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Creating Communication Environments. An Overview. Learner Outcomes. Understand the foundations of functional and interactive communication Identify target activities and strategies for eliciting active participation by student(s)

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learner outcomes
Learner Outcomes
  • Understand the foundations of functional and interactive communication
  • Identify target activities and strategies for eliciting active participation by student(s)
  • Select communication opportunities that are natural and appropriate
  • Arrange the environment to promote communication
  • Identify the steps in a “least to most” prompt hierarchy
agenda
Agenda
  • Background of “Creating Communication Environments” (CCE)
  • Purposes of Communication
  • The Three Main Ingredients of Creating a Communication Environment
    • Activity
    • Environment
    • Partner
  • The Prompt Hierarchy
  • How Can This Be Useful for YOU?
background information
Background Information
  • CCE is based on ECT (Environmental Communication Teaching) - developed by Dr. George Karlan at Purdue University
  • Developed for a classroom TEAM
  • Emphasis on eliciting communication within natural environments
  • Originally developed as a 5-day training program for school-age children who use or need AAC
  • Replicated throughout the country for children and students of all ages & disabilities (CCE in Wisconsin since 1999)
everyone communicates
Crying

Eye contact

Sounds

Words

Pointing

Falling asleep

Screaming

Communication boards

Picture exchange system

Voice output systems

Gestures/signing

Hair-pulling

Everyone Communicates…
  • Silence
communication purposes
Communication Purposes
  • Expressing Wants and Needs

*Once desired action or object is achieved, communication ends

  • Social Interactions including Social Etiquette

*Social vocabulary is difficult to provide, but vital for social acceptance

      • Greetings, Conclusions, “manners”, etc

.

Exchanging Information

* Starts as “joint attention” then develops into more complex interchanges with content or topic specific vocabulary

Janice Light 1988, 1997, 2005

slide7

Changing Purposes of Communication

Infancy

Secondary

Elementary

Sharing Information

Sharing Information

WANTS

&

NEEDS

Sharing Information

Social Interactions & etiquette

Social Interactions & etiquette

WANTS

&

NEEDS

Social Interactions & etiquette

WANTS

&

NEEDS

The importance of different communication purposes changes over our lifetime

J. Cumley, 2001

Based on J. Light, 1988, 1997, 2005

slide8

If we only have to think about encouraging our students to communicate for three different purposes, why is it so HARD…..what can make it easier?

aac augmentative alternative communication
AAC Augmentative/Alternative Communication

*refers to the ways (other than speech) that are used to send a message from one person to another (ASHA, 2005)

Examples

  • Communication boards/books/picture symbols
  • Speech Generating Devices (SGDs)
  • Picture Exchange Communication System (PECS)
  • Morse Code
  • Eye Gaze
  • Picture Schedules
slide10

AAC can be a vehicle for developing:expressive languagereceptive languageliteracycontrol over the environmentcommunication initiation

aac is not
AAC is not….

A last resort

“Giving up” on speech

Only for those of a certain IQ or Age

Only the job of the speech-language pathologist

myths and misconceptions young children with ccn complex communication needs
Myths and Misconceptions: Young Children with CCN (Complex Communication Needs)

Myth and Misconceptions

AAC hinders or stops further speech development

The Evidence

AAC approaches (signs, picture symbols, VOCAs*) do NOT hinder speech development. In fact, speech often increases during AAC treatment approaches

*VOCA= Voice Output Communication Aid

From: Augmentative Communication News, Volume 18, Number 2, June, 2006

myths and misconceptions young children with ccn complex communication needs1
Myths and Misconceptions: Young Children with CCN (Complex Communication Needs)

Myth and Misconceptions

There is a representational hierarchy of symbols from objects to written words

The Evidence

Children can learn to understand and use a variety of symbols at a very young age (e.g., sign language) through repeated exposure to the symbol and its referent in natural contexts

From: Augmentative Communication News, Volume 18, Number 2, June, 2006

myths and misconceptions young children with ccn complex communication needs2
Myths and Misconceptions: Young Children with CCN (Complex Communication Needs)

Myth and Misconceptions

Children must have certain skills to benefit from AAC (e.g., be at a certain age, have a particular cognitive or linguistic level, etc.)

The Evidence

There are NO prerequisites for communication. AAC focuses on all aspects of communication and communication begins at birth. AAC is an appropriate intervention approach for anyone with CCN.

