Procedures for Teaching C ommunication S kills

1. Procedures for Teaching Communication Skills

2. Instruction of Communication Skills • Communication is one of the most important and most difficult skill to teach students with severe disabilities • Successful Communication is a result of the integration and performance of cognitive, social, and motor skills. • See Communication Bill of Rights (see page 281) by the National Joint Committee for the Communication Needs of Persons with Severe Disabilities (1992) • Within the last decade important milestones have been achieved including: • a shift in belief that communication instruction is appropriate for all students • Focus on development of functional communication • Understanding of the importance of multimodal communication

3. Six tenets for communication • From the National Joint Committee for the Communication Needs of Persons with Severe Disabilities (page 282) • Communication is a social behavior • Appropriate communication functions enable productive participation in interactions with others • Communication acts can be produced in a variety of modes • Effective communication intervention must fully utilize naturally occurring interactive contexts • Service delivery must involve family members working collaboratively with a cadre of professionals and paraprofessionals • Effective interventions must modify the physical and social elements of environments to invite, accept, and respond to communicative acts. • The areas of knowledge that are essential to appropriate instruction in communication are: communication skill development and assessment, augmentative communication systems, instructional strategies, and generalization procedures.

4. Communication Skill Development Early Communication Development Pragmatics – the use of communication indexes with the social context. • Research on the development of prelinguistic communication skills has shown that these skills develop within the context of a social relationship, predictably, functioning in the relationship between the caregiver and the child. Consideration of the social context that communication exchange occurs in is essential to evaluation of communication skills. Intentionality – the deliberate pursuit of a goal ( child sends communicates a message to a listener and that listener will receive it and act on it). • Behavioral evidence and the use of behavioral criteria may signal intentionality Bates (1979) three stage model for describing development of communication and intentionality: • Prelocutionary: (birth – evidence of intentionality) – communication through gestures and utterances. Child has effect on listener without intending to. • Example: Interpretation by caregiver that baby’s crying means the baby wants to be held • Illocutionary: Child uses gestures and sounds to intentionally effect the listener • Example: child uses gestures and sounds to intentionally affect the listener • Locutionary: when language emerges and the child communicates with words • Example: child says calls for mom when they want their mother

5. Communication Skill Development • Bates framework offers distinctions between communicative stages but doesn’t fully explain the development of intentionality. • A child with disabilities may reach for a toy that is on a shelf to signal a request to a caregiver, but may also cry or shift their gaze during a play activity without intentionality.How would we distinguish whether they were at the prelocutionary or illocutionary stage? Wetherby and Prizant (1989) discuss intentionality occurring along a developmental continuum. In their model intentionality is developed from children who have no awareness of the goal to an ability send a message and then repair or change the form of their signal if their needs are not met.

6. Communicative Means and Functions • Wetherby and Prizant (1989) explain that sophistication in the means to express intentionality develops in the horizontal direction during the prelinguistic stage. • In learners with severe disabilities, means used for communicative functions can range from nonverbal, idiosyncratic behavior (eye poking, slapping) to a variety of conventional means (pointing, words) that are more easily understood. • Teachers can use information on the development of intentional communication and the description of communication functions to understand the communication behavior of students with sever disabilities who are in the prelinguistic or nonsymbolic stage of communication development. • This framework assists the teacher in analyzing the range of means (the form of communication) and functions (the reason for communicating) and the level of intentionality the student exhibits.

7. Assessment Issues • Before communication intervention can begin, the educator must determine the student’s current repertoire of communicative behavior. • It is essential to know: • What current communicative functions are exhibited by the learner • What means are used to express these functions • Under what conditions different communicative means and functions are exhibited • What level of intentionality is present in communication • Assessment of motor skills, sensory functioning, cognitive functioning, and receptive language comprehension.

8. The process for assessing the communication skills of students with severe disabilities involves an array of informal and nonstandardized procedures. • Direct assessment of skills in traditional skills checklist format • Interview procedures • Collection of communication sample Interviews can be an efficient way to gain information on student’s communication behavior in a variety of settings. (See table 11-1, page 285 for sample interview questions).

9. Wetherby and Prizant (1989) “communicative temptations procedure” where student is tempted into showing some elicit behavior to show intentionality. • Teachers must realize that students with severe disabilities may express communicative functions using means that are viewed as aberrant or problematic behavior. A student who has not developed a conventional signal for protest may engage in aggression or self-injury to communicate a signal for “no” or “stop” during an assessment. Methods for discerning these problematic behaviors are discussed in chapter 12.

10. Ecological Assessment • Used to collect information about the unique communicative demands and opportunities of the environments that the student will encounter. • This information will assist the interventionist in understanding the communicative needs of the student, what modes of communication may be needed, and how the learner currently functions in these situations.

