AAC, SLPS AND ABA:

USING LAMP TO MAKE

IT WORK

Lydia MacKay, MA, CCC-SLP, BCBA

Jeremy Legaspi, MS, CCC-SLP

Kassi Rollins, MS, CCC-SLP

COMBINING APPLIED BEHAVIOR ANALYSIS AND AAC

TECHNIQUES TO TEACH COMMUNICATION

o Explore common obstacles you may encounter in the field

o Understand the outcome based AAC approach known as LAMP

o Understand ABA terms and principles–Yes, you can!

o How the LAMP approach to communication can appeal to ABA providers

o Find common ground that can help improve communication and reduce

challenging behaviors

o Share tools you can use to start collaborating

WHAT YOU MAY HAVE HEARD WHEN DISCUSSING

AAC WITH OTHER PROVIDERS:

o We only use ______(insert AAC software/PECS) here.

o AAC devices discourage vocal speech

o We only use outcome based treatments.

o We only use ABA to teach language.

o Gigi has a lots of language- she can label 300 pictures!

o Sam is not ready for an AAC device until he improves his visual scanning.

o Sam has great language- he uses an I WANT strip on his PECS book/says, “ I

want _____, please.”

o *Note: other professionals may say these things, too! Not limited to what

an ABA provider may say

TEACHING COMMUNICATION (AAC OR VOCAL SPEECH)

IS VERY COMPLEX. WE OFTEN ENCOUNTER…

• Children who use rote phrases (Hi, How are you, Fine….I see red bird

looking at me…I want cookie please thank you)

• Children who are prompt dependent

• Children with challenging behaviors

• Yet very few assessments look at and address these obstacles to

learning (Esch, B. E., LaLonde, K. B., & Esch, J. W. (2010), Sundberg

(2014))

An ABA based assessment tool such as the VB-MAPP (Sundberg 2004)

and LAMP AAC (Halloran, 2009) could address some obstacles to learning

communication

WHAT CAN YOU DO?

o Open a dialogue with other providers

o Understand some ABA- based and Verbal Behavior terms

o Share your knowledge of the outcome-based AAC approach (LAMP)

o Team together to focus on the the student

o Design a plan for the student based on ABA and LAMP approaches

o Take good data that will show progress

WHAT IS LAMP? Language Acquisition through Motor Planning

1. a 2. all done/finished3. go 4. help5. here6. I7. in8. is9. it10. mine11. more12. my

13. no

14. off

15. on

16. out

17. some

18. that

19. the

20. want

21. what

22. yes

23. you

EXCERPTS FROM “LANGUAGE FUNCTION AND EARLY GENERATIVE LANGUAGE” BANAJEE, M., DICARLO, C., & BURAS-STRICKLIN, S. (2003). CORE VOCABULARY DETERMINATION FOR TODDLERS, AUGMENTATIVE AND ALTERNATIVE COMMUNICATION, 2, 67 - 73

TEACHING CORE VOCABULARY: Top words- Toddlers

EXCERPTS FROM “LANGUAGE FUNCTION AND EARLY GENERATIVE LANGUAGE” BANAJEE, M., DICARLO, C., & BURAS-STRICKLIN, S. (2003). CORE VOCABULARY DETERMINATION FOR TODDLERS, AUGMENTATIVE AND ALTERNATIVE COMMUNICATION, 2, 67 – 73, ADAPTED FROM RANDLES, J (2016)

