Post by Emily Webb, Speech and Language Therapist/Tobii Dynavox Community Evangelist

Life as a Newly Qualified Therapist is daunting. Wide-eyed and enthusiastic with a degree hot off the press, but an overwhelming feeling that you know nothing.

Never one to make life particularly easy for myself, I have chosen to undertake my first role as a Speech and Language Therapist at Tobii Dynavox, who just happen to be the largest AAC company in the world.

As a result, I now find myself talking to some of the most qualified AAC specialists internationally, trying hard to strike the balance between being knowledgeable enough to engage meaningfully in conversations whilst humble enough to ask the most basic questions. This is all whilst trying desperately to hide the fear in my eyes when anyone mentions anything about programming.

So, two months in to the job let me summarise what I have learnt in to two key points.

  1. There are LOTS of AAC options.

And I mean lots. I spent my first couple of weeks dreaming about pagesets, vocabulary packages, symbols, core vs pre-programmed messages, hi-tech, low-tech, paper based solutions, PODD, Compass, Communicator, switches, eyegaze, partner-assisted scanning. I could go on…

Stepping in to the AAC world is overwhelming. But it’s overwhelming for good reason.

Each individual requires their own particular mix of AAC options to build an effective communication system. This means that lots of options are available, meaning that people like me need a lot of time to get their heads around all of these options.

It means that it’s OK not to know everything and it’s OK to feel that you never will.

Which is why…

  1. There is a HUGE amount of AAC support online.

The AAC community online is large, active and vocal. I am now a member of several AAC groups on Facebook and not a day goes by without several exchanges from various members sharing achievements, difficulties and day-to-day advice and support. There are a huge number of individuals dedicated to promoting good practice with AAC.

I read blogs, engage in Twitter discussions, follow Pinterest boards, Google most terms that I see on Facebook and find hundreds of search results.

These forums teach me something new every day and I have been welcomed and supported by people who have never even met me. I have learnt from parents, teachers, therapists and users themselves. Social media allows a unique insight into the thoughts and feelings of families and AAC users accessing speech therapy services. Every pin, tweet and post adds something new to the mix, something to be considered and something to learn.

Turns out, it’s OK knowing nothing. You just need to know where to look.

CM7C2903By Patrick Brune, M.S., CCC-SLP and Marleah Herman-Umpleby, M.S., CCC-SLP

Sometimes children with autism and other developmental conditions experience behavior issues that interfere with their augmentative and alternative communication (AAC) device use. We’re pleased to present this series of three articles exploring common behavior challenges and ways to work through them toward successful communication. Here is the last article in the series.

 

Challenge 3: My student is just using this device to play or as a toy.

Why?   Have you ever heard someone say that an AAC device is not appropriate for someone because they will just “play” with the device or “use it as a toy?” Perhaps you’ve heard this after someone gets an AAC device.  Families and therapists say they sometimes worry that a device is not being used properly or effectively because the individual plays around with the buttons. Maybe you’ve felt this way, too.  Experience and observation tell us that typically speaking students like to play with language. They may try funny combinations of words and speech to laugh or make others laugh. This can be fun.

Sometimes, however, it is not appropriate behavior for a specific setting or situation. When you first saw an AAC device or keyboard, what did you do with it? You probably spelled out your name.  Most people do. This is a way of exploring or playing with the device. You probably did not hold back for a moment because you wanted to convey a very specific message. The same is true for students who must use AAC devices each day. Often they just need time to find out what the technology offers.  It’s not fair to expect them to resist temptation to explore the device when they first turn it on. The problem enters when prolonged exploration, or play, prevents the student from learning to use the device to communicate.

What you can do. Practices that can help establish boundaries between “playing” with the device and using it for self-expression include:

  • Designated time for exploration and play. The device, though not a toy, is something new to your student. It’s important to acknowledge their desire to check it out—and let them. Some classroom teachers have success with building time for device exploration into their students’ schedules.   It can vary with the day. A small interval of time may be available before morning circle time on some days or after classwork is done on others.
  • Partner-Augmented Input (PAI). This simple strategy involves using the device yourself, pointing to its content and pairing that with speaking in your own voice, during a typical classroom communication interaction.  Your student, in essence, will learn to use their device by watching you.  It might feel a little awkward at first, but as you get to know the device content, you’ll find that you can easily work it into what you are saying.

