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AAC Implementation

Presented by:

Justin Sims, MA.

AT Specialist LA-AEM

Adjunct LSU Faculty, COMD Department

Justin@ssdla-aem.org

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This is a simulation of a team implementing AAC

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Main goal: Understanding best practices to successfully implement AAC in all environments with your TEAM

  1. Preemptively Prepare (training)
    1. Misconceptions
    2. Core Vocabulary & Grid Size
    3. Symbol Sets
  2. Modeling at School & Home
    • Video Examples
    • Communication Partner Training
    • Engineering the Environment
  3. Mangining the devices and measuring progress

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AAC requires these beliefs:

  1. AAC promotes speech instead of inhibiting speech
  2. AAC Impacts children 3 years and younger
  3. AAC has no prerequisite skills including intent to communication (motor planning)

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AAC requires these beliefs:

  • AAC promotes speech instead of inhibiting speech
  • AAC Impacts children 3 years and younger
  • AAC has no prerequisite skills including intent to communication (motor planning)
  • Core Vocabulary is essential to communicate with a device.
  • We all learn communication by being submerged in language rich environments

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“The Power of Core Vocabulary”

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Project Core

  • http://www.project-core.com/
    • A great tool that assist in the training of AAC implementation from all levels (misconceptions, core vocabulary, modeling, and more..)
    • Has modules for self/team training online
    • Has resources to train teams in person
  • A few examples..

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We are Submerged into language before school age.

  • From ages of 1 ½ to 6 years children can learn up to 13 words per day (Miller and Gildea, 1887)
  • Vocabulary Size (Smith, 1973, McNacnamara 1982)
    • 2 years - 500 Words
    • 3 years - 1000 Words
    • 5 years - 3000 Words
  • This is from hearing vocabulary and observing natural consequences in the environment
    • Not the same as studying for a vocabulary quiz in grade school

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Importance of receptive communication with AAC

  • “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.”
  • “If someone is using a 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, SLP, (2011) QIAT Listserv 4th April

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84 Years

18 Months

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How many core words to start with (grid size)?

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How many core words to start with (grid size)?

  • In most cases 64 to 84 word grid on first page
    • Access to hundreds of words on subsequent pages
    • Some professionals (Linda Burkhart) will tell you 4k+ minimum

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What if…….

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_________

_____ ___ ____ _____ ____ ____ ___ ___ ________

____ a _____ ____ ____ ____ ___ a ____ _____

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___________

_____ the ____ _____ ____ ____ ___ ___ the____

not a _____ ____ ____ not ___ a ____ _____

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First Grade

_____the _____ before ______ when all______ the ____

Not a _____ was ____ not even a _____

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Second Grade

_____The night before ________ when all through the house

Not a _____ was ____ not even a mouse

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…. Several years later

'Twas the night before Christmas, when all thro' the house

Not a creature was stirring, not even a mouse;

The stockings were hung by the chimney with care,

In hopes that St. Nicholas soon would be there;

The children were nestled all snug in their beds,

While visions of sugar plums danced in their heads

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EVERYONE needs the least restrictive access to See, Hear, and speak in order to learn language

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You can hide a few things…...

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You can use core boards that build

You can use midtech with levels

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Stay “Snug” spontaneous novel utterance generation

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Two types of approaches

  1. You want your child/student to speak
  2. You want to hear what your child/student has to say

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Make sure you get to a device that will “dynamically” grow with the student, or find multiple aac systems if there are other difficulties to accessing a dynamic device.

Low-tech

Communication Boards

Mid-tech

Static Display Devices (1 to 128 locations with or without levels)

High-tech

Dynamic Display Device (simple to complex)

Alternative Augmentative Communication

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Pragmatic Organizational Dynamic Display

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Problem: Which symbolset ?!

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How long to learn a 2nd language (communication partners).

  • It can be difficult for adults to learn a 2nd language (expectations and time)
  • It may take several hours a day for consistently over a month to reach a limited basic fluency
  • If the language is not maintained in daily practice then many adults, including children, may regress

"MIT Scientists prove adults learn language to fluency nearly ...." https://medium.com/@chacon/mit-scientists-prove-adults-learn-language-to-fluency-nearly-as-well-as-children-1de888d1d45f. Accessed 26 Oct. 2020.