TEACHING CORE VOCABULARY: First 30 words

1. again

2. all done/finished

3. away

4. big

5. do

6. down

7. get

8. go

9. help

10. here

11. I

12. In

13. it

14. Like

15. Little

16. mine

17. more

18. my

19. off

20. on

21. out

22. put

23. some

24. stop

25. that

26. there

27. up

28. want

29. what

30. you

finmshed mmne

THIS; ~ . 9i:: LONG$ TO •

~

liittlle

II

are

Ii

up

t

tiiime

0 J -;

down out off bad

i CI\ : ~ (~,~ what a +s

~~~ the

~ ~e~t

fast

g,et help

~~a ~

WHY LOOK AT EARLY CHILD USE OF CORE?

o Core words are emphasized. Nouns are very important and teach specific

requests, and for many students this eases frustration. However, many

students get “stuck” on nouns or stuck on: I want _____(noun), please.

o Core words and little words can be used regardless of activity

o Teaching Core and little words can lead to novel combinations, a.k.a.

language (e.g., turn me, get me, like that, go up, play more, you go)

IF YOU ONLY HAD NOUNS …

IF YOU HAD CORE WORDS…

Activity Core Words to Model

Lining up to leave room

Academics

Outdoors/ Recess

Arts and Crafts

Go, out, go out,

goodbye, play,

Want, like, get, put, in, on, eat, play, stop, no,

more, turn, actions in

books

Go, fast, slow, up,

down, more, play,

come, get me

Put, on, put on, make, you do, big,

little, like, good, bad,

yuk!

INCLUDE BLANK IN APPENDIX CORE

WORDS CAN BE USED IN ANY ACTIVITY…

ELEMENTS OF LAMP APPROACH

Auditory Signals

atural Consequences ~

Consistent and Unique Motor

Pattern .--------~

La guage Connections

/ Readiness to

Learn Joint

Engagement

READINESS TO LEARN

o Learners need to be in an optimal state of arousal

and readiness

o Motivating activities are preferred over adult

chosen activities (HIGH MO)

o Learners must be comfortable, calm and in a state

that helps them share focus on an activity they

enjoy (REINFORCERS)

SHARED FOCUS

o Expand vocabulary around the learner’s interests

o Activities that are initiated by the learner are going to increase

joint attention and engagement (HIGH MO)

https://www.youtube.com/watch?v=hrQclfxmRsE

Joint attention

Joint referencing

NATURAL CONSEQUENCES

o Need to receive an intrinsically rewarding consequence after saying the

word (Positive Reinforcement)

o Consequence must be an animated reaction, receiving the item, having

control over activity (Functional Communication Teaching)

o Consequence relates to interests, is playful, keeps one engaged (as opposed

to rote)

o NATURAL ENVIRONMENT TEACHING vs DTT

o FUNCTIONAL COMMUNICATION TEACHING (FCT)

AUDITORY SIGNAL

o Produce words via a consistent and unique motor pattern (there is only

one motor path per word)

o Never need to say a word to get a word!

o Can practice words when not in presence of a listener (babble). This is

automatically reinforcing!

o Connection between hearing word and consequence!

o Can address ECHOLALIA/SEGMENTATION ISSUES

UNIQUE & CONSISTENT MOTOR

PLANSo Speaking is a motor plan, as are tying shoes and typing. Once the plan is learned

it becomes automatic.

o We don’t have to think about how to make a word with our articulators

o We communicate well because we have automaticity

o LAMP helps develop automaticity in a way that other approaches do not.

o If a motor movement changes each time we say a word, we do not develop

automaticity. Consistency of that motor pattern is key for teaching language.

o A word can be produced in 1-3 keystrokes along a unique and consistent motor

pathway. The AAC user can devote more cognitive energy to interacting vs. navigating through category pages.

LANGUAGE CONNECTIONS

o Phrase-based teaching does not help learners access words they may

wish to say (I want cookie learned as a chunk does not teach how to

combine words to produce a variety of utterances)

o Teaching the meaning of single words helps learners with auditory

processing difficulties learn word meanings and use word combinations

o A consistent unique motor path paired with the auditory signal, plus a

rewarding consequence, helps children learn meanings of words in a

meaningful context.

LANGUAGE CONNECTIONS

(CONT.)o Teach frequently occurring core words

o Teach Fringe words (special nouns are important)

o Teach small words (on, off, me, my, in, out, to, my, you)

o Consistent motor plans are taught across activities to teach flexibility or

different senses of a word (e.g., Go to make a car go, Go to start

chase, Go to say Go away, Go to ask permission to leave)

o This can lead to a language explosion

WHY IS LAMP BASED AAC

NEEDED?

o Vocabulary using icons with multiple meanings helps learners quickly

find words they want to say.

o Categorical or single meaning icons make learners navigate through

several layers of pages, which places a high cognitive load on

interaction. For many learners, this does not help develop

automaticity.

o Category- based vocabulary programming can steer learners down

a path that is not generative in nature (e.g. ,won’t see turn unless

learner says my first, or won’t see mama unless learner says want)

WHAT IS APPLIED BEHAVIOR ANALYSIS?

A set of principles used to analyze how an individual learns in the

environment. An individual emits a behavior in the presence of a

stimulus. There is a consequence to that behavior. That consequence

can increase or decrease the likelihood that the behavior will be

emitted the next time the individual encounters that stimulus.

WHAT IS VERBAL BEHAVIOR?

Very broadly, we learn verbal communication the same way we learn

nonverbal behaviors. Verbal skills are controlled by the same set of

variables as for nonverbal behaviors (Skinner, 1957).

Antecedent Behavior Consequence

ABA: WHY IS IT IMPORTANT TO UNDERSTAND?

Can’t we just say request instead of mand?

o Yes! But it is important to know why a behavior analytic approach uses

