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AUTISM PROGRAMS

UNIVERSITY OF NEW MEXICO

CENTER FOR DEVELOPMENT AND DISABILITY

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Meeting Communication Needs:

AAC Part 1

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Meeting Communication Needs:

AAC Part 1

AUTISM PROGRAMS

UNIVERSITY OF NEW MEXICO

CENTER FOR DEVELOPMENT AND DISABILITY

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A Message from NMPED

  • “Evidence-based interventions for individuals with ASD are not universal. Although these are evidenced based interventions, they should be individualized for that particular student. In the education setting, the IEP team will develop the plan for that student.  The IEP team shall review an IEP at least on an annual basis.”

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11 Autism Considerations

  • 1. Extended Educational Programming - Extended School Year (ESY) services or programs offered when school is not in session and/or the extension of the school day. 
  • 2. Daily Schedules reflecting minimal unstructured time and active engagement in learning activities - Developing a schedule dependent on the students individual functioning including short blocks of time or the use of more organized arrangements during unstructured times. 
  • 3. In-home and Community-Based Training or viable alternatives that assist the student with acquisition of social/behavioral skills - Teaching in “real world” environment where social/behavioral skills are needed. 
  • 4. Positive Behavior Support Strategies - Modifying environments to help students learn new and appropriate behaviors and the prevention of problem behaviors through Behavior Intervention Plan. 
  • 5. Futures Planning (beginning at any age) - Having an end goal in mind and in each grade level build skills to reach long-term goals.

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  • 6. Parent/Family Training and Support - Providing training and support by personnel with experience in ASD. 
  • 7. Staff-to-Student Ratio - Providing the number of staff members needed in classroom and out of the classroom to provide appropriate identified activities that are needed to achieve social/behavioral progress at the student’s developmental and learning level. 
  • 8. Communication Interventions - Including language forms and functions that enhance effective communication across settings such as assistive technology. 
  • 9. Social Skills Supports - Providing strategies based on social skills assessment/curriculum and provided across settings.
  • 10. Professional Educator/Staff Support – Ensuring staff have general training about autism and strategies to implement an IEP for students with ASD. 
  • 11. Teaching Strategies based on peer-reviewed, and/or research based practices - Considering various teaching strategies, visual supports, augmentative communication, or social skills training.

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https://webnew.ped.state.nm.us/wp-content/uploads/2018/01/Autism-Spectrum-Disorders-Considerations-Definitions.pdf

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Want More Info?

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Objectives

  • Participants will be able to:

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  1. Understand what AAC is by:
    • breaking down the acronym
    • becoming familiar with different types of AAC
  2. Understanding how to introduce, teach, and support AAC users
  3. Identify ways to increase use of AAC in a variety of settings

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Center for Development and Disability

  • University of New Mexico Hospitals
  • Department of Pediatrics

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First Tell Us…

  • What AAC do you interact with in your day to day life?
  • What general questions do you have about AAC?
  • Have you interacted with anyone who uses AAC as their main form of communication?

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AAC Visualized

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What is Augmentative and Alternative Communication (AAC)?

  • Augmentative and Alternative Communication (AAC) means any form of communication other than speech.

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    • Augmentative: to add or support a person’s speech (ASHA, 2023)
    • Alternative: modality other than speech
    • Communication: exchanging of information

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What is Augmentative and Alternative Communication (AAC)?

  • This can look like a variety of modalities:

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    • Low tech:
      • gestures
      • non-verbal cues
      • writing
      • pointing to words, pictures, photos

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    • High tech
      • App on iPad or tablet
      • Speech generated devices

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Effectiveness of AAC

  • Device gives an immediate output
    • Can be rewarding for user to hear, increasing overall motivation
  • Aids in understanding how symbols and spoken words are connected
  • Experimenting with sounds and words is a part of language development

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Where to start

  • Connect with SLP
  • IEP team and goals within IEP to support language acquisition using AAC
  • Locate training and support
  • Does your team have access to a ACC evaluation?
  • Is there a certain program that would benefit students needs?
  • Do I have the equipment needed?
    • Can insurance support?
    • Can it be provided by the school?

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Who can use AAC?

  • Anyone! We already use it daily.
  • Anyone whose needs may not be met by vocal speech alone
    • Individuals who are non-speaking
  • Autistic Community
    • 25% of the community is non-vocal or “minimally verbal”
  • Deaf Community
    • Signed languages are AAC
    • About 1 million individuals in the U.S. use ASL as primary language

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Who can use AAC?

  • Individuals identified with a disability
    • Developmental Delays
    • Autism Spectrum Disorder
    • Apraxia & dyspraxia
    • Traumatic Brain Injury
  • Individuals diagnosed with degenerative diseases
  • Individuals identified with a speech language impairment (SLI)
  • d/Deaf or hard of hearing individuals

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Who can support individuals using AAC?

  • Speech Language Pathologists (SLP)
  • Occupational Therapists (OT)
  • Applied Behavior Analysis (ABA) professionals
  • Teachers/School Staff
  • Daycare Staff
  • Parents/Caregivers
  • Employers/Colleagues
  • EVERYONE!

