Building Successful AAC Outcomes: Language Goals and Communication Partner Instruction

1. Building Successful AAC Outcomes: Language Goals and Communication Partner Instruction Cathy Binger, Ph.D., CCC-SLP University of New Mexico ArSHA 2013

2. Overview ArSHA Binger 2013

3. Role of AAC in Communication ArSHA Binger 2013

4. Role of AAC in Communication • AAC is a TOOL • GOAL = Improved daily life communication • TOOL = AAC • GOAL ≠ Using AAC • AAC is about COMMUNICATION ArSHA Binger 2013

5. 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

6. Role of AAC in Communication • AAC is much less intimidating when viewed this way! ArSHA Binger 2013

7. Language Goals for Children who use AAC ArSHA Binger 2013

8. Language Goals for Children who use AAC Our research has focused on: ArSHA Binger 2013

9. 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., Do NOT use the PLS: Requires verbal output ArSHA Binger 2013

10. 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? ArSHA Binger 2013

11. Receptive-Expressive Gaps • Even if there is a big gap between chronological age and receptive age • You may be underestimating expressive capability • Many children simply lack: • There are (many) exceptions, of course • Low level symbolism; pre-symbolic communicators ArSHA Binger 2013

12. 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. ArSHA Binger 2013

13. Environmental Inventory Example • Provide the person using AAC with this same vocabulary ArSHA Binger 2013

14. Additional Techniques • Aided AAC Modeling • When 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 & activities • IEP goals, curriculum, daily/classroom activities ArSHA Binger 2013

15. Example Goals: Pragmatics • Increase turn-taking ArSHA Binger 2013

16. Pragmatic Goals, con’t Ask partner-focused questions ArSHA Binger 2013

17. Example Goals: Semantics Increase expressive vocabulary ArSHA Binger 2013

18. Example Goals: Syntax • Increase sentence length ArSHA Binger 2013

19. Facilitating Syntax Examples of Page-Based Communication Boards ArSHA Binger 2013

20. 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 ArSHA Binger 2013

21. More Complex Grid • This one is for a storybook ArSHA Binger 2013

22. Another Moderately Complex Grid • This one is for a 4 year old who loves to play with dolls ArSHA Binger 2013

23. Picture WordPowerTM Grid • A more complex grid for someone learning to spell ArSHA Binger 2013

24. Case Studies Providing Communication Opportunities ArSHA Binger 2013

25. Providing Communication Opportunities • Let’s start by looking at two videos • Notice differences with • What the teacher is doing • What the child is doing ArSHA Binger 2013

26. What’s Different in the 2nd Video? ArSHA Binger 2013

27. Necessary but not Sufficient Conditions • Even in the first video, we had • Identified motivating contexts for communication • Developed appropriate communication boards • Selected appropriate vocabulary • Organized vocabulary appropriately • These steps are necessary but not sufficient for communicative success • Communication partners must change how they interact with AAC clients ArSHA Binger 2013

28. What is “Timmy” Doing and Not Doing, Communication-Wise? • Timmy is doing a lot pragmatically • Taking communicative turns • Pointing to what he wants • Using gestures to communicate • Answering questions • Vocalizing • Timmy is not • Using words to communicate ArSHA Binger 2013

29. 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! ArSHA Binger 2013

30. Differences between the 1stand Last 2 Videos ArSHA Binger 2013

31. Lessons from Timmy • Don’t hold your clients back ArSHA Binger 2013

32. Ray’s Choice Book & Schedule Board ArSHA Binger 2013

33. Lessons from Ray ArSHA Binger 2013

34. Providing Communication Opportunities: Summary • Multiple steps are involved in creating meaningful communication opportunities ArSHA Binger 2013