that I know is that many kids who seem unable to hit a small target (or even isolate a finger) can often develop that ability with a keyguard, or fingerless glove, combined with creative positioning of the device and some stabilizing hand-under-hand (or wrist) support. I've seen an AAC user who uses his toe for direct access. If I were the AAC user and I had the following two choices: say exactly what I want to say, but it will take longer and more effort or say a few things (eat, drink, more, stop) really fast . . . well, I would choose the former. I don't know how to create systems for all users (and I'm not even going to wander into the waters of non-direct access here), but I believe that the above features can be considered when planning any system.

4. Who are you, anyway? You aren't even qualified to make a list of what needs to be considered.  If a professional's response to this list is to defensively point out that I am not a professional, rather than to consider these points with an open mind (and then provide well-argued critiques, if necessary), well . . . I would have reservations about working with that professional. Feel free to come back with a point-counterpoint rebuttal. I welcome debate and feel like we can all learn and grow from it. (If you ended up here following links and are sincerely wondering who I am, I'm an AAC parent who has spent a few years doing a lot of reading, research, immersion, and training about all things AAC. And I'm in school now to become an SLP.)




Tuesday, October 21, 2014

Take-a-Look Tuesday: AAC user videos

Both of these videos, which I found during my search for an effective AAC system for Maya, shaped my perception of AAC users . . . in very good, but very different ways. The first video is short (and silly!) and the second is actually a full-length documentary (which I shared several years ago, so if you're a long time reader it may seem familiar).

The first video is of a boy talking with his brother and sister (they're triplets!) at dinner (using a Springboard Lite from PRC). I remember first seeing this video and loving it---it was one of the first times I saw AAC included in home life like it was no big deal. Also, you kind of can't help but laugh at the typical kid talk :)




The second video is the movie "Only God Could Hear Me." This documentary follows the lives of four adult AAC users and simultaneously tells the story of the creation of the Minspeak AAC language. The opening scene of this movie totally blew me away, simultaneously revealing and destroying assumptions that I was unaware I had about people who use AAC. Chris Klein, who is featured in that opening scene (and throughout the movie) is now the president of USSAAC, the United States Society for Augmentative and Alternative Communication. If you don't have time for more, at least watch the first four minutes and twelve seconds.




Happy viewing!  


 

Monday, October 20, 2014

More Resources Monday: Pinterest



Today's resource post is a DIY resource: Pinterest!

The reason it's DIY is because, frankly, Pinterest is a bit foreign and overwhelming to me. So many links! So many pictures! At the same time, it's a great place to find, collect, and organize resources that you may want to refer back to or save for later. (Sitting here and thinking about Pinterest is causing me to think that I should really use my account more.)

I'm only going to link to two Pinterest resources, because these two AAC pinners are certainly enough to keep you busy and reading for at least this week:

PrAACtical AAC: See their boards here

Lauren S. Enders, MA, CCC-SLP: See her boards here (there's a lot of stuff here---scroll down until you see a cluster labeled "AAC" if you're not interested in other tech/speech boards)

Happy reading!


 

Friday, October 17, 2014

#AACfamily Friday: AAC Users & Communication Partners

Welcome to #AACfamily Friday! This week we had a drop in submissions---mid-month slump? (Honestly, it was kind of appreciated during a rather stressful week on my end.) Here are some awesome AAC users with their communication partners!


Felix showing his sister that we programmed "feather" into Speak for Yourself!

3 year old Harry from Australia and his dad playing and having a chat first thing in the morning!

Olivia (who will be 4 in two weeks) using Speak for Yourself on her iPad mini with her brothers, Michael and Jayden, and her sister, Carlie!

A whole AAC family! Jess's parents each went voiceless for several days in October to get the true feel for being an AAC user---you can read about the experience on her mom's blog

James (4) learning to communicate using a Tobii C-12 via auditory scanning with his SLP, Landon. They are playing a fishing game, talking, having a good time!

Maya and Will, chatting in the stroller!

Daniel uses Speak for Yourself to talk to his grandparents, who live far away!

Hosea joking with his sister Avelina by saying "pants" and gesturing to his head!