specific terms.

o Understanding specific events and functions of communication prevents

confusing a mand (request) when it is an echoic (imitation), for example

o If we know the real antecedent controlling a response we can help avoid

rote responding or less functional responses that are hard to change once

established.

ABA AND VERBAL BEHAVIOR TERMS

ABA PRINCIPLES:

Motivating Operation (MO)/Establishing Operation: a condition of

deprivation that temporarily alters the value of a particular reinforcer.

An MO increases the effectiveness of a reinforcer a stimulus, object, or

an event). Example: If you haven’t eaten lunch, food becomes a

valuable reinforcer. (Michael, 1982; 2000; Cooper, Heron, & Heward,

2007).

Why is an MO important? MOs are essential to teaching early

communicators to make requests, or mand. The goal is to increase

Spontaneous requests.

ABA PRINCIPLES: Abolishing Operation (AO) a stimulus, object or event that decreases

reinforcer value

o If you just ate a snack, this is an AO as it reduces the value of food as

a reinforcer.

o Response Effort: if child views Manding as too hard, the response

effort kills the motivation for the item ( I want it but don’t want to have

to ask)

o Why is this important? You want to make sure that the learner finds

your activity highly motivating, and values you as a key part of that

reinforcing activity

A BEHAVIORAL SITUATION TO

AVOID

o Conditioned MO-Reflexive: presence of a teacher, instructional items

have been established as aversive. Children begin to exhibit any an d all

problem behaviors that have led to escaping that situation.

o Why is this important? Children may have high demands upon them, with

low reinforcement, or items may be too challenging. This will take some

unlearning that needs teamwork.

o *Nobody said that ABA approaches had to be aversive ! (Carbone, 2010,

Sundberg 2012). This is not good ABA, nor is it good teaching or speech

therapy!

VERBAL BEHAVIOR TERMS

(SUNDBERG, 2008,2016)

o Stimulus Control- A behavior is under stimulus control when it occurs in the

presence of one particular stimulus. The antecedent becomes a signal

once the person notices it. Example: traffic signals, unplugging computer at

onset of a storm.

Why Important:

o Many children demonstrate what looks like a request or response to a

question, but the behavior is controlled by a different signal (antecedent)

than we may think.

VERBAL BEHAVIOR: MAND (SUNDBERG, 2004)

Child wants juice

Child says juice

Child gets juice

Response ReinforcementMotivation

Motivating Operations are a huge

component of both Mand Training and the

LAMP Approach

Mand: a verbal operant involving a response that is evoked by an MO and followed by

specific reinforcement. It allows speakers get their wants and needs reinforced by listeners.

VERBAL BEHAVIOR: TACT (SUNDBERG, 2012)

Child sees

cat

Child says

cat

Adult says,

Yes, that’s a

cat!

Response ReinforcementAntecedent

Tacting allows a speaker to identify or describe the features of the physical environment. Early Tacts are often MAND based! Appeals to child’s interests, as in LAMP approach!

Tact: a verbal response evoked by a nonverbal discriminative stimulus and followed by

generalized conditioned reinforcement.

VERBAL BEHAVIOR TERMS (SUNDBERG, 2008, 2016)

Echoic Imitation-a response that is evoked by a verbal discriminative stimulus that has point-to-

point correspondence and formal similarity with the response. Learning to repeat the words of

others is essential to language, but it can be too strong, as in *echolalia.

Child sees

cat“cat”

Child gets

praised

Response ReinforcementMotivation Echoic Prompt

What’s

that?

Say

“cat”

*Echolalia indicates poor segmentation of words (where word begins and ends and what

individual words mean) LAMP teaches better segmentation (Halloran, 2014)

Antecedent Behavior Consequence

WHY ANALYZE BEHAVIORS? BEHAVIORS CAN BE APPROPRIATE OR MALADAPTIVE

REMEMBER: BEHAVIOR IS COMMUNICATION

The purpose of analysis is to determine the function that the

behavior serves. Then the ABA provider, teacher and SLP

can teach the learner an easier way to serve that function

SOME ABA PRINCIPLES

o Reinforcement – a consequence that provides (+) or removes (-)

something, which increases the chance the behavior will occur again

o Positive Reinforcement: Praise, social attention, tangible reward

o Negative Reinforcement: Ending the task, an annoying sounds stops, get a

break, staff goes away, work materials are removed)

o Children with challenging behaviors have a history of being reinforced for

that challenging behavior.

CONSEQUENCE FUNCTION

Reprimand

Remove Work

Praise

Gets Cheetos

End of Worksheet

Disappointed Look

Flapping hands

Attention

Escape

Attention

Tangible

Escape

Attention

Automatic

Antecedent Behavior Consequence Function

Bus arrives

early; no time

for breakfast

Sally arrives to

school crying

Staff hurry &

feed Sally

breakfast

Tangible

Johnny takes

Sally’s toy

Sally cries Staff give Sally

back her toy

Tangible

End of Recess

bell

Sally cries Staff say,

“Okay, just 5

more minutes:

Tangible

Mom says, “It’s

time to go to

bed”

Sally cries Mom says,

“Okay, one

more story”

Tangible

How one simple behavior chain can

quickly turn into a pattern of behavior…

What is really sad in this situation?

Sally has no functional communication skills!

SO, HOW CAN WE HELP?

Bus was early; no time for breakfast

WHAT CAN SHE DO INSTEAD OF

CRYING?

Staff hurry & get Sally breakfast

Tangible

o Let’s teach her functional communication.

o Functional communication is when the BEHAVIOR (communication) is related to the

FUNCTION.

o In the Individual Behavior Intervention Plans (IBIPs), we call it replacement behavior.

WORKING WITH A BEHAVIOR INTERVENTION PLAN TO

TEACH AAC / FUNCTIONAL COMMUNICATION

