Functional Curriculum: Session 7

“If I could not express myself, I would become like the tree in the forest—the one for which it does not matter if it makes a sound when it comes crashing down, because there is no one around to hear it. Unfortunately, there are still many silent fallen trees all around us if we stop and look.”

Bob Williams, AAC user with complex communication needs(Williams, 2000, p. 250)

Complete Entry Activity

Multicultural Issues in AAC

Entry Activity

Communication strategies are often developed by the practitioners without adequate knowledge of the AAC user’s culture.

Providing a culturally acceptable strategic system may enhance the strategic competence while enabling the user appropriate use of the chosen technology.

What can you do to ensure a student’s culture is considered in the development of a communication system?

AAC users are vulnerable to the culture of practitioners

Quiz #2 Today Next Week….November 16th:

Ability Awareness Lesson Plan Due November 23rd: Quiz #3 November 30th: Submit Work Sample &

Powerpoint Presentation

Updates

I will not be available on Monday & Tuesday- normal office hours

I will make myself available on Friday. Please email me if you would like to set up

an appointment.◦ sheldon.loman@pdx.edu

Change in office hours for this upcoming week

Quiz Review

Teaching Skill Maintenance Maintenance: skill continuing to occur for as

long as it is needed without having to be taught again.

Common error in teaching is that the skill is learned and generalized, but not practiced sufficiently beyond initial learning

Maintenance strategies should be used in addition to generalization strategies

Maintenance Strategies Overlearning

◦ Continue practicing a skill◦ Leading to automaticity◦ Overlearning opportunities should be at least 50%

of the opportunities necessary for the student to initially learn the objective.

Distributed Practice◦ Practice during distributed learning sessions◦ Practice is spread out across the day (vs massed

practice)◦ Practice 1 wk, 2wks, 4 wks later to ensure retention of

skills

Intermittent Reinforcement- variable reinforcement schedule

Using a maintenance schedule- build in practice for infrequently used skills

Teaching self-management & self-instructional skills

Start teaching students to manage their prompts and performance

Teach “self-talk” of what steps or what each cue should be “saying” to them, etc.

◦ Chained: multi-step behaviors E.g. sweeping the floor, playing UNO, ordering food

◦ Discrete: stand alone (e.g., naming people, matching numbers to quantities, reading words)

◦ It is sometimes hard to distinguish the difference, depending on the learner

Chained response skills vs discrete response skills

Cue(opportunity to respond)

Response/Behavior

Consequence Pause

FR Environment provides a natural cue

Student does each step needed to complete the activity

Student gets natural outcome of activity

Student focuses on next routine

EX Student’s bus arrives and door opens.

Other students get off bus

S gets off bus, goes in the correct direction, enters building, goes to class, puts away materials

Student is now inside with other students and has inviting activities to do. Teacher offers praise

Student transitions to next routine

Functional Routines Instruction

Cue(opportunity to respond)

Response/Behavior

Consequence Pause

DTT T provides instructional cue (prompting may be needed)

Student Responds

Teacher praises and give child a positive reinforcer

There is a pause

EX 1. Student indicates interest in chips

2. Teacher says “Give me a car”

Student gives car to teacher

Teacher praises student and gives student a chip

Student eats chip and teacher waits a few seconds before next cue

Discrete Trial Training

Pivotal Response TrainingCue(opportunity to respond)

Response/Behavior

Consequence Pause

PRT 1. S indicates interest

2. Teacher withholds access to desired item/activity

Student Responds

S gets desired item

There is a pause

EX 1. Student reaches for car.

2. Teacher withholds and says, “Car”

Student imitates the word car.

Teacher gives student access to car

Student plays with car

Generalization “Appropriate responding in untrained

situations” (Haring, 1988). What would be features of untrained

situations? How determine relevant features of

untrained situations?