Thanks for the contributions-I look forward to seeing these pictures each week! For next week's #AACfamily Friday post, anything goes: any AAC related picture is game. More information is more fun, so try to include your location and the name of the device/app. Email submissions to me (by next Thursday, 8pm EST) at: uncommonfeedback@gmail.com 

   

Thursday, October 16, 2014

Throwback Thursday: I Am Not A Mindreader (And Neither Are You)




This is for all of the parents who think "We really don't need AAC at home, because I can tell what he wants to say" or "I can understand about half of her words, and when she combines them with gestures I get the main idea." 

This is for the teachers/staff who think "She's vocalizing so much! I don't want to encourage the device when she's trying to talk instead" and "He's so communicative---he'll grab our hands and point to the paint and that's a pretty clear way of saying 'let's paint', so we can leave the talker off to the side."

You are selling these kids short when you do that. You are predicting that they are trying to say something simple (let's paint) instead of something complicated (your hands can reach the paint but not mine-it's too high!). 

We are not mindreaders. This throwback post explores this point:



   

Wednesday, October 15, 2014

Getting Started with Meaningful Modeling

So you’ve got an AAC device and you’re ready to see the magic of communication unfold? 

Well, get ready to jump in and help with the unfolding, because this is going to require your participation. Look back at Monday’s post about aided language input, check out yesterday’s video clips of modeling in action, and get ready to jump in. (Or, to re-jump in, because modeling never stops. Once your child is speaking in 6 word sentences, you can model 7 word sentences. Or metaphors. Or alliteration. Or something. There’s always more.)

First things first: you have some work to do before you can start modeling.  You need to learn the language. I remember the first night we had Maya’s app: as soon as she was in bed I sat with in a tapped in and out of screens, trying to note where important words were.  Here are some tricks that might be helpful:

  • Read a children's book using your child's device. Choose something simple, substitute pronouns (he/she/it) for overly specific vocabulary that you may not have programmed yet.

  • Have a conversation with your spouse, a friend, or yourself, using only the device as your voice.
  • Look at any random thing in your line of sight and describe it using the device: what it is? what can you do with it? what are some adjectives that you could apply to it (color, texture, materials, attributes)?

This is a blue, hard chair. I can sit on the chair, and you can too. 
I can push on the chair and make it go.
She can sit on the chair and so can he, but not everyone together. 
It is a small chair, not a big one. I can step on the chair and climb up high. 
Can you step up? Be careful not to fall! 
I like the blue chair, but I love yellow chairs. What color do you like?

  • If you're a member of an online users group, see if other parents want to connect over Skype/Facetime and try to talk using only the device.

Now that you've prepped, you need to figure out what to model. 

How many words to model: If you read this post on the Speak for Yourself blog, you would have in mind that it's a good start to model one more word than the child is currently producing (sometimes I mix it up and throw in a few complete sentences---you know your user and you'll see what works best for them). 

Which words to model: Core words offer the most bang for the buck. There are only a few conversations that involve the word "rhinoceros" . . . but the words "go" "can" "make" "stop" "on" "off" "in" "out" . . . well, you probably use them everyday, many times, without even noticing. Ideally, you want to make sure you're modeling a nice mix of nouns, verbs, prepositions, etc. (Old school AAC focused a lot on making choices/requests from a field of nouns, and the verbs were shelved for too long.) All of that being said, if your child is rhinoceros obsessed, then teach it! And then, quickly, start teaching about how the rhinoceros can move or stop, is heavy, has four feet, etc.

Which types of speech to model: Besides thinking about the specific words you're modeling, think about the different ways that people use language. If you want to help model communication, you need to model all types of communication. Speech is used for a ton of different purposes. Imagine sitting with a child and a pumpkin (since fall is in the air)---here are some different types of language that can be modeled just about one pumpkin. 


Functions of Language
Examples

Labeling

“pumpkin”   “orange” “That is a pumpkin.”

Requesting

“Give me that” “Give me pumpkin” “For me”


Asking questions

 “What is that?”   “Is it heavy?” “Is it big?” “Can you pick it up?” “Can it move?”  “What can you tell me about that thing?” "Where could we look for pumpkins?" "When do you see pumpkins in the store?" "Do you know a holiday that has to do with pumpkins?"  "Who can eat a pumpkin?"