Hypotheses Based on QABF (Questions About Behavioral Function) March 2013 Indirect and Direct Crying: Tangible Assessment( s)

Replacement Behavior:

Crying Teach Sally to request items that she needs or wants using augmentative communication device.

• When Sally begins to show signs of agitation, prompt her to ask for preferred items by touching the symbol on her device that correlates with the desired item.

• Initially reinforce all attempts to appropriately communicate her wants.

• Once she has begun to consistently ask for preferred items, begin to introduce a wait time. (Ex: "Thanks for asking for the train, I will get it for you in a moment,").

• Begin with short wait times, and systematically increase them as Sally is more and more successful at waiting.

COMBINE BEHAVIOR PLAN FUNCTIONS WITH WORDS TO TEACH

Antecedent Behavior Consequence Function

Bus arrives

early; no time

for breakfast

Prompt Sally to

request foods-

eat or food items

Sally gets food

after asking

Tangible

Johnny takes

Sally’s toy

Sally is

prompted to

say Mine

Staff give Sally

back her toy

Tangible

End of Recess

bell

She is

prompted to

say “Play” or

More Play

Staff say,

“Okay, just 1

more minute:

Tangible

Mom says, “It’s

time to go to

bed”

Sally is

prompted to

say Read or

Read More

Mom says,

“Okay, one

more story”

Tangible

Note: The student must first be taught these words in a fun way, as in the LAMP approach, and not

during a behavioral challenge.

TEACHING FUNCTIONAL COMMUNICATION USING LAMP

AND ABA: REINFORCERS

o Assess Reinforcers: Behavior Analysts use Preference Assessments to

determine interest in activities and items, and rank them in order of

preference (DeLeon, 2013).

o Preferences can change daily so you will need to assess preferences

frequently (Is there an MO, or did the child become satiated (A0)?

o Without a high MO, student will not Mand or request, because the

reinforcer has less value at that time.

TEACHING FUNCTIONAL COMMUNICATION USING LAMP

AND ABA: AVERSIVES OR CHALLENGING BEHAVIORS

o Work with your Behavior Analyst to determine the function of the challenging

behaviors

o Set up what words can be taught as replacement behaviors (Functional

Communication Training)

o Ensure your student can use core words and some fringe nouns, in a

playful/engaging activity (LAMP- shared focus, natural consequence,

auditory signal)

o Students will remember the word and use it in the proper context if they learn

it in a meaningful way

LAMP Component Benefit to ABA program

Readiness to Learn: student in

state that allows attending and

learning, requires access to

motivating activities

Student attends to stimulus

presentation and to activities for

longer time

High MO leads to increased Mands

Unique and Consistent Motor

Plan: stable word location leads

to effortless communication due to low cognitive load

Minimal Response Effort, leads

to increased Mands and Joint

Attention

Auditory Signal: hear the word

and pair it with consequences

across context

Student gets immediate delivery

of word and consequence, can

help with Stimulus Control issues

and Echolalia

Shared Focus: Child led activities

will increase joint attention

Increase spontaneous Mands,

Pairs adult as reinforcing

Natural Consequences: Student

learns the word in meaningful context

Increases generalization of

Mands across contexts

BENEFITS OF ABA AND LAMP APPROACHES

TO INTERVENTION PROGRAMS

o VB MAPP in particular (see references) and LAMP approach can address

obstacles to learning language (does the learner understand what

individual words mean and multiple meanings of words?)

o Both LAMP and ABA approaches help build communication first and

follow typical communication development (solid Manding repertoire of

single words is taught before longer phrases or adjectives).

o Both LAMP and VB MAPP program emphasize using Motivation to increase

early communication

RESOURCES

https://www.prentrom.com/support/vocabulary-and-software/pass-2/downloads

http://www.aacandautism.com/references

https://aaclanguagelab.com/

SHOW ME THE RESEARCH

Evidence-Based Practice-"Evidence-based medicine is the

integration of best research evidence with clinical expertise

and patient values.“- Sackett D et al. (ASHA website)

Evidence-Based Intervention- There is strong research to

indicate the treatment method is effective. Different

organizations use different criteria and levels of efficacy.

Level 1: “Best Support”

• Two or more between-group design experiments demonstrating that treatment is superior to placebo

or superior or equivalent to already established treatment

Ten or more rigorous single case design experiments which demonstrate treatment efficacy

Level 2: “Good Support or Moderate Support”

• Two or more experiments showing treatment is superior to a wait-list control group

One between-group design experiment utilizing manuals and a specified sample which demonstrates

treatment is superior to placebo or superior or equivalent to previously established treatment

Four or more rigorous single case design experiments utilizing manuals and specifying sample clients

which demonstrate treatment efficacy

Level 3: “Promising Practice”

Sound theoretical basis in generally accepted psychological principles or has been demonstrated to

be effective with another target behavior.

Substantial clinical-anecdotal literature indicating treatment value with the target behavior

Generally accepted in clinical practice as appropriate for use with the target behavior

Effective ASD Treatments

ABA

Joint Attention intervention*

Video Modeling

Modeling-emerging

Naturalistic Interventions*

PECS

Speech Generating Devices – Emerging

No differentiation between SGDs

Research Supporting LAMP