Strategies Identified to Promote Generalization Antecedent Generalization Strategies

◦ Teach in natural setting◦ Use sufficient exemplars◦ Train loosely

(varying stimuli, responses, reinforcers allowed)◦ Program common stimuli

Training setting contains stimuli that are also in the generalization setting

◦ General Case Design Using several specific exemplars based on the

learner’s “instructional universe”

Consequence Generalization Strategies Introducing natural maintaining consequences

◦ Teaches skill during acquisition period that will be reinforced by natural contingencies in the environment in which behavior will occur, instead of artificial reinforcers that were used during acquisition

Using Indiscriminable Contingencies◦ Use of intermittent schedule of reinforcement◦ Does not know when, where, or what will result in

reinforcement Training to generalize: differential reinforcement in

“generalization” condition rather than original condition

General Case Design (GCD)1. Define the Instructional Universe

-Understand the student & where behaviors need to be performed

2. Define the range of relevant stimulus and response variation-important to identify generic response-all important stimuli that could prompt the target responses listed-possible variations of stimulus classes listed-ways in which the learner might respond outlined -List of anticipated problems, errors, exceptions

GCD Cont’d

3. Select examples for teaching and probe testing -teaching: general case-probe: testing generalization/variation

-don’t need all “stores”, but adequately represent all variations of important stimuli & responses-positive & negative teaching examples

GCD Cont’d4. Sequence the teaching examples

Guidelines for sequencing:A. Teach multiple components of an activity within an instructional sessionB. Present variations within individual sessions. Teach as many examples as possible within instructional sessionsC. Juxtapose most similar positive and negative examples.D. Use cumulative programming. If all examples cannot be taught in one session, work on a few at a time, adding new examples to already learned examples in each new session. E. Teach the general case before exceptions.

GCD cont’d

5. Teach sequence

6. Test using the non-trained probe examples -to determine whether generalization has occurred.

Consider these steps when collaborating and designing instruction for students.

1. Think long term and broader environments….where/when/how do you want the student to perform these skills in the future?

2. Outline the steps student needs to perform to complete task/routine.

3. Identify the cue for each step.4. Identify the variation in the features of each cue for

each step.5. Identify the variation in the conditions/environments

student will need to perform task6. Systematically introduce these variations to avoid

stipulation

Generalization. The basic idea: teach to avoid stipulation

Elements of Objectives Learner (who) Behavior (what) Condition (when, where, with whom) Criterion (how much, how fast)

Given a 15 min daily snack period with seven other children, Darin will use a “please-statement” to verbally request an item at least two times across 4 of 5 snack periods.

Quiz

Self-grade quiz

◦ Chained: multi-step behaviors E.g. sweeping the floor, playing UNO, ordering food

◦ Discrete: stand alone (e.g., naming people, matching numbers to quantities, reading words)

◦ It is sometimes hard to distinguish the difference, depending on the learner

Chained response skills vs discrete response skills

Cue(opportunity to respond)

Response/Behavior

Consequence Pause

DTT T provides instructional cue (prompting may be needed)

Student Responds

Teacher praises and give child a positive reinforcer

There is a pause

EX 1. Student indicates interest in chips

2. Teacher says “Give me a car”

Student gives car to teacher

Teacher praises student and gives student a chip

Student eats chip and teacher waits a few seconds before next cue

Discrete Trial Training

Pivotal Response TrainingCue(opportunity to respond)

Response/Behavior

Consequence Pause

PRT 1. S indicates interest

2. Teacher withholds access to desired item/activity

Student Responds

S gets desired item

There is a pause

EX 1. Student reaches for car.

2. Teacher withholds and says, “Car”

Student imitates the word car.

Teacher gives student access to car

Student plays with car

Forward Chaining Backward Chaining Total Task Chaining

Teaching chained response skills

Generalization “Appropriate responding in untrained

situations” (Haring, 1988). What would be features of untrained

situations? How determine relevant features of

untrained situations?

Strategies Identified to Promote Generalization Antecedent Generalization Strategies

◦ Teach in natural setting◦ Use sufficient exemplars◦ Train loosely

(varying stimuli, responses, reinforcers allowed)◦ Program common stimuli

Training setting contains stimuli that are also in the generalization setting

◦ General Case Design Using several specific exemplars based on the

learner’s “instructional universe”

Consequence Generalization Strategies Introducing natural maintaining consequences

◦ Teaches skill during acquisition period that will be reinforced by natural contingencies in the environment in which behavior will occur, instead of artificial reinforcers that were used during acquisition

Using Indiscriminable Contingencies◦ Use of intermittent schedule of reinforcement◦ Does not know when, where, or what will result in

reinforcement Training to generalize: differential reinforcement in

“generalization” condition rather than original condition

Elements of Objectives Learner (who) Behavior (what) Condition (when, where, with whom) Criterion (how much, how fast)

Given a 15 min daily snack period with seven other children, Darin will use a “please-statement” to verbally request an item at least two times across 4 of 5 snack periods.

