Microsoft PowerPoint - AAC Star Training Spring 2018

The Role of Augmentative Alternative

Communication Systems for Children with Autism

Spectrum Disorder

Presented by:

Melissa Subock, M.S., CCC/SLP

Spring 2018

Definition of AAC

From the American Speech Language & Hearing Association

(ASHA)

• Augmentative and Alternative Communication (AAC) includes all forms of

communication (other than oral speech) that are used to express thoughts,

needs, wants, and ideas.

• This includes…

AAC: Who Should It Be Used For?

AAC is useful for any child with Autism Spectrum Disorder (ASD)

who is unable to use speech to meet their communication needs

 Across all communication partners

 Across all contexts/settings

CommunicationPartners

Settings

‐Home

‐School

‐Community

AAC: Who Should It Be Used For?

Most, if not all, children with ASD can benefit from some

form of AAC support

Children with mild-moderate

social/ communication deficits

• Visual schedules

• Topic boards to generate

language

• Social stories

• Visuals for social skills

Children with moderate-severe

social/ communication deficits

• Visual schedules

• Picture Communication systems

• Voice output devices

Does your child need AAC Supports?

Think about PURPOSES of communication

-Requesting wants/needs

-Developing social closeness

-Giving information

-Joining in social etiquette routines

Think about HOW your child communicates

-Across different people, in a variety of environments…

-Are there communication breakdowns?

-Does your child know how to repair a communication interaction?

-Is your child’s communication system meeting all of his or her communicative

needs?

How do I get started?

 Contact your child’s IEP team to discuss an Assistive

Technology evaluation

 Discuss concerns with your child’s intervention team (both

school-based and private)

 Consider an Augmentative- Alternative Communication

evaluation through a private facility (e.g., Kennedy Krieger

Institute)

Preparing for an Assistive Technology/ AAC

evaluation

• Identify your child’s current mode(s) of

communication

– Gestures (symbolic, socially-directed vs. reaching to

grab/hand as tool)

– Eye contact

– Current AAC systems: Picture Exchange Communication

System (PECS), Topic Boards, Speech-generating device

– Vocalizations (sounds, words, phrases)

• Related to context vs. scripted

Preparing for an Assistive Technology/ AAC

evaluation

• Gain access to previous speech-language

evaluations and/or AAC evaluations to provide them

to the speech-language pathologist prior to or during

the evaluation

• Prepare a list of objects, activities, familiar people,

etc. that the child would need to communicate about

• Consider bringing motivating toys, books, snacks,

etc., that the speech-language pathologist could use

during the evaluation to tempt your child to

communicate

• Limit your child’s screen time

AAC Assessment: What to expect

During the evaluation, the speech language pathologist will:

• Talk to you about your child’s current communication abilities and needs

• Conduct a standardized assessment of communication if one has not been

completed within the six months

• Identify the child’s motivators

• Initiate a fun & engaging context-based activity w/ a variety of AAC tools

programmed for the experience

• Obtain consent to communicate with your child’s teachers, intervention

providers, etc. to learn more about how he or she is communicating in other

environments

AAC Assessment: What to Expect

SLP will determine which type of communicator

your child is to assist with AAC system selection

Emerging Communicator

• Emerging/limited understanding of symbols (e.g.,

pictures, words, etc.)

• May use the following methods of communication

– Facial expressions

– Body movements/physical manipulation (e.g., pulling others

by the hand)

– Basic gestures (e.g., reaching, pointing, giving)

– Requires substantial assistance from caregivers or other

familiar communication partners to successfully

communicate

– May be difficult to determine how much the child

understands (e.g., inconsistently follows directions)

Intentional/Context Dependent

Communicator

• Understands picture symbols or photographs that represent

familiar objects, people, and actions that occur frequently in their

environment

• Follows simple instructions in both highly-familiar and new

environments.

• Able to use symbols to communicate basic wants and needs

spontaneously

• Starting to use symbols to communicate for other purposes

• Initiates interactions with familiar adults and peers

• Most successful communication occurs within familiar contexts

with familiar communication partners

• May still need some support from familiar communication

partners when the topic, partner, or context is less familiar

Independent Communicator

• Understands at a level commensurate with age (i.e.,

no delay in receptive language)

• Combines words, phrases, and written text to

communicate across a variety of topics and

environments

• Able to engage in conversation

• If using a speech generating device, able to prepare

content in his or her device (e.g., stories, narratives)

and use features, such as word prediction,

independently

Emergent Communicator Intentional/

Context Dependent Communicator

Independent Communicator

Picture Exchange Communication

System (PECS)

Static display devices (e.g., Go Talk,

Tech Speak, etc.)