Does not meet the strict criteria of evidence-based treatment; however, initial case studies are promising. Components are based on evidence-based practice. Stress importance of individual’s data and personal progress.

LAMP

Esch, B. E., LaLonde, K. B., & Esch, J. W. (2010). Speech and language assessment: A verbal behavior analysis. The Journal of Speech-Language Pathology and Applied Behavior Analysis, 5, 166-191.

Gould, E., Dixon, D. R., Najdowski, A. C., Smith, M. N., & Tarbox, J (2011). A review of assessments for determining the content of early intensive behavioral intervention programs for autism spectrum disorders. Research in Autism Spectrum Disorders.

Sundberg, M.L. ( 2008) The Verbal Behavior and Milestones Assessment and Placement Program. The VB-MAPP. Concord, CA. AVB Press

LAMP Words For Life

RESEARCH ON LAMP AND LANGUAGE LEARNING:

NENO ET ALo LAMP is listed under AAC treatment approaches on the American Speech and Hearing Association website

o http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942773&section=Key_Issues

o LAMP Approach Research

o Neno, C., Ellawadi, A., Cargill, L., Lyle, S. & David, A. (2016). Vocabulary Development in School-Age Augmentative and Alternative Communication (AAC) Users. Poster presented at the American Speech-Language Hearing Association Annual Conference, Philadelphia, PA.

o Summary: Researchers collaborated to design and study the effects of a fully immersive Language Acquisition through Motor Planning (LAMP)-based classroom. Eight participants were in kindergarten and first grade and spent two hours in a classroom co-taught by three speech-language pathologists and a special educator. The classroom focused on instruction of a set of core vocabulary words instructed across a variety of sensory and scientific/discovery activities. The immersive portion of this classroom took place in large-scale language around a SMARTBoard projecting the Words for Life language program that an adult would model the sequences of the vocabulary being used by the teacher.

o The findings of this study indicated an upward trend in total use and duration of use of the devices, total number of words usedand the frequency of different words used. The most significant data trend (compared to control classrooms) is that the greatest language use was shown after the program had ended indicating that this 8-week intensive program "set the stage" for further language growth.

RESEARCH ON LAMP AND LANGUAGE

LEARNING: BEDWANI ET AL

o Bedwani, M., Bruck, S, Costly, D. (2015). “Augmentative and Alternative Communication for Children with Autism Spectrum Disorder: An Evidence-Based Evaluation of the Language Acquisition through Motor Planning Programme. Cogent Education. 2(1).

o http://www.tandfonline.com/eprint/gZZtTTfzRYDBqZTsCxWq/full

o Summary: Eight participants received intervention with the LAMP approach and SGD for five weeks. All of the children had received previous intervention prior to the study, (up to 9 years) yet only 25% of them were able to comment at the baseline assessment. At post-program assessment, all subjects showed significant vocabulary increase, all were requesting using a symbolic means of communication (on the device or using spoken language) and 100% of the children were developing social communication through commenting. Other social communication improvements were also observed in gaining attention (75%), expressing feelings (75%) and greetings (87%). All of the children were independently communicating and were not restricted to vocabulary that had been taught to them. Although not the focus of the study, 75% of the children were observed to be using phrases on their device by week 5 of implementation and two of the

o children in the study were observed at the week 9–10 post-program assessment to be using words with multiple meanings in the right context.

o There were a range of other outcomes that parents, teachers and speech pathologists observed and reported including an increase in joint attention, interest, motivation and engagement with others, an overall increase in willingness to communicate and an overall increase in play and social communication. For some of the children, this was the first time they were able tocommunicate and participate in social situations. Behavior was also reported to have improved with a corresponding decrease in frustration as a result of improved expressive communication.

RESEARCH ON LAMP AND LANGUAGE LEARNING:

PULLIAM

o Pulliam, M. H. (2010). “The initial and renewed impact of an AAC device, using the LAMP

approach, on an individual with autism spectrum disorder.” Master’s thesis. Arkansas State

University, Jonesboro, Arkansas.

o http://gradworks.umi.com/14/83/1483250.html

o Summary: Case study of a child who used the LAMP approach, then an alternate approach, and

the LAMP approach again several years later. Vocabulary increase was only noted during the

periods where the LAMP approach was implemented. The same study was published recently in a

peer-reviewed journal but they focused on the AAC device rather than the approach.

o Neeley, R., Pulliam, M. H., Catt, M., McDaniel, D.M. (2015). “The Impact of Interrupted Use of a

Speech Generating Device on the Communication Acts of a Child with Autism Spectrum Disorder:

A Case Study.” Education. 9:371-379.

RESEARCH ON LAMP AND LANGUAGE

LEARNING: POTTS AND SATTERFIELD

o Potts, M. and Satterfield, B. (2013). “Studies in AAC and Autism: The Impact of LAMP as a Therapy Intervention.” PrentkeRomich. Web. 2 Jan. 2015.

o http://www.gatfl.gatech.edu/tflwiki/images/4/43/LAMP_Rsch_Article.pdf