Answering questions

(answer any of the stuff above)

Getting someone’s attention

“Look! A pumpkin!”



Protesting

if the child isn’t interested in what you’re doing
“Don’t like this.” “No pumpkins!” “Hate pumpkin!” “Something different now.”


Commenting

“This pumpkin is so big!” “Pumpkins grow outside.”
“The pumpkin feels bumpy.” “I like this color.”



Teasing

“Can we cut it up and make a pumpkin pie?”
“This is my pumpkin!”
“I really like this blue pumpkin.”



Correcting

referring to the box directly above
“Not yours---mine!”
“No! Orange pumpkin!”

Bossing people around
Directing

Roll the pumpkin and have the child direct the activity:
“Go!” “Stop” “Go faster!” “Go slower!”


Negotiating/arguing

(in the activity above)
“No more game. All done.” “Not done. More now!”







Tattling

Tell the pumpkin not to roll. Tell the child that the pumpkin isn’t going to roll anymore. Roll the pumpkin and pretend that you didn’t see it happen (or have a puppet/doll push it and pretend you didn’t see)

“It went!” “More rolling!” “I saw it go!” “Naughty!” “Sneaky!” “Silly pumpkin!”

Talking about feelings

“I like the pumpkin” “The pumpkin makes me happy”

Talking about the past

“Last year we went to pick a pumpkin at the farm.”

Talking about the future

“Maybe we can go pick a pumpkin tomorrow.”

And that's not a comprehensive list of language functions, either! And it's just one silly pumpkin! Imagine all of the great stuff you could say about something that's actually cool!

At this point, you could be thinking Wait, I couldn't really say any of that stuff with our system. It's too hard to model novel sentences on, or We have a lot of specialized vocabulary but not a lot of core words, or We have a lot of nouns and requesting words but I don't think I've ever noticed the question words. Well then . . . it may be time to re-evaluate your system. If the words aren't there, or if they are there but in a way that you (as a fully literate adult without motor/access challenges) can't get to them easily, then this is not a fair long-term set-up for your child.

Hopefully you're thinking Wow! I'm really getting this! But understanding is easier than actually doing it. And that's true. You know what makes modeling easier? Planning. For some reason I just thought modeling for Maya would come naturally (which it did, a little, but certainly not to the extent that I'm discussing here). I attended the ISAAC conference in 2014 and was impressed by the amount of planning and structure that went into the AAC interventions that were presented and discussed. I realized that I should approach AAC teaching/learning the same way that I would approach any other type of teaching/learning (by planning and preparing ahead of time). 

Here are two resources that may help you to approach modeling with a bit of forethought: 

First, this brainstorming chart from the Speak for Yourself team lets you start simply---what's one thing that your child really loves---and helps you build from there. (It originally appeared here.)

Second, here's an empty copy of the chart I made above. If you're a planner, you can think about an activity (play-doh? reading a book? playing with toy cars? digging a hole outside?) and brainstorm different things that you could model. You can view and print it here.  

Remember, this is a marathon. All modeling is good modeling. Any time you use AAC to communicate, you are validating and supporting your child's use of AAC. The offerings here may help to boost your modeling game and help you target language in a more meaningful way, but don't waste one second feeling badly if you read this and thought "well, there's another thing I don't have time for." Maybe you don't have time today, but you can carve out time at some point this week to work on this (put it on your calendar). This adds up. This will make a difference.

Happy Modeling!



Tuesday, October 14, 2014

Take-A-Look Tuesday: Aided Language Input/Modeling

Yesterday I gave you some links and information about aided language input, today you can see it in action. Continuing the Take-A-Look Tuesday theme for #AACawareness month, here are some video clips worth watching about ALI!

Note: These are all YouTube hosted public listed videos. I don't own them (well, except for the two that have my kids in them) or have any affiliation with anyone involved in them.

This is a really solid, great overview to Aided Language Input. I love how it doesn't focus on requesting, but shows how to model comments, questions, and many other things that a child (or, really, any person) might want to say.