From: Augmentative Communication News, Volume 18, Number 2, June, 2006

myths and misconceptions young children with ccn complex communication needs3
Myths and Misconceptions: Young Children with CCN (Complex Communication Needs)

Myth and Misconceptions

AAC is a last resort and means professionals are “giving up” on speech

The Evidence

The “Wait and See approach” is not an effective way for teams (e.g., speech-language pathologists, teachers, paraprofessionals, parents to develop communicative competence)

From: Augmentative Communication News, Volume 18, Number 2, June, 2006

using aac effectively
Using AAC effectively

Communication partners must model AAC use

Use of a penlight or finger on paper displays (aided language stimulation)

Sit next to individual with device to facilitate modeling

Use it as both a receptive and expressive tool

Be natural-focus on communication, not the device/board

AAC must be engineered into the environment

Displays mounted around the room/school/home

ACCESS to communication wherever student “is”

Pool

Playground

Home

Out shopping

Bathtub

School or instructional settings

when designing aac overlays be sure to include
When designing AAC overlays, be sure to include...

Vocabulary that reflects all 4 categories

Wants & Needs

Exchanging Information

Social Closeness

Social Etiquette

Use a communication board to talk to each other. Does it contain the 4 purposes of communication?

slide18
AAC:
  • Establishes a means of communication
  • Provides opportunity for social interaction
  • Promotes receptive communication
  • Encourages expressive communication
  • Decreases frustration
  • Provides opportunity for initiation
think about your students who are struggling to communicate effectively

Think about YOUR students who are struggling to communicate effectively…

What are some characteristics of their communication?

common characteristics of students using aac
Common Characteristics of Students Using AAC
  • Rarely initiate interactions
  • Usual form of communication is NOT using a communication device
  • Gestural responses (head nods) to yes/no questions main form of communicating
  • May use “challenging” behaviors to communicate
common characteristics of students using aac1
Common Characteristics of Students Using AAC
  • Most vocalizations are unintelligible
  • Rarely interact with peers
  • Communication system may not be available when needed
  • Necessary vocabulary is not programmed or correct symbol is not available
supporting aac users create a communication environment
Supporting AAC users….Create a Communication Environment
  • Expect all students to communicate
  • Recognize and respond to the student’s communication initiations
  • Arrange the environment to increase the likelihood for communication
  • Identify communication opportunities within natural routines and activities
addressing communication challenges and creating a communication environment
Addressing Communication Challenges AND Creating a Communication Environment…
  • Requires changes in the…
    • Activities
    • Environment
    • Partner

Communication

Activities

Partner

Environment

slide24

“Incidental teaching episodes are brief,

positive, and oriented toward

communication rather than

language teaching.”

Dr. George Karlan

slide25

Selecting a Target Activity to Elicit Communication

  • Should be brief in nature, but occur 3-4 times per week
  • Requires communication (initiations) by the student
  • Activity should be process - not product oriented
  • Activity represents a class of activities
    • Art activities, cooking, reading books, snack
    • Variation in content from episode to episode,

but same “core” vocabulary

  • Choices are offered during the activity
  • COMMUNICATION

is the goal of the Target Activity!

selecting target activities
Selecting Target Activities
  • Start by identifying a “target” activity
    • Student must have a reason to perform the activity
    • Activity must provide opportunities for success
    • Must be motivating
    • Must be functional and interactive
    • Must be age-appropriate
    • Must reflect family wishes/team consensus

Describe your Target Activity on the

Target Activity Form

slide27

The Target Activity Form- Sample

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws,

milk (white & chocolate), communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc.

How is vocabulary represented:

Activity Vocabulary:

Wants/Needs:

Social Interactions & Etiquette:

Sharing Information:

does your target activity have at least three opportunities for the student to initiate
Does your Target Activity have at least THREE opportunities for the student to initiate?
  • What does the student have to say to BEGIN the activity?
  • What does the student to have to say to CONTINUE the activity?
  • What does the student have to say to END the activity?

If you can’t think of 3 statements the student needs to say to be engaged in the activity….

pick a different activity!

communication turns example
Communication Turns-example

Snack

Beginning:Student asks for snack items.(e.g., milk, cracker, napkin, straw, placemat)

“I want….” “Can I have ….” “milk”, etc.