o Summary: The seven children in this study, who ranged from age three to age seven, had a diagnosis of autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) and complex communication needs (CCN). All seven were diagnosed with expressive-receptive language disorder. Four presented with severe/profound apraxia. Two were found to have dysarthria of speech. Each obtained a speech generating device (SGD) and received LAMP therapeutic intervention. Each child demonstrated communication progress. Language samples from six participants revealed gains as measured by mean length of utterance (MLU) within the first year. Other progress was noted in areas such as enhanced receptive vocabulary, spontaneous use of language, natural vocalization, and in the reduction of difficult behaviors and increase in shared attention.

o Findings Were Presented:

o Satterfield, B. & Halloran, J., (2013, June). Research Insights into LAMP (Language Acquisition through Motor Planning. Institute Designed for Educating All Students (IDEAS) Conference. (St. Simon’s Island, GA. June, 2013).

RESEARCH ON LAMP AND LANGUAGE

LEARNING: STUART & RITTHALER

o Stuart, S. and Ritthaler, C. (2008). “Case Studies of Intermediate Steps/Between AAC Evaluations and Implementation.” Perspectives on Augmentative and Alternative Communication, 17, 150-155.

o http://sig12perspectives.pubs.asha.org/article.aspx?articleid=1765951

o Summary: Informal case studies on two children who began using the LAMP approach with a Vantage SGD with a secondary evaluation/therapy center outside of the schools where they received primary services. Both children showed communication improvement while using the LAMP approach. Difficulties with coordinating services with the primary team and modifications that were made to accommodate the primary team are discussed.

RESEARCH SPECIFIC TO MOTOR LEARNING & SGDS

o 1. Dukhovny, E. Effect of Size-Centered vs. Location-Centered Grid Design on Aided AAC Productions. Poster session presented at American Speech

and Hearing Association Conference; 2015 Nov 12-14; Denver CO.

o Summary: Learning of aided AAC displays frequently begins with several large icons, with icon size decreasing as more vocabulary is introduced

(“size-centered design”). Another approach introduces small icons from the start, with icon location maintained as new vocabulary is introduced

(“location-centered design”). This on- going study compares the effectiveness of these display designs with neurotypical adults. More subjects are

needed but location-centered design is trending toward significance for accuracy and speed of access. Findings support using Vocabulary Builder

in a complex communication system over providing limited vocabulary in an orientation that will change as language develops.

o 2. Dukhovny, E. and Gahl. S. (2014). “Manual motor-plan similarity affects lexical recall on a speech-generating device: implications for AAC users.”

Journal of Communication Disorders, 48, 52-60.

o Summary: Neurotypical adults were more successful with recall of motor patterns to access words on SGD when the motor patterns for those words

were dissimilar indicating that motor patterns play a role in access speed and recall. “This study provides initial support for the use of motor

sequences in SGD-based language production.... If supported with further research findings, evidence of SGD-based motor plans for production will

have significant practical clinical implications. Prior research in AAC design has focused primarily on facilitating visual search of the SGD interface by

comparing the effectiveness of visual properties of the symbols on the grid, such as iconicity and use of color cues (Thistle & Wilkinson, 2009).

Developing motor plan automaticity is a complementary and, in later stages of device use, possibly more efficient, approach to reducing the

cognitive load of production (Grabowski, 2010). If SGD-based production quickly becomes automatic, as the current study suggests, one implication

is that, with continued SGD use, location of symbols on a grid becomes more relevant to fluent SGD production than the internal visual

characteristics of the symbols. Therefore, in planning SGD design and intervention, location of symbols on the AAC device, and the resulting motor

plans for accessing symbols, must be taken into account along with visual considerations.”

RESEARCH SUPPORTING READINESS TO LEARNo Ashburner, J., Ziviani, J., & Rodger, S. (2008). Sensory processing and classroom emotional, behavioral, and

educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy, 62(5), 564-573.

o

Ayres, A. Jean (1983). Sensory Integration and the Child. Los Angeles: Western Psychological Services Csi ́kszentmiha ́lyi, Miha ́ly (1998). Finding Flow: The Psychology of Engagement with Everyday Life. New York: Basic Books.

o

Ayres, J., Mailloux, Z., and Wendler, C. (1987). “Developmental dyspraxia: is it a unitary function?” Occupational Therapy Journal of Research, 7, 93-110.

o

Dunn W. (1997). Implementing neuroscience principles to support habilitation and recovery. In: Christiansen C, Baum C, eds., Occupational Therapy: Enabling Function and Well-Being. 2nd ed. Thorofare, NJ: SLACK Incorporated, 186-232.

o

Kranowitz, Carol Stock and Miller, Lucy Jane, The Out-of-Sync Child: Recognizing and Coping With Sensory Processing Disorder, Revised Edition. Skylight Press. 2005

o

Lupien, SJ, Maheu F, Tu M, Fiocco A, Schramek TE (2007). "The effects of stress and stress hormones on human cognition: Implications for the field of brain and cognition". Brain and Cognition 65: 209–237

o

Tomcheck, Scott D. and Dunn, Winnie. (2007). “Sensory Processing in Children with and Without Autism: A Comparative Study Using the Short Sensory Profile.” American Journal of Occupational Therapy, 61, 190-200.

RESEARCH ON JOINT ENGAGEMENT

o Adamson, Lauren B., Bakeman, Roger and Deckner, Deborah F., (2004). “The development of symbol-infused joint engagement.” Child Development. 75: 1171-1187.Adamson, Lauren B.; Kakeman, Roger; Deckner, Deborah F.; and Romski, MaryAnn. (2009). “Joint Engagement and the Emergence of Language in Children with Autism and Down Syndrome.” Journal of Autism and Developmental Disorder. 39(1): 84-96.