Keyboards, letter boards, text- to-

speech apps for iPhone

Single- button speech generating

devices

Simple speech generating

communication apps (e.g., Go Talk

Now, Scene Speak, etc.)

High-tech AAC systems that afford the

opportunity to use predictive-text,

create narratives, etc.

Simple gestures/body language and

facial expressions

Picture-based communication systems

(e.g., Flip ‘N Talk, topic boards)

Dynamic Display, speech-generating

devices (e.g., NovaChat, TouchChat

Express, Prio, Accent, QuickTalker,

etc.)

Communication apps for the iPad (e.g.,

Proloquo2go, LAMP Words For Life,

TouchChatHD-AAC, etc.)

AAC Assessment: Device Selection

AAC Assessment- Funding

Options for obtaining a device include the following:

• Self pay (out-of-pocket)

• Grant funding

• Request an Assistive Technology evaluation through school

• Insurance funding

• Rental through Maryland Technology Assistance Program

(MDTAP)

AAC Assessment- Funding, cont’d.

• Parent forms

• PCP/ CARD MD forms

• SLP forms- in addition to evaluation report

Getting Started with AAC with your SLP

1. The new AAC device gets delivered to your speech-

language pathologist (SLP)

2. The SLP works with you to identify important vocabulary

and then he or she will program the AAC device

3. Your child will come in for several initial training

sessions (follow-up/referral for treatment programs

dependent on child’s progress your interest in pursuing

further parent training)

4. The SLP may refer to other short-term treatment

programs within CARD or ongoing treatment closer to

home

Getting started with AAC at home

• Identify motivating activities that your child enjoys

• Work with your child’s SLP on learning to program the new device so

that you feel comfortable adding words and icons to the system

• Ensure the words your child would need to use during the activities are

available on the AAC system

• Initially, model language on the AAC system while you are talking

– Improves understanding of the purpose of the system

– Builds receptive vocabulary

• Accept all attempts your child makes to use his or her AAC system,

even if he or she makes a mistake

– Repeat the word or phrase your child activates on his or her system if

correct

– Model a word or phrase that is relevant to the activity if your child’s attempt

was not related

– Expand on his or her communication by adding words to his or her

utterance

Tips for getting started- ENCOURAGE

• Make simple changes to the environment to “tempt”

your child to communicate using his or her AAC

system

– Snacks

–Toys

– Daily living activities

– Book activities

Tips for getting started- MODEL

• Model words and short phrases on your child’s AAC

system

– Throughout the day

– During many different types of activities (play, dressing,

snack time, family outings, etc.)

• Work on generalization

– Model the same words or phrases across multiple activities

Tips for getting started- REWARD

• Reward all attempts your child makes to use his or

her AAC system

– He or she may make mistakes, and that’s OK!

– If your child chooses an incorrect icon, model the correct

icon as you are rewarding your child for the attempt

– After practicing this several times, you can challenge your

child by prompting him or her to select the correct icon

before giving the reward

Tips for getting started: PROMPT

• Model prompts

• Physical Prompts

• Gesture Prompts

• Wait prompts

• Expansions

Tips for getting started- RESPOND

• Make sure to respond to all attempts your child makes to

communicate with you with his or her new system

• At first, your child may initiate communication in a different way

 Grabbing the item himself

 Vocalizing

 Looking at the item and/or you

• Shape attempts by responding positively

 Model a word or phrases on your child’s system and then give the

child access to the item he or she wants

 If your child presses an incorrect icon, model the correct icon

 Provide a “natural consequence”

Children need a lot of practice to start

using AAC independently.

Final Thoughts, Questions, and Resources

• Maryland Technology Assistance Program (MDTAP)

– 1-800-832-4827

– http://mdod.maryland.gov/mdtap/Pages/MDTAP-Home.aspx

• CARD’s AAC Program

– 443- 923-9400

– https://www.kennedykrieger.org/patient-care/make-

appointment

• http://praacticalaac.org/

References

• Dynavox and Dynamic Therapy Associates (Comps.).

(2014). The Dynamic AAC Goals Grid 2. Georgia,

Kennesaw.

• Light, J., Beukelman, D., & Reichle, J. (Editors).

(2003). Communicative Competence for Individuals

Who Use AAC: From Research to Effective Practice.

Paul H. Brookes Publishing Company.

• Cafiero, J. (2005). Meaningful exchanges for people

with autism: An introduction to AAC. Bethesda, MD:

Woodbine House.