Teaching Communication

Like teaching other skills: Use systematic instruction & evidence-based

practices

Communication Bill of RightsEach person has a right to:

• Request desired objects, actions, events, & people• Refuse undesired objects, etc.• Express personal preferences & feelings.• Be offered choices & alternatives.• Reject offered choices & alternatives.• Request & receive another person’s

attention/interaction• Ask for & receive info about changes in routine &

environment.• Receive intervention to improve communication

skills From the National Joint Committee for the Communicative Needs of Persons with Severe Disabilities. (1992). Guidelines for meeting the communication needs of persons with severe disabilities. ASHA, 34(Suppl. 7), 2–3.

Communication Bill of RightsEach person has a right to:

• Receive a response to any communication, whether or not the responder can fill the request.

• Have access to augmentative and alternative communication and other assistive technology services & devices at all times.

• Be in environments that promote one’s communication as a full partner with other people, including peers.

• Be spoken to with respect & courtesy.• Be spoken to directly and not spoken for or talked

about in 3rd person while present.• Have clear, meaningful, and culturally &

linguistically appropriate communication.

Assessing Communication Skills Standardized Tests will not provide the

information you need

Assessment driven by questions that need to be answered to help benefit from communication intervention—Team Effort

Interviews with Significant Others &

Ecological-Functional Assessment Process

Functional Behavioral Assessments (FBA)

Functional Communication Training: Carr & Durand, 1985

Typical Consequence

Maintaining Consequence

Desired BehaviorProblem BehaviorAlternate Behavior

Antecedent

Setting Event

Summary of Behavior

Considering assessment options?

Current communication

Environmental conditions

Motor capabilities

Cognitive/linguistic capacities

Language capacities

Literacy capacities

Sensory/perceptual capacities

Assessing Receptive Communication Skills Receptive skills for a specific activity need to be

identified

What does the student do to demonstrate that the message has been received and understood?

Document what forms of communication seem to be best understood

Assessing Expressive Communication Skills Any attempt by the student to start, maintain, or end a

communicative exchange should be noted.

How the students communicates (the form)—Skill level?

Why the student is communicating (function/intent)—different forms of communication for different purposes?

What the student talks about (content)—information on breadth of skills and accessibility?

1. List Domains

2. List environments

3. List sub-environments

4. List activities associated with each

sub environment

5. Task analyze each activity to identify skills

6. Observe the performance of the

activity to identify needs

Communication Ecological Inventory Worksheet (Figure 8-10, p.249, Best, Heller, Bigge, 2005)

1. Ask: Where does the student spend time? (environment, sub-environment, activities)

2. Select Activity: (e.g., ordering food)

3. Observe: (for vocabulary used in activity) List Expressive Vocabulary used in the activity List Receptive Vocabulary used in the activity

4. Review listed words and determine which words & skills need to be taught to the student.

Example of Communication Ecological Inventory Where does the student spend time?

◦ Environment: Community: McDonald’s◦ Sub-environment: McDonald’s counter area◦ Activities: Ordering food, waiting in line,

socializing in line

Select activity: Ordering Food

Example Cont’d Observe vocabulary used in activity

◦ Expressive: “I want, hamburger, fish sandwich, small, medium, large, coke, milkshake, yes/no, that’s all, thank you, my order is wrong, I need, extra ketchup, for here, please repeat that, how much?”