o Bakeman R., Adamson L. B. (1984). “Coordinating attention to people and objects in motor-infant and peer-infant interaction.” Child Development. 55: 1278-1289.Harris S., Kasari C, Sigman MD. (1996). “Joint attention and language gains in children with Down Syndrome.” American Journal on Mental Retardation. 100:608-619.

o Kasari, Connie; Freeman, Stephanny; Paparella, Tanya. (2005). “Joint attention and symbolic play in young children with autism: a randomized controlled intervention study.” Journal of Child Psychology and Psychiatry. 47: 611-620. Kasari, Connie; Paparella, Tanya; Freeman, Stephanny; Jahromi, Laudan B. (2008). “Language outcome in autism: Randomized comparison of joint attention and play interventions.” Journal of Consulting and Clinical Psychology. 76: 125-137.

o Lewy, Arthur L. and Dawson, Geraldine. (1992). “Social stimulation and joint attention in young autistic children.” Journal of Abnormal Child Psychology. 20 (6): 555-567.Moore, Chris; Dunham, Philip J. and Dunham, Phil. (1995). “Joint Attention Across Contexts in Normal and Autistic Children.” In Sigman, Marian and Kassari, Connie eds. Joint Attention: It’s Origins and Role in Development. London: Psychology press.

o m Predict the Subsequent Development of Their Children's Communication.” Journal of Autism and Developmental Disorders. 32: 77-89.

RESEARCH ON UNIQUE AND CONSISTENT MOTOR

PLANS

o Duffy, E. (1962). Activation and Behavior. Oxford, England: Wiley.Gentile, A. M. (1972). “A working model of skill acquisition with application to teaching.” Quest, 17, 3-23.Hebbs, D.O., (1949). The Organization of Behavior: A Neuropsychological Theory. Mahwah, NJ:Lawrence Erlbaum Associates.

o

Ferguson, Janice M. and Catherine A. Trombly. (1997). “The effect of added-purpose and meaningful occupation on motor learning.” American Journal of Occupational Therapy, 51, 508-515.

o

Higgins, Susan. (1991). “Motor Skill Acquisition.” Physical Therapy, 71, 123-139.

o

Jarus, Tal and Yael Loiter. (1995). “The effect of kinesthetic stimulation on acquisition and retention of a gross motor skill.” Canadian Journal of Occupational Therapy. 62, 23-29.

o

Keele, Steven W. (1968). “Movement Control in Skilled Motor Performance.” Psychological Bulletin 70, 387-403. Keele, Steven W., Matthew Davidson, and Amy Hayes. “Sequential representation and the neural basis of motor skills.” Motor Behavior and Human Skill: a multidisciplinary approach. Jan Piek, ed. Champaign, IL: Human Kinetics. 1998. 3-27.

o

Lee, Timothy D., Laurie R. Swanson, Anne L. Hall. (1991). “What is repeated in a repetition? Effects of practice conditions on motor skill acquisition.” Physical Therapy 71, 150-156.

o

Levelt, Willem J. M. (1989). Speaking: From Intention to Articulation. Cambridge, Massachusetts: The MIT Press. Schmidt, Richard A. (2003) “Motor schema theory after 27 years: reflections and implications for a new theory.” Research Quarterly for Exercise and Sport. 74, 366-375.

o

Schmidt, Richard A. and Lee, Timothy D. (2005). Motor Control and Learning: A Behavioral Emphasis. Champaign, IL: Human Kinetics.Schmidt, Richard A. and Wrisberg, Craig A (2008). Motor Learning and Performance. Champaign, IL: Human Kinetics.

RESEARCH ON AUDITORY SIGNALo Boddaert, N., Chabane, N., Belin, P., Bourgeois, M., Royer, V., Barthelemy, C., Mouren-Simeoni, M. C., Philippe, A., Brunelle, F., Samson, F. and Zilbovicius, M. (2004).

“Perception of Complex Sounds in Autism: Abnormal Auditory Cortical Processing in Children.” American Journal of Psychiatry. 161: 2117 - 2120.Courchesne E, Kilman BA, Galambos R, Lincoln AJ. (1984). “Autism: processing of novel auditory information assessed by event-related brain potentials.” Electroencephalography and Clinical Neurophysiology. 59: 238-248.

o Siller, Michael and Sigman, Marian. “The Behaviors of Parents of Children with Autism Predict the Subsequent Development of Their Children's Communication.” Journal of Autism and Developmental Disorders. 32: 77-89.

o D’Ausilio, Alessandro, Pulvermuller, Friedemann, Salmas, Paola, Bufalari, Ilaria, Begliomini, Chiara, and Fadiga, Luciano. 2009. “The motor somatotopy of speech perception.” Current Biology. 19: 1-5. Fadiga,L,Craighero,L,Buccino,G,Rizzolatti,G.2002. “Speechlisteningspecificallymodulatestheexcitabilityof tongue muscles: a TMS study. European Journal of Neuroscience. 15(2): 399-402.

o LeDoux, Joseph. (2002)Synaptic Self: How Our Brains Become Who We Are. New York: Penguin Books.Parsons, C. L., and La Sorte, D. 1993. “The effect of computers with synthesized speech and no speech on the spontaneous communication of children with autism.” Australian Journal of Human Communication Disorders. 21:12-31Pinker, S. (1994). The Language Instinct: How the Mind Creates Language. New York: HarperCollins.Rowland, Benjamin A. and Stein, Barry E. 2007. “Multisensory integration produces an initial response enhancement.” Frontiers in Integrative Neuroscience. 1:4.Russo, N., Foxe, J. J., Brandwein, A. B., Altschuler, T., Gnomes, H., and Molholm, S. 2010. “Multisensory processing in children with autism: high-density electrical mapping of auditory-somatosensory integration.” Autism Research. 3:1-15.Schroeder, C. E., Smiley, J., Fu, K. G., McGinnis, T., O’Connell, M. N., and Hackett, T. A. 2003. “Anatomical mechanisms and functional implications of multisensory convergence in early cortical processing.” International Journal of Psychophysiology.” (50). 5-17.Stein, B. E. 1998. “Neural mechanisms for synthesizing sensory information and producing adaptive behaviors.” Experimental Brain Research. 123:124-135.

