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COMMUNICATION STRATEGIES FOR STUDENTS
WITH COMPLEX NEEDS INCLUDING TEACHING CORE
VOCABULARY
Betsy Flener Ed.D.Joni Nygard M.S. CCC-SLP
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Definition
Students with Complex Communication Needs (CCN) are those students who are nonverbal and who have an additional disability. For this presentation that includes students who are blind or visually impaired.
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Challenges
■ Blind or low vision with additional disabilities
■ Many have Cortical Visual Impairment (CVI)■ Low muscle tone
■ Many have cerebral palsy and therefore limited movement
■ Cognitive abilities are uncertain■ May have limited interests
■ Many have auditory strengths■ Continuity due to extended absences because of illness
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Thoughts to Consider■ There is a strong connection between literacy and
communication: Communication involves symbolic and non-symbolic forms
■ Most early literacy experiences involve social routines between children and adults (Berkowitz, n.d)
■ Many of our reasons for literacy are social
■ Students with complex needs are typically motivated by sensory and social opportunities
■ Language must be taught.Flener & Nygard Copyright 2017
Tools for Access
■ Functional Vision and Learning Media Assessment (completed by TVI)
■ Cortical Visual Impairment (CVI) Range by Roman-Lantzy (2007)
■ Augmentative Communication Evaluation Simplified (ACES)
■ Introductory Workshop Manual: Pragmatic Organization Dynamic Display (PODD)
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Assessing Communication
■ Every Move Counts■ Communication Matrix■ Functional Communication Profile■ Augmentative Communication Evaluation
Simplified (ACES)
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Assessing Communication
■ AAC Skills Assessment by Vicki Clark■ Core Word Lists■ Pragmatic Profile of Everyday
Communication Skills in Children■ Social Networks
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Communication Functions§ Request
§ Protest
§ Ask for help
§ Indicate stop, continue, and more
§ Greet
§ Initiate
§ Comment
§ Yes/ No
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Important Information
■ Behavior■ Likes/dislikes
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Challenges of Students with Cortical Visual Impairment
■ May be difficult to fully determine the primary sensory channel used since some visual challenges with time may resolve
■ Visual field difficulties
■ May need movement to see
■ Many are auditory learners
■ For students with CP, often their best limbs are on opposite sides of their best line of vision
■ Instruction may have been primarily focused on visual skills rather than literacy and fine motor/tactile and communication
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Strategies for Students Who Are Blind or Visually Impaired
■ Audio scanning and switches■ Partner assisted■ Direct selection with high contrast pictures■ Adapted Picture Exchange Communication System
(PECS)■ Eye gaze (can be an option depending on the type and
degree of visual impairment)■ Use of tactile/tangible symbols and/ or textures■ Gestures and affect■ Communication passports
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Auditory Scanning
■ Often useful for students who have severe visual and motor impairments
■ Best to begin with menus of less than 4 items or teach groups
■ Best if also give an option to leave or stop the activity■ Can be slow and time consuming but does enable
independence■ Places demands on student in that it requires much
cognitive awareness, understanding phrases, and memory
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Considerations for Students with Limited Mobility
■ Look for most predictable movement■ Movements may often be very small ■ May include the cheek, chin, back of head, finger,
knee, toe, the ability to grasp■ Positioning can often be challenging■ In order to use switches, students need to be well
supported■ Many often person best when side-lying■ Proximity switches can often be an option
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What is Core Vocabulary
Core Vocabulary is a small set of simple words that are used frequently and across contexts (Cross, Baker, Klotz & Badman, 1997 as quoted in Baker 2009). These words make up 80% or more of everyday communication and are at the heart of language development (Baker, Hill & Devylder, 2000).
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Benefits of Core Vocabulary
According to Hatch, Geist, and Erickson (2015); the benefits of core vocabulary are as follows:• Variety of word classes included• Allows for expression of a variety of
communication functions• Vocabulary is useful across contexts• Vocabulary can be combined to increase
semantic and syntactic complexity
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Core Word Lists
Banajee’s Study: http://www.minspeak.com/documents/1-BanajeeList.pdf
Hill conducted over 40 interviews with adult augmentative communicators. The top 100 most frequently words of fluent adult augmented communicators comprise this list and make up 62% words used.