Middle:Student asks for “more”, “help”, makes social, informational or etiquette comments to peers and adults

“I want more ….”, “more ….”, “good …..” “I like …” “You want…”

End:Student indicates when finished

(asks to be excused, says “all done”, asks for clean-up materials, asks to go to transitional activity)

“all done”, “clean up”, “no more”, “bye-bye”

slide30

The Target Activity Form- Sample

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate),

communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc.

How is vocabulary represented:

Activity Vocabulary:

Wants/Needs:

Social Interactions & Etiquette:

Sharing Information:

Student asks for snack items (e.g.,

Milk, cracker, napkin, straw, placemat)

“I want …”

“Can I have….”

“milk”

Student asks for “help”

Student asks for “more…”

Makes comments to peers and adults

“I want more…”

“I like ….”

“good …”

“You want …..?”

Student says “all done” when finished

“clean-up”

“go play”

“bye-bye”

slide31

Communication Considerations

  • How will the vocabulary be represented (e.g., objects, tangible symbols, photos, symbols, etc.)
  • List the vocabulary that must be available. Try to have vocabulary that represents
      • Wants/Needs
      • Social Interactions & Social Etiquette
      • Sharing Information
slide32

The Target Activity Form - Sample

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate),

communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc.

How is vocabulary represented? Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands

Activity Vocabulary: milk, straw, napkin, cracker, placemat…

Wants/Needs:I, want, more, help, specific snack items

Social Interaction & Etiquette:sit here, want some?, please, thank you

Sharing Information:good, yucky, uh oh, all done

Student asks for snack items (e.g.,

Milk, cracker, napkin, straw, placemat)

“I want …”

“Can I have….”

“milk”

Student asks for “help”

Student asks for “more…”

Makes comments to peers and adults

“I want more…”

“I like ….”

“good …”

“You want …..?”

Student says “all done” when finished

“clean-up”

“go play”

“bye-bye”

addressing communication challenges and creating a communication environment1
Addressing Communication Challenges AND Creating a Communication Environment…
  • Requires changes in the…
    • Activities
    • Environment
    • Partner

Communication

Partner

Activities

Environment

arrange the environment to increase the likelihood of communication
Arrange the Environment to Increase the Likelihood of Communication
  • Common Strategies….
    • Use motivating materials and activities
    • Materials should be in view but not accessible
    • Student should need assistance with some materials
    • Provide small or inadequate amounts of materials
    • Sabotage
    • Provide something the student doesn’t like/want
    • Use communication boards/devices & visual tools
your environment
Your Environment
  • Are there any environmental changes you could make to increase communication?
    • Activity-based environmental changes
      • Material location, amount, type
    • Communication-based environmental changes
      • Picture symbols, communication boards, device placement
slide37

Video-

Note Environmental Arrangements

slide38

The Target Activity Form - Sample

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate),

communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc.

How is vocabulary represented?Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands

Activity Vocabulary: milk, straw, napkin, cracker, placemat…

, Wants/Needs: I want, more, help, specific snack items

Social Interaction & Etiquette: sit here, want some?, please, thank you

Sharing Information: good, yucky, uh oh, all done

Student asks for snack items (e.g.,

Milk, cracker, napkin, straw, placemat)

“I want …”

“Can I have….”

“milk”

Student asks for “help”

Student asks for “more…”

Makes comments to peers and adults

“I want more…”

“I like ….”

“good …”

“You want …..?”

All students have snack placemat with

specific snack vocabulary velcroed on

top & core vocab. permanently on sides.

Single small pieces of snack

Straw on table, but out of reach

Milk carton not open

Wrong flavor of milk (sabotage)

Student says “all done” when finished

“clean-up”

“go play”

“bye-bye”

addressing communication challenges and creating a communication environment2
Addressing Communication Challenges AND Creating a Communication Environment…
  • Requires changes in the…
    • Activities
    • Environment
    • Partner

(And that means YOU!)

Communication

Partner

Activities

Environment

slide41

As a Communication Partner…

What Can DISCOURAGE a

student from

communicating…

--test, bombard, or demand responses (e.g., “what is this called” “what do we use a knife for?” “what do we call this?”)

--use rhetorical questions (e.g., “you don’t want milk, do you?”)