◦ Receptive: “May I help you?, Is that all?, Here or to go?, Your order will be ready soon?, I don’t understand, Your total is_____”

Review listed words: which are above, below, and at the student’s level. Which are within or outside student’s experience, which are necessary for the task

Ecological Inventory of Communication Skills

Steps in Activity

Natural Cues

Comm. Skills Needed

Student Performance

Discrepancy Analysis

Interv.Plan

Receptive or Expressive

+ or - Why student isn’t doing the step

suggestions

http://www.wati.org/?pageLoad=content/supports/free/index.php

Number of free publications WATI Assessment- provides an overview of

the assistive technology consideration, assessment and planning process

WATI AT Checklist in your book pg. 514-515

Great Resource:Wisconsin Assistive Technology Initiative

SETT- similar to ecological inventoryStudent

S

Environment

E

Task

T

Tools

T•What are the student’s current abilities?

•What are the student’s special needs?

•What are the functional areas of concern?

•What activities take place in the environment?

•What activities do other students do that this student cannot currently participate in?

•What assistive technology does the student have access to or currently use?

•What specific tasks occur in the environment?

•What activities is the student expected to do?

•What does success look like?

•Are the tools being considered on a continuum from no/low to high-tech?

•Are the tools student centered and task oriented and reflect the student’s current needs?

•What are the training requirements for the student, family and staff?

Augmentative & Alternative Communication is…

• “any means that helps a person communicate when conventional speaking, writing, and/or understanding others are not possible.”

(McCormic, Loeb, & Schieffelbusch, 2003)

• “any item, piece of equipment, or product system, whether acquired commercially off the self, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities.” (IDEA, 1990 ~ Federal Register)

Developing a communication system for a student is a team effort.

Speech/Language Pathologists will be your “go-to” person to collaborate with when selecting system, designing instruction, implementing communication instruction

Work closely with them. Make sure you emphasize the ecological

assessments and preference assessments conducted with student.

Collaborating with SLPs?

Consider their home-language, culture, and long-term vision for the student’s communication.

Want to build system so that you can bridge home and school vocabulary, language, etc.

May be an issue when device is not allowed to go home.

Try to work with school to allow device to go home. Parents may need to sign responsibility for device.

Working with Parents?

Comm. Skills are best taught throughout the day where they typically occur or are expected to occur (Beukelman & Mirenda, 2002; Fox, 1989; Haring et al., 1985)

Students without disabilities play a critical role in the development of communication for students with severe disabilities (Carter & Hughes, 2005; Kamps et al., 2002; Von Tetzchner et al., 2005;

Research on Intervention Strategies

What should we choose to teach?

Consider:

What to communicate about

Activities/environments used in

People communicate with

Initial Instructional Strategies Establishing Want/No

Response Prompt Strategies (Time Delay, System of Least/Maximum Prompts)

Milieu Teaching- modeling, requesting, time delay, incidental teaching (e.g., pivotal response training)

Environmental Arrangement & Interrupted-Chain Strategy

Greetings & Farewells◦ Age-appropriate vocabulary, mannerisms◦ May not necessarily need a Speech Generated

Device (SGD) Asking for Attention/Help- “Can I Play?” Requesting objects/activities/people Turn taking Approval & Rejection Commenting Asking questions

Communication Skills Across Classes & Subjects

Social Closeness◦ Observe what typical students do to achieve this◦ E.g., admiring another’s hairstyle, telling secrets

Asking peer-focused questions◦ “what are you doing this weekend?”

Holding a conversation Communicative Skills specific to a class or

an activity

Other communication skills to teach

Language Comprehension◦ Understanding spoken language and graphic

symbols (if used for device)◦ Using visual schedules, sequences

Receptive Vocabulary◦ Teaching the meaning of specific vocabulary

words◦ Using both spoken language and graphic symbols

Expressive Vocabulary◦ Developmental Vocabulary

Linguistic Competency Skills

Developmental Vocabulary◦ To encourage language & vocabulary growth◦ Should include words or messages that encourage

students to use various language structures and combinations E.g., more, no, there

◦ Variety of nouns, verbs, & adjectives to support word combinations E.g., more car, OR no eat