PAI is a highly effective way to model device use without pressuring your student for an immediate response. It also shows successful communication in situations the student can easily relate to.

Click on these links to watch a video or download a handout with PAI tips.

  • Natural consequences. It is entirely appropriate for a child who uses an AAC device to experience the natural consequences of goofing around in class when it’s not appropriate to do so. Imagine any child calling out silly words or rhymes or words during a teacher-directed classroom activity. The teacher would likely redirect this behavior by telling the student to stop and perhaps asking the student to leave the area where the activity is taking place. Natural consequences are peer inclusive and expected at those times.
  • Shaping and expanding. As your student learns to use their AAC device, a helpful teaching strategy is shaping their messages (i.e. vocabulary selections) as if for a real conversation.

For example, if the student says “green elephant” and laughs, you might laugh along and offer a new way to talk about elephants, like this (student’s messages in parentheses):

“I never saw a (green) (elephant)! I did see the (baby) (elephant) at the zoo.  Have (you) been to the (zoo)? My favorite animal was the (giraffe).   I know you have some pictures in your photo pages from the class trip to the zoo.  Let’s take a look there!”

Note that we did not ignore the “incorrect” statement about green elephants in the example, honoring the student’s use of language. Our aim as educators is not to reinforce errors in language production but to shape them into appropriate productions. While research suggests such trial and error approaches to learning may reinforce incorrect productions in some children, especially those with autism, it can also be motivating for the student to build conversations through this type of exploration.

Getting a child to use their AAC device more functionally means giving them chances to explore and utilize their language skills within practical and functional routines.   It helps to teach skills within frequently occurring contexts. Encourage your student to use their AAC device across the day, providing time for exploration, partner-augmented input, and shaping and expanding their expressive language use.  We think you’ll find this approach exciting and ultimately beneficial for your student.

 

 

By Patrick Brune, M.S., CCC-SLP and Marleah Herman-Umpleby, M.S., CCC-SLP

 

Sometimes children with autism and other developmental conditions experience behavior issues that interfere with their augmentative and alternative communication (AAC) device use. We’re pleased to present this series of three articles exploring common behavior challenges and ways to work through them toward successful communication. Here is the second article in the series.

 

Challenge 2: I can’t give my student a high-tech AAC device; he/she will just throw it.

Why? Behavior that includes throwing objects is often a way of telling us something. It’s our job to figure out what the student is trying to communicate.   We may not know exactly why they throw their AAC device, but most likely it’s because they are frustrated about something.

Could the “something” be that we are asking too much of them too soon? Or that they can’t find the right words or phrases to use to tell us something important? Then maybe we need to rethink how we are teaching them to use the AAC device

Once you determine possible reasons your student throws the device, you can provide a replacement strategy for that behavior.  Such strategies offer alternatives to negative behavior as well as ways to prevent it from happening in the first place.

What you can do:   Put on your detective hat. Take time to observe your student throughout the school day. What you’re looking for is really as simple as ABC:

  1. The A Consider what happens right before an incident. This occurrence is called the antecedent. Perhaps someone placed a demand on your student to use their AAC device. Maybe you saw that the student wanted to say something and attempted to find the needed words or phrases on the device without success.
  2. The B Notice what happens immediately following the behavior. What did you do when the student threw the device? Did they get attention for that action? What did the other students do?
  3. The C What consequences will there be for the student after throwing the device? This doesn’t necessarily mean punishment. A consequence could be a sensory break or simply putting the device back on the student’s desk, helping them find desired vocabulary and resuming the task at hand.