--use YES/NO questions

--anticipate their needs so they don’t have to ask

slide42

As a Communication Partner…

What else Can DISCOURAGE a

student from

communicating…

--don’t give them regular access to their communication system(s)

--when they make a choice, ask them again

--use only teacher-directed activities so the student doesn’t HAVE to communicate

--”GOOD TALKING!” as a reinforcer

--use figurative language (“take your seat” vs. “sit”)

--”rush” the student’s communication

slide43

Strategies to Promote CommunicationAdapted from Original ECT, Hodgdon, 1999

  • Engage (get at their level, eye contact)
  • Establish attention
      • Proximity to child
      • Be in their line of vision
      • Watch for student to orient to you (attention shift)
      • Use visuals (present visual first)
  • Use meaningful gestures
      • Exaggerate movements to attract attention
      • Hold gestures (point long enough to mutual referent)
  • Less may be better!
      • Match student’s verbal output?
      • Expand by one
slide44

Strategies to Promote CommunicationAdapted from Original ECT, Hodgdon, 1999

  • Wait for responses
      • Count to 5, 10 after a command/question
      • Stay engaged
  • Increase opportunities for initiation
  • Be consistent with labels (why?)
  • Modify the environment to create active participation, communication
  • Make sure the student has access to communication at ALL TIMES!
slide45

The most language learning will occur when your response is related to the student’s focus of interest or to what he has communicated.

you are part of the environment
YOU are part of the environment …

When you use a prompt hierarchy you can:

  • Provide consistency across partners because of framework
  • Give students processing time
  • Be individualized
  • Provide only as much prompting as is needed
prompt hierarchy
Prompt Hierarchy
  • Environmental Cue
    • PAUSE
  • Open Question
    • PAUSE
  • Prompt OR Request for Communication
    • PAUSE
  • Full Model
    • PAUSE
  • Incorporate descriptive feedback into each step
descriptive feedback
Descriptive Feedback
  • Use after the student has produced a communicative response (at any point within the hierarchy)
  • Descriptive feedback is specific to the student’s communication
    • “Oh, you asked for more juice, here’s your juice.”
    • “You want paint. Here’s some blue paint.”
    • “You asked to be all done. We need to do just one

more, then we’re all done.”

    • “You looked at the cheese, here’s some cheese for your sandwich”.
descriptive feedback1
Descriptive Feedback
  • Serves Three Functions
    • Acknowledges
      • Immediately acknowledges that the partner “heard” the student’s communication attempt
    • Confirms
      • Confirms that the message sent by the student is the same as the message understood by the partner.
    • Models
      • Can be used to model an expanded version of the communication message.
prompt hierarchy step 1 environmental cue
Prompt Hierarchy Step #1Environmental Cue
  • Set up the environment to signal to the student that an activity is about to begin.
    • Lining up at the door
    • Getting everything ready for an activity & then waiting……..
    • Art materials prepared but out of reach
    • Desired items visible but inaccessible
    • Cutting the pizza up and waiting
  • If student responds, provide... Descriptive Feedback
prompt hierarchy pausing pause after every step to give the student time to respond to the cue
Prompt Hierarchy--PausingPause after every step to give the student time to respond to the cue.
  • Focus your attention on the student (expect communication!)

A

N

  • PAUSE D
  • If the student responds, provide... Descriptive Feedback
prompt hierarchy step 2 open question
Prompt Hierarchy Step #2Open Question
  • If the student does not respond to the pause by making a response:
    • Ask a WHAT, WHY, WHO, WHEN, WHERE, OR HOW Question ONE time
      • “What do you want?”
      • “Whose turn is it?”
      • “Where does that go?”
  • AND then…...PAUSE
  • If student responds now, provide... Descriptive Feedback
prompt hierarchy step 3 prompt or request communication
Prompt Hierarchy Step #3Prompt or Request Communication
  • If the student does not respond to the open question & pause……
    • Provide a prompt to students (ONE time)
      • Choices, carrier phrase, initial sound, visual cue OR
    • Request Communication (ONE time)
      • “Tell me what you need.”
      • “Tell me what goes next.”
  • AND then……PAUSE
  • If student responds now, provide... Descriptive Feedback
prompt hierarchy step 4 full model
Prompt Hierarchy Step # 4Full Model
  • If the student does not respond to the partial prompt and pause…..
    • Provide a full model for student
      • Use student’s AAC device
      • Use developmentally appropriate model
  • AND then…...PAUSE
  • If student responds now, provide... Descriptive Feedback
pause
PAUSE

Pause Pause PausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePausePause!