◦ As vocabulary expands encourage use of combinations of 2,3,4, or more

Pre-literate vocabulary Needs for an AAC system

Substantive words (i.e., people, places, things) Relational words (e.g., big, little) Generic verbs (e.g., give, get, make) Specific verbs (e.g., eat, drink, sleep) Emotional state words (e.g., happy, scared) Affirmation/negation words (e.g., yes, no, not) Recurrence/discontinuation words (e.g., more, all gone) Proper names for people first (Mike) and personal

pronouns (his) later Single adjectives first (e.g., hot, dirty) & polar opposites

later (e.g., cold, clean) Relevant colors Relevant prepositions (e.g., on, over)

Developmental vocabulary categories (include from the lists)

If limited sight word recognition… Messages chosen from a functional rather

than developmental perspective Single words or whole messages are selected

to meet individual communication needs. ◦ One or more symbols to represent messages◦ Age/context/culturally appropriate.

Include some developmental vocabulary in AAC systems◦ Added whenever new environments or participation

opportunities are included

Vocabulary selection for nonliterate individuals

Words & messages that are commonly used by a variety of individuals and occur very frequently.

Sources to identify core vocabulary items◦ 1. Word lists based on the vocabulary-use

patterns of other individuals who successfully use AAC systems (http://aac.unl.edu/vocabulary.html)

◦ 2. Word lists based on the use patterns of the specific individual

◦ 3. Word lists based on the performance of natural speakers or writers in similar contexts.

◦ http://www.youtube.com/watch?v=Vib2__BDCXc

Core vocabulary

Two types of AAC techniques• Unaided- Do not require any

external equipment (i.e. manual signs, facial expressions, gestures)

• Aided- Incorporate external devices (i.e., computers, microswitches, or speech-generating devices (SGDs)

• Most people use both to communicate in different situations with different people

Communication System

Combination of all of the techniques used by an individual student

Unaided Communication

• Teachers need to be attuned to how student communicates

• Understand what various gestures, vocalization, and other techniques mean

Gesture DictionaryWhat John

DoesWhat it means

How to Respond

Runs to the door

“I want a drink of water”

Let him go for a drink of water from the water fountain or set a timer for when he can go

Grabs another student’s arm

“I like you”

Explain the meaning to John’s classmate & help them work together

When is unaided communication appropriate?• Used when students have

no other way to get their messages across

• Must be socially acceptable & intelligible

Manual Signs: Pros & Cons• Some people who can hear

use manual signs (e.g. ASL)

• Advantage: requires no equipment

• Disadvantage: Many people do not understand signs, therefore limited communication partners

• What are other pros or cons?

When to teach signs

• Poor prognosis for speech

• Signing partners available

• Physically able

• Adequate cognitive skills

• A portable communication system is desirable

Aided Communication

• Low-Tech/Non-electronic: symbols, and communication displays

• Hi-Tech/Electronic: Speech-generating devices

• Advantages/ Disadvantages of both?

Behavioral approach to teach self-initiated requesting with aided symbols

Teaches requesting as the very first skill in the person’s communicative repertoire, without requiring the individual to have skills such as eye contact, imitation, facial orientation, match-to-sample, or labeling as prerequisites

Manual by Frost & Bondy (2002)

Taught to exchange symbols for desired items rather than point to them on a communication display; communication partner provides the requested item or activity

PECS (Picture Exchange Communication System)

http://www.youtube.com/watch?v=ZP48lxnNdHM

http://www.youtube.com/watch?v=tr3lQXNEcps&feature=related

http://www.youtube.com/watch?v=ZrELOVWnp28&feature=related

PECS video examples

Symbols for Communication

• Real Object Symbols

• Photographs & Pictures

• Line Drawing Symbols

• Textured Symbols

• Letters & Words

Selecting Symbols—What to look for?• Should make sense to the user &

communication partners (assess with range of choices)

• Similarity between the symbols & what represents should be obvious

• Students sensory modalities should be considered

• Symbols introduced gradually building on current communication skills

Communication Displays--examples• Velcro board with a few picture

symbols that students point to

• Plexiglas eye gaze display that a student uses eye to “point” (Figure 8-19, p.261)

• Communication Book or Wallet

http://www.youtube.com/watch?v=mCeOMoQPn_8Eye-gaze technology

http://www.youtube.com/watch?v=DgTMBwcoicY

http://www.youtube.com/watch?v=AooDQOzdOyE http://

www.youtube.com/watch?v=Rz2HpGC9vbw

Considerations for Designing Displays• Messages: which are needed,

in what contexts

• Symbols: depending on the individual & messages

• How symbols are displayed: booklets, notebooks, wheelchair trays, scanners

• Organizing symbols: context specific, how many per page, etc.