11. Augmentative and Alternative Communication (AAC) • Augmentative systems involve the use of aids that supplement existing vocal communication skills; alternative systems are methods of communication that are sued by a person without vocal ability. • The many types of symbols, methods, techniques, and systems that can be sued for augmentative alternative communication can be classified as either gestural or graphic modes of communication. • Selection of augmentative or alternative systems depends in part on the student’s motor, cognitive, and sensory abilities. • Example: Students with vision impairments will need a communication system with enhanced visual symbols, tactile cues, or auditory feedback. Families must also be part of the process of selecting an appropriate system for their child. Their participation and ability to buy-in and participate with the communication system is crucial. Their input must be considered and they must be informed by special educators.

12. Augmentative and Alternative Communication • Gestural communication – ranges from the sue of natural gestures to indicate communicative functions to formal sign language systems. • Example: pointing, holding something out to show someone an object, handing someone an object, head nodding (yes), head shaking (no) Sign language and sign systems have been developed to offer nonverbal communicators a symbol set for communication. Example: American Sign Language (Ameslan), Signing Exact English, Ameri-Ind Ease of which signs are learned depends on several features of the sign language or system: Easiest to learn are those that: - take two hands - are symmetrical - are produced within communicators visual field - resemble the referents

13. Challenges for use of signed comm with students with disabilities include: • Majority of people in community are not trained in manual sign language and would have difficult time interpreting it • Production of sign language requires a level of manual dexterity that many individuals with severe disabilities to not have • Signs are dynamic displays of language, and therefore learner may be unable to maintain a mental representation of the communication utterance when attempting to form a sign symbol Although sign language is frequently taught as an augmentative system, few studies have shown that learners with severe disabilities acquire generalized sign language systems that involve more than one- or two-word utterances or generalization.

14. Aided Systems • Include a range of alternatives, from the use of objects and pictures to communicate to complex electronic communication devices. • When selecting an aided communication system, the educator must consider: • Whether the student is capable of using a representation communication system • The type of symbols to be used • The format in which the symbols are displayed • The method the learner uses to select the symbol for communication expression Symbol selection: - Real objects or tangible symbols – (student uses a piece of a milk carton to request for milk) - Representations of objects, activities, places, and expressions – photographs, product logos, and line drawings (Blissysymbols – a type of pictographic system that has approximately 100 symbols representing general concepts or ideas)

15. Aided Systems • Symbol display and organization: • There are several ways that communication symbols can be displayed, organized, and carried by the communicator: • Communication wallet • Symbols on laminated cards, attached to a ring • Communication books (more symbols, less portable) • Communication boards Communicating with symbols • Students must be able to gain the attention of people they want to communicate with (vocalizing, pressing a buzzer, pressing icon that activates message) • They must be able to indicate their selection of a symbol

16. Modes for selecting symbols direct selection – learner points to a symbol scanning – learner indicates a selection by signaling to the listener that the desired symbol has been reached (can be used with electronic devices) In last 10 years, cost of electronic devices has dropped and the practical applications have increased. There has been an increase in the development of electronic aids for communication purposes. The advantages of electronic devices include the capacity to produce speech, visual displays, and written output; the capacity to display messages beyond the learners capability ( e.g. the symbol for play results in the phrase “can I play with you?); the capability to store messages; and the ease with which scanning can be used with the system.

17. Considerations To Guide Symbol Selection Process (Quist & Lloyd, 1997) In selecting a devices or communication systems, several Parsimony – device should be simple as possible and still meet the user’s communication and goals Minimal Learning – system or device should be immediately usable by the student with minimal instruction Minimal energy – device should require minimal physical effort and not result in student fatigue Minimal interference – device must not interfere with or distract the student from ongoing activity and participation in daily activities Best fit – device should fit the personality and preferences of the student Practicality and use – device should be easy to use in all environments, affordable, and easy to maintain

18. Selecting an Alternative or Augmentative Communication Mode • First step in developing an augmentative or alternative communication system is to conduct an ecological analysis in an effort to determine the environments, activities, and situations that demand communicative behavior from the learner.

19. Considerations for Alternative/Aided Communication Devices • Portability • Cost • Durability • Adaptability (ability to grow with the person) • Ease with which the person can be understood by others/audience/secondary users • Interference with ongoing activities • Physical/sensory/cognitive ability of the person for whom it is intended

20. Hierarchy of communication needs (in increasing degrees of complexity) • Accept/Reject – the most basic • Greeting – Hi/Bye • Inform – I am hungry • Describe something (I was sitting over there and he came over and kicked me!) • Maintain conversation • Redirect (back to the topic, get off the topic)