What if your student continues to throw the device?  Then you’ll want to change the antecedent.   This may happen gradually and requires awareness of your student. If, for instance, they’re looking intently at their device, maybe they are trying to find the phrase “I need a break” phrase.  Instead of asking, “What do you need?”, sit next to them and acknowledge that they have something to say. Use their device to show them where the desired phrase is and help them find it. Let them make their request using the device without pressure or demands. This replacement strategy is a hands-on way of teaching your student to use their device instead of engaging in a challenging behavior.

It’s possible your student is throwing the AAC device for a different reason altogether, so hold on to your detective hat. One tool that may give insight into why your student acts a certain way is a functional motivational assessment. This relatively quick and easy method of observation and data collection   lets you track situations where your student may be inclined to throw the device, allowing you to more proactively address behavior issues.

Whatever the outcome, know that Tobii Dynavox is proactive in supporting your efforts. Our devices are built to withstand extra tough situations.  Should an incident affect a device’s operation, we will work with you step by step. CLICK HERE for details.

While there is no guarantee that the throwing  will cease, tucking the device, ” safely” into a bag set out of the way  may be your worst recourse. With time and practice, your student’s communication abilities will likely improve, reducing the frustration that leads to challenging behaviors. Keeping that in mind may be your best bet.

 

By Patrick Brune, M.S., CCC-SLP and Marleah Herman-Umpleby, M.S., CCC-SLP

 

Sometimes children with autism and other developmental conditions experience behavior issues that interfere with their augmentative and alternative communication (AAC) device use. We’re pleased to present this series of three articles exploring common behavior challenges and ways to work through them toward successful communication. Here is the first article in the series.

 

Challenge 1:  My student is not interested in using their augmentative and alternative communication (AAC) device.

Why? This can happen for are several reasons. Let’s look closely at three common ones.

 

First, consider the emotions your student might have around using the device.  Research shows that individuals with similar attitudes can more easily create friendships with peers when everyone feels the same.  Conversely, it is difficult for a person to be accepted into a group when they’re seen as different than their peers. Students who use AAC and typical peers may engage in more successful peer interactions and social acceptance when they all feel a sense of uniformity. (Beck et. al, 2002).   In other words, sometimes kids just want to fit in.  Using an AAC device can set them apart.  Often it is hard to get a student to accept their AAC device or use it outside the therapy room.  Motivating them to use the device when interacting with peers who do not need one can, at times, seem impossible.

 

What can you do?  Ask to join the AAC evaluation team if you’re not on it already. You can inform and influence other team members on issues pertinent to your student’s device use. It is wise to support the recommendation of an AAC device that looks and acts like the technology other kids are using. A device that mirrors other technology used in the classroom is also a good fit.  Think about it. The more it blends in, the less “different” or “special” it will appear, fostering a more inclusive atmosphere. You contribute to that atmosphere as you encourage your student to use the device thoroughly throughout the school day.

 

Keep in mind that AAC devices once seldom resembled popular technologies. That has changed dramatically over time. Today’s devices are smaller, lighter and sleeker than before Very often they have the same hardware found in personal tablet computers.

 

The Tobii Dynavox T10 and Tobii Dynavox Compass software are leading this trend. A dedicated communication device sporting a familiar tablet design, the T10 offers the durability and robust language elements your students need. Its Compass software is also available as a subscription app for commonly used tablets.

 

At Tobii Dynavox, we understand that attitudes shape interactions between augmented communicators and their typical peers and successful interactions happen when students feel positive toward each other. A child’s use of progressive AAC technologies can be a catalyst for such interactions and ultimately for good social relationships.

 

 

Another reason your student may not want to use the AAC device is because its language content doesn’t suit their needs. Every student you meet has words and phrases uniquely important to them. Easy access to this preferred vocabulary is a top priority for students with AAC devices. Such vocabulary includes:

  • Names of important people and places
  • Words and phrases supporting frequent activities (getting ready for school, social events, recreational activities, games, etc.)

 

  • Language for everyday classroom communication including vocabulary that supports the curriculum and class participation. Phrases the student can use to ask for help, request breaks and answer questions on their own make school life easier.