Graphic arrays• Designing communication

boards or communication notebooks– Choosing items– Size of each item– Positioning each item– Accessibility of each item– Perception of each item (both user

and communication partner)– Item placement/ordering- groups?

Effort in scanning?– Motor involvement in using array-

vertical or horizontal?

Using Symbols to Promote Participation/Conversation• Calendar/Schedule

Systems• Choice Displays• Remnant (e.g. Movie

ticket, scraps from activities) Displays

• Conversation Displays

Hi-Tech: Speech Generating Devices• Devices “talk” when a

student touches a symbol on the device

• What are advantages/ disadvantages??

Types of Electronic Devices

• Single-level Devices: deliver a limited number of messages (about 20), simple to program & operate (e.g. BIGmack)

• Multi-level Devices: Up to thousands of messages, more difficult to program, multiple symbol displays to program messages on two or more levels.

• Comprehensive Devices: “dynamic display” technology

http://www.youtube.com/watch?v=S7ShtIwkuwY

http://www.youtube.com/watch?v=2iYxYh_ZfQk

Supporting AAC learners is a collaborative effort

– Family/caregivers & friends– Present & future employers– Teachers (SPED & Gen Ed.)– Speech/language specialists– Physical & occupational

therapists– Student

Supporting AAC Learners (continued)

• Access to AAC– Available– Accessible– Appropriate

• Atmosphere of acceptance– Nonjudgmental - OK to make

mistakes, model correct response, praise attempts, allow more time, minimize peer pressure, reinforce tolerance of individual differences.

Teaching Communication Skills• General Education Classroom

Ideal environment- numerous opportunities to communicate with responsive communicative partners

• However, students need specific & systematic instruction to acquire desired skills

• Educational Team must develop teaching strategies and implement them consistently

Need to teach students how to use their AAC system

AAC places an array of motor, visual, auditory, and cognitive demands on student

Programming- may be done by SLP or teacher, but…

Students need to know how to operate devices◦ E.g., scanning can be complicated and multi-step◦ May want to teach specific operational skills as an

objective untied to actually requesting items, etc.

Teaching Operational Skills

Things to Consider with AAC• Mode of communication – Input: how

the student receives the message; • Output: means in which the student

transmits the messages to others• Mechanism for communication –

Gestures, Vocalizations, Graphic• Type of selection - Direct selection,

Scanning, Encoding• Physical display - Number of graphic

symbols, Spacing and arrangement, Background, Orientation, Fixed or dynamic

• Vocabulary selection• Output - Print copy, Speech, Scan

display

Supporting AAC Learners

AAC Training◦ Training for student,

parents/family/friends, teachers, employers, peers

◦ Training in the use/maintenance of the system

◦ Training in facilitative/instructional techniques that promote communication

Choosing Outcomes and Accommodations for Children (COACH, Giangreco et al., 2011).

Vermont Independent Services Team Approach (VISTA; Giangreco, 1996)

Unified Plan of Support (Hunt et al., 2003) Goal Attainment Scaling (GAS; Schlosser,

2002)

Tracking Student Progress

Simple method for evaluating individual progress toward unique goals

Helps develop consensus-based goal-setting Looks at more than just one outcome

measure that the student either achieves or does not achieve

5 possible outcomes are determined for each to goal

Expected outcome=0, above expectations +1 & +2, below expectations -1 & -2

Goal Attainment Scaling

http://www.otap-oregon.org/Pages/Default.aspx Try to get involved with AT/AAC team in your

district… or whoever is doing it and make a “team”

Proloquo2Go http://www.youtube.com/watch?v=dKc1Ss5d1N

w&feature=related http://

www.youtube.com/watch?v=W-eWvnWMx6c http://

www.youtube.com/watch?v=4FkSNMLVlmk

Resources/ iPAD