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Importance of Collaboration

  • Who is part of the team and what is their role?
    • AAC User
      • Knows what they want to say-provide opportunities for them to lead
    • Family Members
      • Experts on the individual, modeling and reinforcing use of AAC
    • SLP
      • Conducting assessments, teaching AAC, and coaching
    • Teacher/Classroom Staff
      • Modeling and creating a classroom to support AAC use
    • ABA provider
      • In collaboration with SLP, develop goals to increase use of AAC

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AAC Myths

  • Introducing AAC means giving up on vocal speech
    • Per research, 89% of participants who use AAC improve their speech skills
  • Bilingual families should choose only one language to use with the AAC user
    • Per research, bilingual children can readily distinguish two languages and show no evidence of confusion
  • AAC is only for non-vocal individuals
  • AAC has prerequisite skills

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Introducing AAC

  • Phase 1
    • Teaching (select one of the two options)
      • WOW
      • ACE
  • Phase 2
    • Teaching Plus:
      • WOW + Pause
      • ACE + Pause
  • Phase 3
    • Independent Communication

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Phase 1: WOW (word of the week)

Goal

  • Teach the concept of common words

Implementation

  1. Choose one core word each week to model throughout the day in a variety of settings/situations
  2. Aim for 100 repetitions each day

Tips & Tricks

  • Speak in full sentences
  • Only model the selected core word on AAC
  • “point and say”

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Phase 1: ACE (All Communication Expansion: Introducing Communication)

Goal

  • Teach the versatility of communication

Implementation

  1. Choose one activity each day
  2. Activity must have opportunities for full range of communication
  3. Model using AAC for all communication

Tips & Tricks

  • Aim for 80/20 (core/fringe)
  • Prioritize core words
  • Aids in building your fluency

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Phase 2: WOW + Pause

Goal

  • Engage their engagement in communication

Implementation

  1. Model word of the week then pause
  2. If they use the AAC independently deliver reinforcement by repeating word/sign/etc.
  3. If they don’t independently use AAC, continue to model

Tips & Tricks

  • Use with individuals who start showing interest in their AAC
  • Be patient and flexible!

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Phase 2: ACE + Pause

Goal

  • Encourage their engagement in expanded communication

Implementation

  1. Model AAC
  2. Create a communication opportunity
  3. Pause-if they use AAC, reinforce, if not continue to model

Tips & Tricks

  • Use when individual has shown interest/copying modeled communication
  • Follow individual’s lead
  • Use in activities that have multiple parts/steps and are of high interest to the individual

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Tips and Tricks for Introduction of AAC

  • Model More
    • “Point & say” key/core words
    • Repetition is key
    • Aids in you becoming more fluent in AAC
    • Collaboration across settings is important

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  • Use AAC to teach AAC
    • Use AAC to talk to individual
    • Fade this as individual becomes more fluent

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Tips and Tricks for Introduction of AAC

  • Choose Individualized Targets
    • In collaboration with SLP

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    • Fringe words vs. Core words

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    • Maintain consistent location of words in AAC devices

    • Classroom application:

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      • Focus on one core word at a time
      • Visual supports of sequences

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Tips and Tricks for Introduction of AAC

  • Embody Communication Partner Etiquette
    • Allow processing and response time

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    • Respect personal space

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    • Use open-ended questions

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    • Tone of voice stays the same as it is with any communication partner

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    • Be flexible with responses after modeling

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Resources

  • UNM CDD Online Training Resources

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References:

  1. Blischak, D., Lombardino, L., & Dyson, A., (2003). Use of speech-generating devices: In support of natural speech. Augmentative and Alternative Communication, 19, 29-35. doi: 10.1080/0743461032000056478
  2. Cooper J.O, Heron T.E, Heward W.L. Applied behavior analysis (2nd ed.) Upper Saddle River, NJ: Pearson; 2007.
  3. Drysdale, H., van der Meer, L., & Kagohara, D. (2015). Children with autism spectrum disorder from bilingual families: a systematic review. Journal of Autism and Developmental Disorders, 2, 26-38.
  4. Gevarter, C., O’Reilly, M.F., Kuhn, M., Mills, K., Ferguson, R., Watkins, L., Sigafoos, J., Lang, R., Rojeski, L., Lancioni, G.E. (2016). Increasing the vocalizations of individual with autism during intervention with a speech-generating device. Journal of Applied Behavior Analysis, 49(1), 17-33.
  5. van Diepen, M., & Bedoyan, J. (2022). AAC visualized: A visual guide to augmentative and alternative communication.

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Center for Development and Disability:

https://hsc.unm.edu/cdd/

CDD Library:

https://unmhealth.org/services/development-disabilities/programs/other-disability-resources/information-network/library.html

CDD Information Network:

https://unmhealth.org/services/development-disabilities/programs/other-disability-resources/information-network/

505-272-8549

Patrick Blevins, MA

BCBA, AODD

prblevins@unmmg.org

CDD Autism Portal: https://cdd.health.unm.edu/autismportal/

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