Evidence-Based Language Supports for Children Using AAC: Increasing Expressive Communication

1. Evidence-Based Language Supports for Children Using AAC: Increasing Expressive Communication Cathy Binger, Ph.D., CCC-SLP University of New Mexico

3. BACKGROUND Risks to Development for Children who use AAC At risk in all aspects of development, including language (e.g., Lund, 2001). Contributing factors (Romski, Sevcik, & Adamson, 1997) intrinsic factors e.g., cognitive and motor speech impairments extrinsic factors e.g., lack of communication opportunities

4. BACKGROUND Communication Characteristics of Children who use AAC These children often (e.g., Light, Collier, & Parnes, 1985): are passive communicators initiate few interactions respond infrequently produce a limited number of communicative functions use restricted linguistic forms

5. BACKGROUND Communication Characteristics of Communication Partners Partners often (e.g., Light, Collier, & Parnes, 1985): Take the majority of conversational turns Provide few opportunities for communication Ask predominantly Yes/No questions Interrupt individuals using AAC Focus on the technology, instead of the individual

6. Limited Communication

7. BACKGROUND Language Intervention Techniques To Increase Early Expressive Communication Skills Aided AAC Modeling Expectant Delay Open-Ended Question Asking Increased Responsivity e.g., Binger (2004); Kent-Walsh (2003)

8. BACKGROUND Using these techniques increases: Communicative Turntaking Communicative Functions Length of Utterances Semantic Diversity Syntactic Complexity e.g., Binger (2004); Kent-Walsh (2003)

9. Increased Communication

10. Aided AAC Modeling Purpose To provide functional models of effective AAC system use. Method The communication partner: Selects aided symbols while labeling the symbols orally if light tech AAC is used the speech synthesizer provides the label if a voice output system is used.

11. Without Aided AAC Modeling

12. With Aided AAC Modeling

13. Expectant Delay Purpose To provide communication opportunities. Method The communication partner: Maintains eye contact while: Maintaining an expectant facial expression Providing increased conversational pause time (Light & Binger, 1998)

14. Without Expectant Delay

15. With Expectant Delay

16. Asking Open-Ended Questions Purpose To prompt higher-content communicative turns (e.g., Basil, 1992; Bruno & Dribbon, 1998). Method Replace yes/no questions with open-ended questions

17. Without Open-Ended Questions

18. With Open-Ended Questions

19. Increased Responsivity Purpose To reinforce communicative attempts & expand utterances. Method Provide appropriate and consistent responses to communicative intent of messages.

20. Limited Responsivity

21. Increased Responsivity

22. Putting It All Together Can assemble the skills within an interaction strategy for specific activities. Storybook Reading Activities Classroom Activities Play Activities Activities of Daily Living Can teach communication partners to implement such strategies. Kent-Walsh & McNaughton (2005)

23. Storybook Reading Context

25. Storybook Example

26. WRAP-UP Implementing these evidence-based skills results in: Communication Partners Become less dominating Provide increased opportunities & support for communication Individuals who use AAC increase Communicative Turntaking Communicative Functions Length of Utterances Semantic Diversity Syntactic Complexity * Children may begin using skills that they already possess or acquire more complex linguistic structures

27. WRAP-UP Clinical Implications Instruction involves very little training time Instruction yields very positive changes in children Instruction yields high participant satisfaction

28. Acknowledgements Funding Support Penn State College of Health and Human Development Bloorview MacMillan Children’s Center; Toronto, ON SERTOMA Foundation American Speech-Language-Hearing Foundation UCF College of Health and Public Affairs & Dept. of CMDIS UNM Dept. of Speech & Hearing Sciences UCF Academy for Teaching, Learning and Leadership UCF Center for Autism and Related Disabilities (CARD) Participants

29. QUESTIONS

30. Contact Information Cathy Binger Department of Speech and Hearing Sciences University of New Mexico E-mail: cbinger@unm.edu Phone: 505-263-0036 Jennifer Kent-Walsh Department of Communicative Disorders FAAST Atlantic Region AT Demonstration Center University of Central Florida E-mail: jkent@mail.ucf.edu Office Phone: 407-823-4800 FAAST Clinic Phone: 407-xxx-xxxx