STRATEGIES FOR SUPPORTING AAC USE Cathy Binger, Ph.D., CCC-SLP University of New Mexico All Roads Lead to ECHO Conference Wyoming Institute for Disabilities, 2016
Disclosures ¨
I have received ¤ Funding
from the ASHFoundation, NIH, and internal grants at UNM to support this work. n
¨
NIH grant: 1R03DC011610
I have received travel expenses from the Wyoming Institute for Disabilities for serving as your speaker today.
Binger WIND 2016
AAC Strategies: Overview 3
Framing AAC and Communication
Language Goals for Children who use AAC
Techniques to Improve Expressive Communication
Binger WIND 2016
Framing AAC and Communication
Binger WIND 2016
AAC is a TOOL, not a Goal ◦
GOAL ◦
◦
TOOL ◦
◦
Improved daily life communication AAC
GOAL ≠ AAC AAC is about COMMUNICATION
Binger WIND 2016
What are the Outcomes? AAC use is never an outcome in and of itself Devices cannot accomplish anything in and of themselves
Participation
Language skills
Increase/Improve
◦ Nothing magical about
using aided AAC
Devices are TOOLS to reach the same goals as clients who rely on speech
Social skills
Binger WIND 2016
Academic/ employment outcomes
Language Goals for Children using AAC
Binger WIND 2016
Focus, Goals, & Context of Communication
Focus Goals Context
• Improving daily life communication
• Very similar to non-AAC clients; e.g., • Expand sentence length • Expand vocabulary diversity, etc. • We will discuss AAC devices within the context of communication • NOT the features of each device in isolation
AAC is much less intimidating when viewed this way! Binger WIND 2016
Goals for Children who use AAC
Social skills
Vocabulary
• Turn-taking, commenting, asking questions • NOT just requesting!
• Vocabulary size & diversity
Sentence structure • Grammatical markers such as plural –s and progressive -ing • Message length and complexity
Binger WIND 2016
Example Goals Early vocabularybuilding
• Dakota will label 5 different insects and snakes and 5 new verbs (e.g., crawl, hop, slither) accurately during science center over three consecutive days
Social skills
• Jasper will take at least three commenting turns with his peers during free play time using an appropriate communication mode (e.g., using preprogrammed phrases such as “That one is fast!”)
Sentencebuilding
• Margarite will use at least 5 grammatically complete sentences when giving an oral presentations in science class
Binger WIND 2016
Techniques to Improve Expressive Communication
Binger WIND 2016
Intervention techniques to Improve Expressive Communication
(e.g., Binger, Kent-Walsh et al., 2008,
2010; Binger & Light, 2007; Kent-Walsh, Binger, et al.,2010)
Prompts • • • •
Aided modeling Spoken modeling Expectant delay Open-Ended or WHquestion asking • Direct spoken prompting • (Physical prompting)
Responses • Contingent responses • Imitations • Recasts • Can be spoken and aided
(c) Binger 2015
Sample Communication Board: Sentences with Prepositions and Adjectives
(c) Binger 2015
Early Sentence Productions with Prepositions ¨
Child H Video 1 ¤ ¤
Motivation situation Prompts n
¤
Responses n
¨
Natural set-up and cueing Spoken and aided model
Child H Video 2 ¤ ¤
Motivating situation Prompts n n n n
¤
Natural set-up and cueing Spoken model Direct spoken prompt: “Tell Cow where he is.” Expectant delay
Responses n
Natural consequence
Binger WIND 2016
Early Sentence Productions with Prepositions ¨
Child H Video 4 ¤ Motivation
situation
¤ Prompts
Spoken model + direct prompts n WH question n Spoken choices: “Under? Behind? Next to?” n
¤ Responses
Spoken confirmation within an natural consequence n Aided model n
¤à
Lots of help with forming this new, more complex structure Binger WIND 2016
Early Sentence Productions with Prepositions ¨
Child H Video 5 ¤ Motivating
situation
¤ Prompts
Natural cue n NO higher level cues here; doesn’t need them n
¤ Responses n
Spoken model/ imitation
Binger WIND 2016
Did you see… ¨ ¨ ¨ ¨ ¨ ¨
How much FUN this can be! How expecting more = getting more Encouraging immediate correction of errors Encouraging use of grammatical markers Speed of learning to use the markers Impossibility of producing such sentences without AAC
(c) Binger 2015
Challenge your Clients 18
¨
Provide them with the communication solutions they need ¤ ¤ ¤
¨
¨
Motivating contexts Appropriate vocabulary Expectation for success
Expect them to keep improving Increase expectations every time they improve Binger WIND 2016
Selected References Binger, C., Kent-Walsh, J., King, M., Webb, E., & Buenviaje, L. (submitted). Early sentence productions of five-year-old children who use augmentative and alternative communication. Binger, C., Kent-Walsh, J., King, M., & Mansfield, L. (submitted). Early sentence productions of three- and four-year-old children who use augmentative and alternative communication. Kent-Walsh, J., Binger, C., & Buchanan, C. (2015). Teaching children who use augmentative and alternative communication to ask inverted yes-no questions using aided modeling. American Journal of SpeechLanguage Pathology, 24, 222-236. DOI: 10.3109/07434618.2015.1052153 Binger, C., Kent-Walsh, J., Berens, J., Del Campo, S., & Rivera, D. (2008). Teaching Latino parents to support the multi-symbol message productions of their children who require AAC. Augmentative and Alternative Communication, 24(323-338). Binger, C., Kent-Walsh, J., Ewing, C., & Taylor, S. (2010). Teaching educational assistants to facilitate the multi-symbol message productions of young students who require AAC. American Journal of SpeechLanguage Pathology, 19, 108-120. Binger, C., Maguire-Marshall, M., & Kent-Walsh, J. (2011). Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children with developmental delays who use AAC. Binger Journal of Speech, Language, and Hearing Research, 54, 160-176. 19
WIND 2016