This video is about using a PODD book for communication, but the first three minutes demonstrate some great modeling and exploration that would be useful to an AAC communication partner on any type of system:




This clip shows modeling in a therapy session with a 2 year old who is new to AAC:




This video (of Maya and I) shows dual device modeling--when the AAC user has their device and the communication partner uses a second device to model. At home we use a mix of modeling on one device and dual device modeling:




This video shows modeling in action with an older student (longer sentences, questioning).

 

This video (of my kids) shows Will learning the word "drink" on his talker. There is modeling in the beginning and then again around 1:45 (and I think this shows the light, fun tone that home AAC use can/should have):




   

Hungry for more videos about modeling? Check out this Pinterest Board from the great Lauren Enders: AAC Video Example of Implementation/Aided Language Support.


 

Monday, October 13, 2014

More Resources Monday: Aided Language Input (Stimulation?) (Modeling?)

Once upon a time I spent months (slightly over a year, actually) searching desperately for an AAC system that could be used by my (very young) daughter immediately, yet grow with her into adulthood. It kept me awake at night. I spent all of my free time researching. I was completely consumed. And during this time an assistive tech specialist happened to say to me "Finding the system is the easy part . . . once you have it on the table in front of you  . . . that's when the real work begins."

I hated that I was drowning in "the easy part" . . . but he was right. You fight for a system, you get a system, and then you look at it and think, "Well then. So, um, here you go? Can't wait to hear all of the stuff you want to say! Hop to it!" The truth of the matter is simple, and I've heard the piano analogy used again and again to explain it to new AAC families/professionals: being given an AAC system doesn't make someone a proficient AAC user anymore than being given a piano makes someone a proficient pianist. There must be teaching, practice, and frequent use of the device/instrument.

The type of teaching that is, far and away, the most successful for AAC users is called Aided Language Input. No, it's called Aided Language Stimulation. No wait, it's called Modeling.  Actually those are just different terms for the same thing---and the main idea is simple: If you want someone to use an AAC device to communicate, you have to use the AAC device to communicate. If you want to help a user see how to locate words and build phrases, you must model how to locate words and build phrases.

modeling for my kids (I'd rather sit next to them while modeling, but there had just been a who's-sitting-in-mom's-lap seating battle. 2 kids + 3 talkers + 1 lap does not = success)


Think for a second about the way that adults model language for babies--we expect that they will speak, and so we speak to them so that they have hours and hours of input before they begin speaking back:
The typically developing child will have been exposed to oral language for approximately 4,380 waking hours by the time he begins speaking at about 18 months of age. 
Compare that to a child using AAC, who may only have modeling/teaching on the system during speech sessions (in this example, twice a week):
If someone is using a different symbol set and only has exposure to it two times a week, for 20 – 30 minutes each, it will take the alternate symbol user 84 years to have the same experience with his symbols that the typically developing child has with the spoken word in 18 months!!! -Jane Korsten 
Shocking, right? The first time I heard that Korsten quote (which I broke into two pieces above) I wanted to run home and start modeling constantly in an attempt to even the playing field.

Here are a few resources about modeling/ALI/AlgS* to get you started:


  • So now you know you should model, but how? Which words? How many words? This blog post from Speak for Yourself, Simon Says: Model One More Word, gives concrete guidance and examples as to how to model in a way that will both meet your child where he/she is and also help to push for longer utterances. 


Stay tuned tomorrow for Take-a-Look Tuesday, where I'm going to feature videos that show ALI in action!


*the abbreviation used for "aided language stimulation" is AlgS, so as to avoid confusion with amyotrophic lateral sclerosis (ALS).
 

Friday, October 10, 2014

#AACfamily Friday: Week Two: AAC out and about!

It's time to celebrate our AAC families---near and far, older and younger, using different systems and philosophies--and come together as a community!