In other words…PAUSE!

prompt hierarchy1
Prompt Hierarchy
  • Gives student the necessary time to process information and to formulate a message to communicate
  • Provides a structure for adults that encourages communication
  • Can be customized for individual students
  • Organized as least to most
slide58

The Target Activity Form - Sample

Students come to table at snack time. Snack materials are on counter. Materials: food, placemats, napkins, straws, milk (white & chocolate),

communication overlays for requesting snack items & standard vocabulary-more, all done, uh oh, help, etc.

How is vocabulary represented?Communication board with PCS symbols. Vocabulary for expansion & labeling. Student points w/some vocalizations. Teacher models & expands

Activity Vocabulary: milk, straw, napkin, cracker, placemat…

, Wants/Needs: I want, more, help, specific snack items

Social Interaction & Etiquette: sit here, want some?, please, thank you

Sharing Information: good, yucky, uh oh, all done

Snack materials set out, but out of reach of students.

Adult waits expectantly.

Student asks for snack items (e.g.,

Milk, cracker, napkin, straw, placemat)

“I want …”

“Can I have….”

“milk”

What do you want?

What do you need now?

Who do you want to pass that to?

Student asks for “help”

Student asks for “more…”

Makes comments to peers and adults

“I want more…”

“I like ….”

“good …”

“You want …..?”

Do you want apple or crackers?

I want ……..

Mmmmmmm (for milk)

All students have snack placemat with specific snack vocabulary velcroed on top & core vocab. permanently on sides.

Single small pieces of snack

Straw on table, but out of reach

Milk carton not open

Wrong flavor of milk (sabotage)

I want milk.

Apples please

I want more crackers please

Student says “all done” when finished

“clean-up”

“go play”

“bye-bye”

You asked for milk…here’s more milk.

Crackers…..here’s 3 more crackers.

Milk is good! Are crackers good too?

slide59

CCE is a paradigm shift…

  • From sole focus on the student’s AAC device to communication
  • From focusing on the student’s communication limitations to creating a communication environment
  • From a single player to team ownership
  • for communication opportunities
  • From product-oriented activities to consciously designed communication-based activities
some possibilities
Some Possibilities…
  • Identify one specific student (do not select

your most “challenging” student!)

  • Encourage other teams in the district to join you & form a “study group” where you….
  • Use videotaping to help you analyze your activities, partner behaviors & environment
  • Critically analyze the activities for student communication opportunities (minimum of 3)
  • Set up your environment to maximize communication (one activity a day)
  • Post prompt hierarchy & start to use
  • Provide feedback to team members & ask for same
  • Others?
slide62

References

American Speech-Language-Hearing Association website: www.asha.org

Burkhart, L. 1993, Total Augmentative Communication in the Early Childhood Classroom, p.38

Binger, C. & Kent-Walsh, J. (2005). Evidence-Based Language Supports for Children Using AAC: Increasing Expressive Communication. Closing the Gap conference, Oct. 2005, Minneapolis, MN.

Blackstone, S. (2006). Young children. False beliefs, widely held. ACN:Augmentative Communication News, June 2006, 18 (2).

Casey, K. & Kornfeld S. (2004). Developing language-rich light tech AAC systems for young children. Closing the Gap, October/November 2004, 23 (4).

Hodgdon, L.A. (1999). Solving behavior problems in Autism: improving communication with visual strategies. Troy, Michigan: QuirkRoberts Publishing.

slide63

Karlan, George. Environmental Communication Teaching Training. Field-Initiated Research Grant Award No. H023C9005 from the Office of Special Education, U.S. Department of Education. Lafayette, Indiana: Purdue University.

Light, J. (1996) Communication is the essence of human life: Reflections on communicative competence. AAC Augmentative and Alternative Communication, June 1997 (13), 61-70. Light, J.C. (2005, May). AAC interventions to maximize language development for young children. State College, PA: AAC-RERC. Retrieved June 10, 2008 from http://aac-rerc.psu.edu/index-16147.php.html

Skotko, B., Koppenhaver, D., & Erickson, K. (2004). Parent Reading Behaviors and Communication Outcomes in Girls with Rett Syndrome. Exceptional Children, 70 (2), 145-166.

Quill, K. (2000) Do-Watch-Listen-Say: Social and communication intervention for children with autism. Baltimore: Brookes Publishing.

WATI (2009). Assessing student’s Needs for assistive technology. www.wati.org