 

What can you do? You don’t have to be a programming wiz to make personalization of device content a priority.  One of your best assets is awareness not just of the day-to-day vocabulary your student requires, but of how others in their age group like to say things. Your student likely will be very motivated to use a device offering that kind of language.

A good tool for device personalization is an AAC Needs Assessment, a simple checklist detailing the student’s AAC use including their preferred communication modes; their (and their partners’) communication skills; favorite or frequent conversation topics and communication environment/situations. The assessment can be completed during the initial AAC evaluation or on an ongoing basis after the device recommendation.

AAC companies regularly offer practical advice on device personalization. Members of the mytobiidynavox.com online community can join group discussions 24/7 with the Tobii Dynavox technical support team, clinical implementation specialists and most important, their AAC team members and peers who use AAC devices.  At mytobiidynavox.com, you’ll also find a comprehensive collection of resources, tips and research-based practices handy for those with aT10 and/or Compass software.

 

A third key reason for your student’s lack of interest is twofold: They may be embarrassed to use their AAC device in front of classmates and frustrated because they’re required to do something that no one else has to. A resulting sense of isolation may cause your student to want to abandon the device.

What can you do?   In such cases, it’s critical to get the whole team on board to help. The team can include anyone the student sees on a regular basis—parents, teachers, therapists and the school principal. Together, you can develop a strategy for motivating your student to use the AAC device each day.

Current AAC technologies truly are shared solutions, easily aligned with a universal classroom design that can motivate your student’s device use. Other students can simultaneously learn and benefit from AAC technology in unprecedented ways, often at no cost. The value in terms of raising awareness of learning differences and similarities is incomparable.

 

A student can learn to use their device to participate more fully in classroom instruction and social exchanges by watching someone else do the same, a practice known as modeling. You can use a technique called partner-augmented input (PAI) combining your use of the technology and speech to encourage the student to use their device as communication opportunities occur. Modeling and PAI can optimize teachable moments while easing any pressure to perform.

 

 

This is where tools such as the Tobii Dynavox Compass companion app and free editing software can come in.    Students with a Tobii Dynavox T10 have access to the companion app, which can be downloaded to an IOS- or Android-based personal computer. The Tobii Dynavox Compass editing software (without speech capabilities) can be downloaded to a personal computer.

 

Remember, relationships make AAC device use successful. Classroom teachers and school speech-language pathologists (SLPs) can facilitate a student’s AAC device use through informal peer training during which the SLP models device use for the student and classmates in a game or social activity. Classmates do not need to prompt or model for the student—they just join in the fun with the same technology at their fingertips. The result? A real-life lesson in breaking communication barriers!

 

 

 

 

 

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Happy Monday FunDay! Holly here! This week, I’m introducing you to Voice Banking and providing you with a document that will teach you how to be successful with Voice Banking. At the bottom of this page, I also threw in a few of our upcoming webinars. Enjoy!

Voice Banking Resource

Voice banking is a strategy in which you record and save portions of an individual’s speech. Often, these recordings are later used on communication devices. Voice banking is usually used by individuals who have progressive conditions such as Amyotrophic Lateral Sclerosis (ALS). These individuals are at risk for their ability to communicate through speech deteriorating. Therefore, they choose to record themselves speaking.

The resource below provides some tips for recording with Communicator 5 or Compass software as well as ModelTalker, a web based recording tool to create a personal synthetic voice.

 Tobii Dynavox Voice Banking Resource

 

New Webinars!

All webinars are 12-1pm ET:

  • Wednesday March 23rd – myTobiiDynavox: Managing your Communication Content (.1 ASHA CEU) Register here.
  • Thursday April 7th – Using the Communication Tools in Core First: Register here.
  • Wednesday April 13th – Communicator 5 and Sono Flex (.1 ASHA CEU) Register here.
  • Thursday April 21st – Exploring PODD 15 Preschool & School Pagesets (.1 ASHA CEU) Register here.
  • Thursday May 12th – Compass & the NavBar Pageset. Register here.
  • Thursday May 26th – Personalizing with Digital Images in Compass & Communicator 5 (.1 ASHA CEU) Register here.