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Aided Language Stimulation

“Aided Language Stimulation is the process of modelling Augmentative and Alternative Communication (AAC) language in everyday settings. The communication partner talks to the person while also pointing/selecting keywords on the person’s AAC system. ALS helps develop the person’s understanding of language and symbols. ALS also enhances the person’s expressive language skills.”

Aided Language Stimulation Strategies - Assistive Technology ...." https://at-aust.org/assets/EC_Infosheet-ALS_Strategies.pdf. Accessed 23 Oct. 2020.

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Model, play, and focus on activity/communicator

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Model before asking questions with that vocab

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Teach reciprocate child’s vocab with witn natural consequences

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Plan Activities for AAC opportunities

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Avoid too many questions!

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Avoid obvious questions.

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Prompting hierarchy after targeted words have already been sufficiently modeled.

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Train ALL communication partners

  • Learn the system(s) the student uses
  • Turn taking between oral and non-oral communicators (model in classroom)
  • Teach staff and peers to be good listeners
    • Respond to communication attempts
    • Maintain focus on the communicator (not the technology or another task)
      • Don’t say use the device, or type this
    • Turn taking and seeking clarification
    • Minimal interrupting
    • Confirm communication
    • AAC Do’s and Don’ts

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Frustration

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Avoid Multiple Choice-itus

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Always model a step above the student’s ability

  • More (one word)
  • Want More (two word phrase)
  • I Want more (3 word phrase)
  • I want more of that (3 word phrase plus)

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Engineering the Environment

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Peer Pressure

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You can START with light scripting to get going

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Top scripts for Home with Core

  • Get up/down
  • Go
  • Not go
  • Go eat
  • Not
  • Put on
  • Take off
  • Where is
  • Get that
  • Open it
  • Need more
  • Want more
  • Go play
  • Not play on/in
  • Stop it
  • Turn on/off
  • Make more
  • Make that
  • Turn up/Down
  • Watch
  • Play more

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Top scripts for modeling at school with Core

  • Put Up (books, materials, centers...etc)
  • Look (redirection/grab attention)
  • Need to finish (task completion)
  • Stop it (fussing)
  • Go get (getting materials)
  • Go eat (breakfast/lunch)
  • Go play (recess)
  • Put it here (clean up/ fill in blank)
  • Need help (requesting assistance)
  • More here (coloring/writing)
  • Make it (projects)
  • Give me/it (turning in/sharing)
  • Get down (transition to floor)
  • Have work (assignments)
  • I want (Directions)
  • Not it

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Include a Variety of Pragmatic Functions

Communication Tasks:

  • Greets friends and teachers
  • Makes choices
  • Reads stories and ask questions about a story
  • Comments on and/or directs an activity
  • Initiates conversation with peers and teachers
  • Asks for help or clarification
  • Asks questions
  • Describes pictures, objects, movies, etc.
  • Stays on a topic
  • Repairs miscommunication

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AssistiveWare Core Word Classroom

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Center for AAC and Autism

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Make a Plan to manage the device

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Low Tech Back Up Required!

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iPad instructions for screen shots

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Restrictions/Screentime/Lock Options

Your tablet when a kid gets into the settings….

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Interaction and Access

Stops repeating/multiple presses:

  • Lamp words for life
  • Proloquo2go
  • TouchChat
  • Compass
  • Proloquo4text

Select on release:

  • Lamp words for life
  • Proloquo2go
  • TouchChat
  • Compass

Hold duration:

  • Lamp words for life
  • Proloquo2go
  • TouchChat
  • Compass

Switch Access:

  • Proloquo2go
  • Compass

Auto Clear Message:

  • Lamp words for life
  • Proloquo2go
  • TouchChat
  • Compass

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Keyguards

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So advance they were beyond the scope of this training (contact for consults)

  • AAC users with Hearing Loss
  • AAC users with visual impairment
  • AAC users with physical impairment
  • Any combination of the above

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Get toolkit of AAC assessment tools

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Transition/Implementation Plan

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