o Tsao, Feng-Mint, Liu, Huei-Mei, and Kuhl, Patricia K. 2004. “Speech perception in infancy predicts language development in the second year of life: a longitudinal study.” Child Development. 75: 1067-1084.Vihman, M. M. and Nakai, S. (2003). “Experimental evidence for an effect of vocal experience on infant speech perception. In Proceedings of the 15th international congress of phonetic sciences (pp. 1017-1020). Barcelona. Westermann, Gert and Miranda, Eduardo Reck. 2004. “A new model of sensorimotor coupling in the development of speech.” Brain and Language. (89). 393-400.

o Winstein, Carolee J. (1991). “Knowledge of results and motor learning – implications for physical therapy.” 71, 140- 149.Zelaznic, Howard N. (1996). Advances in Motor Control and Learning. Champaign, IL: Human Kinetics.

SAMPLE GOALS USING FUNCTIONS OF COMMUNICATION

o Student will direct an activity using AAC system using core words (e.g., come, stop, turn,

go, put, make big)

o AKA: MANDING FOR ACTION

o Student will request items/activities using AAC system using core words

o AKA: MANDING

o Student will formulate 5 unique single word comments in a session

o AKA: TACTING

o Student will protest/communicate No using AAC system/ page/voice output

o AKA: MANDING FOR AN ANNOYING STIMULUS TO STOP

RESOURCES

o Mark Sundberg Series Presentation to sutdents at Western Michigan University

o https://www.youtube.com/watch?v=if31I-YG8XU

o Florida Institute of Technology Continuing Education courses for all professionals

o http://web2.fit.edu/bst/programs/aba/ceu.php

o VB MAPP app

o https://www.vbmappapp.com/products_services/vbmapp_app

RESEARCH ON REINFORCEMENT AND

PREFERENCE ASSESSMENT

Carr, J.E., Nicolson, A.C., & Higbee, T.S. (2000). Evaluation of a brief multiple stimulus

preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33,

353-357. doi:10.19017jaba2000.33-353

DeLeon, I.G., Bullock, C.E., and Catania, A.C. (2013). Arranging reinforcement

contingencies in applied settings: Fundamentals and implications of recent basic and

applied research. Chapter 3, APA handbook of Applied Behavior Analysis, Vol. 2:

Translating principles into practice. American Psychological Association.

YOU CAN START TO USE LAMP AND ABA TO ADDRESS THESE OBSTACLES

Obstacle LAMP

Component

Benefit to ABA program

We don’t use

sensory

integration

Readiness to

Learn:

student in

state that

allows attending

and learning,

requires

access to

motivating

activities

Activities serve as reinforcers

Help student attend and engage

for longer periods

Student attends to stimulus

presentation and to activities for

longer time

High MO leads to increased

Manding

High MO reduces the likelihood

that childs finds intstructional

activities as aversive

YOU CAN START TO USE LAMP AND ABA TO ADDRESS OBSTACLES

Obstacle LAMP

Component

Benefit to ABA program

We only

use ______

here.

We only

use

outcome

based

treatments.

Unique

and

Consistent

Motor Plan:

stable

word

location

leads to

effortless

communic

ation, low

cognitive

load

I am glad you said that! would

never use AAC systems that are

not supported by outcome data.

LAMP is an approved, outcome

based approach in the ASHA

Portal.

Unique and Consistent Motor

Plans means Minimal Response

Effort, which leads to increased

Mands and Joint attention

I have seen improvements in my

students’ communication skills

using a stable location and

consistent motor plan. This idea is

supported by research (share

your sources).

YOU CAN START TO USE LAMP AND ABA TO ADDRESS OBSTACLES

Obstacle LAMP

Component

Benefit to ABA program

AAC

devices

discourage

vocal

speech

Sam has

great

language-

“ I want

_____,

please.”

Auditory

Signal:

hear the

word and

pair it with

consequen

ces across

context

Student gets immediate delivery

of word and consequence, can

help with Stimulus Control issues

Auditory signal helps students

learn individual word meanings

and generate novel word

combinations

Can help with Echolalia and rote

responding as student learns the

meaning of a word across

contexts.

YOU CAN START TO USE LAMP AND ABA TO ADDRESS OBSTACLES

Obstacle LAMP

ComponentBenefit to ABA program

Gigi has a

lots of

language-

she can

label 300

pictures!

Shared

Focus:

Child led

activities

will

increase

joint

attention

or

Natural

Conseque

nces

I have noticed she does not have

many spontaneous mands or

requests, despite her ability to

tact 300 words. Maybe we can

look at her reinforcers to increase

spontaneous mands using high

motivation.

YOU CAN START TO USE LAMP AND ABA TO ADDRESS OBSTACLES

Obstacle LAMP

Component

Benefit to ABA program

We only

use ABA to

teach

language.

Natural

Consequence

learn words in

meaningful

contexts

Shared Focus

Readiness to

Learn

Research in Verbal Behavior points to success in

using both Natural Environment Teaching,

Functional Communication Teaching, as well as

Discrete Trial Teaching (Sundberg 2014).

My goal is to increase communication by using

the same principles as found in several different

ABA based teaching strategies, using an

outcome based approach to AAC.

Increases generalization of Mands across

contexts

REINFORCER ASSESSMENT FLOWCHART , DELEON ET AL (2013)

Eval.uate soolal con:S£Ktuences as relnforcers

R.ei nforcer Selection Flowchart.

Ineffective

' 1f'ry establish ng

soclal r,elnforcers

Ineffective

Determine prefenred no~ edible tang hie

Items

I neffectlve

Ineffective

Effective

lneffecblve

Evaluate under more

slrilngerrt conditions

Evaluate under mo~e sll'ingerrt condltlons (e.g .•

ntermlttency),

' / r Evaluate un:der more

slrilngerrt conditions.

------Determine preferred

ecfble re nforcers

Effective

' _,,

Etfocllve

" Evaluate l:anglble

with token

system

Eva uate edillle wl lh

tolilen system

.)

Use soolal rielnforcers

Use Effoctlve token

system

Use d istributed

tangllile

Use offocllve token

system

, I neffectlve Use - dlstrlbuted

tang hie

FIG IRIE 3.1. A decision llowchart for selectiiing reiiioforcers. in appliedl ~Mings.

INSERT LAMP INTEREST INVENTORY FROM JOHN HALLORAN