Happy Monday FunDay !

Hello, Holly here! I’m a member of the Tobii Dynavox Training Team and I’m excited to kick off a new series of bi-weekly posts that will feature helpful resources and links to upcoming or recorded trainings. Today, we have two Communicator 5 needs assessment resources to share along with a new recorded webinar!

 

Likes and Dislikes – The Emergent Communicator

A checklist can be helpful when searching for initial likes and dislikes for an individual with “emerging” communication skills. To use this list, interview familiar partners or conduct some trials with the items. After each section, we have provided some ideas of page sets that exist in the Emerging User.

 

Communicator 5 AAC Needs Assessment – The Symbol Communicator

This AAC needs assessment can be completed as part of an initial AAC evaluation or as part of on-going assessment after AAC strategies and tools have been implemented. Examples of page sets that already exist in Communicator 5 are noted.

This and many other supporting resources can be found on myTobiiDynavox.com!

 

New Recorded Webinars:           

  • (ASHA .1 CEU) Strategic Competency in AAC: Watch it here.

 

Until next time!

-Holly

 

A while back we saw a Dear Abby column in the Erie Daily Times (Erie, Pennsylvania).  Several campers and device users from Camp Courage had written to Abby to let her know that they had some ideas to share with people who might feel uncomfortable talking to people using a speech generating device.  Check out the article at Abby’s website.  Just scroll about ½ way down the page to the second letter.

Just yesterday, I was making a purchase at a gift shop checkout counter. While I was being helped by one employee, another was on the phone with a customer. I overheard her say, “No, we don’t have those.  I’m sorry,” before hanging up.  After the call ended, the employees talked about how the person on the other end sounded like they were using a computer to talk.  The employee who took the call said she didn’t really understand what the caller was saying.  Instead of giving the person an opportunity to clarify the message, she pretended to understand and just closed the conversation. How sad!

The suggestion by these campers that people should feel free to ask questions and not pretend to understand tells me that this must happen often to users of speech-generating devices.    What a wonderful idea to post this message in Dear Abby so that others may read it and know that it’s ok to ask questions! This makes me wonder- what other suggestions would users of speech-generating devices want to share with people who may be unfamiliar with this technology? What would you want that store employee to know now?

 

I recently read an article written by C. Jorgensen (2005) where she proposes a new paradigm in the area of disability and competence.  She found that often times if service providers weren’t sure what a student was capable of, it was presumed that the student could not (and never would be able to) learn to communicate.  In the article, Jorgensen advocates that setting high expectations should be the basis for decision making regarding educational programming.  In addition, Jorgensen stated that decisions made based on high expectations will lead to a higher quality of life in both school and beyond.

What if we lived in a world where high expectations were set for all students with significant disabilities?  What if every classroom created a positive communication environment?  What if communication partners spent more time working on their own communication skills so that they could better support students with complex communication needs (CCN)?  What if we were committed to ensure that parents and educators worked together towards a common goal; building communication and learning success for students with significant disabilities?

I’ve worked with many children with significant communication disabilities over the past 16 years.  In my experience, children with school teams and families who have high expectations and support communication and learning in all environments, always succeeded more than those children who with limited or no expectations put upon them.  Augmentative and alternative communication (AAC) doesn’t just work by itself.  It requires direct teaching, opportunity, and expectations. When high expectations are set, literacy is addressed and social skills are taught. Children have many, many opportunities to practice skills in a safe and supportive environment.

I’ve always tried to have great expectations for every child (even if everyone else thought I was nuts).  I go into every situation assuming that the child is brilliant.  Research tells us that the success of a communication interaction for individuals with complex communication needs is often dependent on the skills of the communication partner (Light and Binger, 2007; Drager, et al, 2006; Bruno and Trembatth, 2006).  With this in mind, I always hold myself responsible for the learning and success of my students.  If things don’t work…I look to myself and the environment to figure out why it’s not working (never the student or device).