AAC use isn't limited to people sitting at home, or sitting in the classroom---it happens everywhere! Any place that a speaking person might want to talk, an AAC user should have access to their device (hint: that's everywhere). Here are some photos sent in by AAC users and supporters out and about with their devices:

Daniel shopping with his mom, talking about "green" and "yellow" bananas using Speak for Yourself! (Frederick, MD)

Millie (2) using her iPad with Proloquo2Go in the car to talk about her breakfast! (Brisbane, Australia)

Hosea (4) watching his sister drive a go-cart (before his turn)! He's using an iPad running Speak for Yourself. (Florida)

Lily Grace (5) rocking her PODD book while riding a steam engine! (San Francisco)

Westin ordering balloons with help from Proloquo2Go!


Ham, 2.5,  telling her favorite joke, "Oh no. What happened?" with Speak for Yourself! Check out her mom's blog here!


Jess heading to work with Speak for Yourself! Check out her mom's blog here!

Mirabel (3) at Culvers (restaurant) patiently waiting for her ice cream! (Ohio) 

Dylan modeling his little brother Charlie's PODD book out and about! (Nottingham, UK)

Eva using Proloquo2Go at her fiddle lesson! (Saskatchewan, Canada)

 Motivational speaker Glenda Watson Hyatt uses the Proloquo4Text app on her iPad to rock the room at the InBound Conference in Boston, mid-September!

Her message: "This is your life. There are no dress rehearsals. Go out and live it!" Check out her website here

 Evie using her iPad with TouchChat to ask for a hot dog . . . 

And, success! (at Detriot's iconic Lafayette Coney Island)


Maya and her mom using Speak for Yourself while out to dinner! You're reading her mom's blog right now. (New York City)


 Jack and his AAC specialist, Mary-Louise Bertram! (Australia)


Jack accesses his customized PODD book via auditory scanning---and has written some amazing poetry! To read one of his pieces, follow this link and scroll down until just until the black box with the whale information!



 Jonas (7) using his PODD book in the air . . . 


and at the park! (France)

Elanor in her carseat with her ever-present talker, an iPad mini running Speak for Yourself! (Check out her mom's blog here.)

Cadence using her talker (Speak for Yourself) at the grocery store! (London, UK)

 Ordering ice cream with Proloquo2Go!


Yum!


Eva (5), using Talk Tablet on a walk! (France) 

Nik shopping at Target with his Accent 1000 (from PRC)! Check out his mom's blog here!

Nicole (25) using Proloquo2Go at her weekly bowling trip! (Nashville, TN)

 Lexy using AAC at the pumpkin patch . . . 


  and while choosing flowers to visit  . . .


at the local park!


Christopher (7) with his AAC device: an iPad mini running an extremely customized version of TouchChat (with 112 buttons per screen) while wading in the river at camp!


Eva (8), using the AACORN app, which is new to her, at the grocery store. (Saskatchewan, Canada)


Tia Sara using AAC picture cards at the mini zoo to talk about the animals that she is seeing. (Slovenia)


Ashlyn using Proloquo2Go on her school field trip to the pumpkin patch . . . 

and on the hayride!


 Felix and Speak for Yourself . . . 


 on a walk . . .

through the leaves!


 Campers using various systems at Camp ALEC, an AAC and literacy camp! (Philadelphia, PA)


 More information about the camp can be found here!






And a few from some dedicated AAC-loving SLPs:


"Heading out for an AAC consultant with a school team for a student we share. AAC device in tow!" from Cassandra of Vlinder Therapies

Angela of OMazing Kids has new vocabulary added to the Aacorn app for several pumpkin-themed books, with Mr. Pumpkin Head!

A cute and trendy strap made by a super crafty SLP, with more details here. 



And now for next week's theme: as we all know, AAC learning (and usage) doesn't happen alone. Giving an AAC device to a child doesn't make them an AAC user any more than giving a child a piano makes them a pianist. So, for next week, let's see AAC users (and their devices) with someone else: a parent, a sibling, a friend, a therapist, a cousin, a teacher, a pet----anyone! 

The more information you include, the more fun it is to see the pics (name of user, type of device, name/relationship of communication partner, location). Photos to be included must be emailed to me  at uncommonfeedback@gmail.com by Thursday night at 8pm (EST). Please email them there and don't message me or tag me on Facebook---it's too hard for my tired brain to keep track of all of them.

If you liked this week's #AACfamily photo post, check out last week's!