I once met a young man who had limited expectations placed on him.  No one expected him to learn to read. No one expected him to sit during classroom activities.  No one expected him to be potty trained.  No one expected him to ever do much of anything.  Once this little guy had access to a school team who placed expectations on all students, tools he needed in order to be a good communicator and learning opportunities, he began to soak things up like a sponge.  I am happy to report that this young man is now reading at grade level and is an effective user of an augmentative communication system.

Lesson learned…Create great expectations and they will learn.

 

These are the things that really drive us crazy.  We know that some of them are ridiculous but we just can’t help ourselves.  www.getannoyed.com claims to have the “World’s Largest List of Pet Peeves” including the following:
  • Drivers who don’t use a turn signal
  • People who drink directly out of the milk/orange juice container
  • Made up car names that are not even real words
  • Couples who sit on the same side of the booth when there is no one on the other side
  • People who sit next to you on public transportation even when there are other seats available
  • Noisy eaters

“Mouth noises” drove my mother crazy.  You know what I mean, those funny noises that kids make when they are bored using their mouths.  Those noises were like fingernails on a chalkboard to her.

What are your pet peeves?  What are the pet peeves of the person who has had a stroke or experienced a brain injury?  What is this topic doing on a blog about AAC?

Well, pet peeves can be something we share to interact with someone else and to express aspects of who we are.  Pet peeves may also need to be expressed to avoid anxiety or frustration on the part of the augmented communicator.  On Tobii Dynavox devices, address this by:

  • Adding a list of pet peeves in the About Me topic and don’t forget to include a question for the communication partner, “What are your pet peeves?” or “What drives you crazy?”
  • Including comments or requests regarding pet peeves in the appropriate topic in which they might be used (“He didn’t even use his turn signal!” – car, “They are sitting on the same side of the table.  Why do people do that?” – restaurant, “Will you try to eat more quietly?” – mealtime, “Please use a glass next time!” – kitchen).  Of course, the level of politeness will depend on who the augmented communicator is talking with and their typical style of interaction.

Now, will you stop snapping your gum?  It’s driving me crazy!

 

The town where I live has a number of statues in front of and around public buildings.  They depict people mostly but one of them is a statue of a bear lying on its back.  It stands (or lies, more accurately) in front of our park district’s main building.  This particular statue sparked my interest because of the consistent reaction children have when they see it.  Child after child approaches the bear and rests his or her hand on its head, grabs its hand then sits on it.  This is true of toddlers to kids in early elementary school.  Rarely does a child walk by without approaching the bear unless being pulled by his or her parent into the building or back to the car. (I’ve even seen older children and adults eyeing the bear.  I have a feeling that if they weren’t so “cool” or “mature” they would be touching and sitting on the bear as well.) When these children think about the park district building, what picture do you suppose pops into their minds?  Probably the bear!

What bearing (insert groaning and head shaking here) does this have on AAC in the classroom?

There are times when we as adults become so task-oriented that we miss what is important to the child.  This is especially true when we are adding stories and news to devices.

I remember a trip to New York City with my Girl Scout troop.  We saw so many wonderful and interesting things including the Empire State Building, Central Park and the Museum of Natural History. We also toured backstage at Radio City Music Hall and attended the Radio City Christmas Show!  What did my fellow Scouts and I tell our families about when we got home?  The men in the dining car on the train who were singing, “You are My Sunshine”, loudly and off-key throughout much of the return trip.  I must say that this was very disappointing to my mother (our troop leader) who was hoping that the trip had some more significant impact.  If I had a communication device, I can guarantee you that the men singing, “You are My Sunshine”, would not have been programmed into my news page.

When we customize a student’s device with stories or news, let’s consider what they find interesting.  How do we do that?

  • Ask them.  They may be able to tell us using their devices, gestures or even eye gaze.
  • Pay attention.  Notice what makes them excited, angry or pay increased attention.
  • Watch or ask other students.  Listen to what other students are talking about or ask what news they plan to share when they get home.
  • Tap into your inner child.  Ask yourself, “When I was ___ years old, what would I have found worthy of talking about today?”

Let’s bear in mind (sorry!), that the communication device should reflect the user primarily, not the programmer.