http://www.minspeak.com/documents/5-HillList.pdf
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Universal Core 36
I like not want helpit more different who sheyou he where up onin over make get lookstop what turn can someput all that finished whygo do when here whoopen
Hatch, P., Erickson, K. & Geist, L. (2016). Core vocabulary AAC instruction for students with significant cognitive disabilities. . Presented at Assistive Technology Industry Association (ATIA) Conference. February 5, 2016
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Universal Core Board
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Core Vocabulary and Sight Words
■ Early core words are made up of sight words
■ Of Banajee et al’s list of 23 top words used by toddlers, 19 are Pre-K and Kindergarten Dolch Sight Words
■ Of Hill’s 100 list, 64 are Pre-K, Kindergarten, and 1st Grade Sight Words
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High Contrast Universal Core 36
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Core Vocabulary and Braille
■ Braille alphabet letters when used alone represent whole words
■ Of the Universal Core Vocabulary First 36, there are 8 braille whole word signs
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Strategies for Teaching Core Vocabulary
■ Direct selection of basic core words■ Build phrases and sentences using core
vocabulary■ Embedded core vocabulary with partner
assisted, auditory scanning, direct selection, eye gaze
■ Functional and classroom routines
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TELL ME: AAC in the Preschool Classroom
Betsy Flener Ed.D. Copyright 2016
Teaching Early Language and Literacy through Multimodal Expression
TELL ME Program
■ A classroom-based approach to teach high frequency words (i.e. Core Vocabulary)
■ Uses repeated reading of 11 storybooks as a context for AAC instruction
■ Designed to be used with any AAC System introducing two-six core words within each book
■ Designed so core words are infused throughout the day
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4 Components of TELL ME
■ Shared reading ■ Shared Writing ■ Classroom centers and routines ■ Home extension activities
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Video Example of Repeated Storyline Use in Classroom
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https://www.youtube.com/watch?v=X0uvw172S8k
Additional Example of Storybook Use in Classroom
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Aided language Stimulation
Aided language stimulation is a communication strategy, where a communication partner teaches a symbol’s meaning. The partner models language by combining his or her own verbal input while selecting the vocabulary on an AAC device, book, etc. In other words, the partner speaks and selects. It is often a good strategy for partner-assisted communication systems. The partner increases the number of vocabulary used as the student progresses.
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Aided Language Stimulation■ Aided language stimulation encourages
functional communication within an activity-based framework.
■ The child’s communication partner point to a graphic symbol while simultaneously producing the corresponding spoken word during natural communicative exchanges.
■ Essentially, a multi-sensory approach to receptive language learning as the child hears the word spoken and sees it.
■ Requires planning and is why many ‘engineer’ their classrooms with materials and communication tools are readily available.
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Language Acquisition Through Motor Planning
(LAMP)
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VI Options with LAMP
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Video Example of Direct Selection with LAMP
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Example Embedded Core with Auditory Scanning
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Video
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Video
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Using Participate NOW in GoTalk NOW app with Auditory Scanning
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Modified Participate NOW Menu
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Video
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Case Study K
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■ CVI with cerebral palsy and significant seizure disorder
■ Receives instruction via homebound services■ Mostly is positioned in various comfortable chairs
in the home■ Has stander that does not presently recline■ Other chairs do not allow for connecting a switch■ Has adapted golf cart
Case Study K■ Mostly auditory but will use
eye gaze to look between two moving toys/stuffed animals
■ Uses vision mostly for lighted objects and other lighted materials, and for movement
■ Attends to others mostly by listening
■ Expresses hunger by smacking her lips
■ Will blow with her mouth if she is uncomfortable
■ If asked if she wants to go outside, will look toward the door
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Case Study K (cont’d)
■ Motivated by vestibular outdoor activities: riding in the golf cart, floating in the pool, going for a walk in her wheelchair
■ Drinks from a bottle and eats pureed food
■ Limited motor skills: Does not reach out, will grasp a wide object that is placed into her hand for a few seconds
■ When placed in a side-lying position, will turn head to operate a proximity switch
■ Current positioning does not allow for head use
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Environment
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K and Routines
Current Routines
§ Eating and drinking§ Riding the Golf Cart§ Going out on the
property§ Reading to her§ Playing with toys
Additional Routines§ Vestibular movement to indicate
“more”: being rolled on a therapy ball, rocked in a chair, etc
§ Routines to encourage looking and taking ”turns” such as spin art
§ Grooming routine with lighted make-up mirror
§ Routines using Powerlink and the following: fan, CD boom box, leaf blower, lamp
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K: Tasks and Tools
■ Increase core vocabulary beginning with: “more,” “go,” “want,” “finished,” “not”, and “help”
■ Increase her ability to express wants: “read,” “play,” “ride in the golf cart,” “go to the pool,” etc.
■ Make choices between books, toys, and activities■ Increase her ability to identify if she needs help or if
something hurts. ■ Use routines such as riding in the golf cart to learn
additional vocabulary: “stop,” “fast,” “slow,” “play”
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Main Page: K’s Communication Book
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https://
Pragmatic Organization Dynamic Display (PODD)
https://www.youtube.com/watch?v=kyV_SVGvT3Q
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TactileTalk
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TactileTalk and Core Vocabulary
TactileTalk Guidebook and Braille with Core Vocabulary
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TactileTalk Next Steps
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iPad Tactile Overlay for Core Vocabulary
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Cookie SheetCore Board
https://www.youtube.com/watch?v=mnyv8h6J4rc
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Resources
Boardmaker: http://www.mayer-johnson.com/boardmaker-software
LAMP Words for Life app: https://itunes.apple.com/us/app/lamp-words-for-life/id551215116?mt=8.
Participate NOW for GoTalk NOW: https://www.attainmentcompany.com/gotalk-now
PCS High Contrast Symbols: http://www.mayer-johnson.com/nsearch/?keywords=PCS+high+contrast+symbols
Project Core: http://www.project-core.com/about-project-core/
TactileTalk: https://www.attainmentcompany.com/tactiletalk-toolkit
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References
AAC TechConnect (2015). ACES module and toolkit approach. Retrieved from http://www.aactechconnect.com/freetools/?form
Baker, B., Hill, K., Devylder, R. (2000). Core Vocabulary is the Same Across Environments, California State University at Northridge (CSUN) Conference, Los Angeles, California. Retrieved on January 10, 2016 from: http://www.minspeak.com/students/documents/2000CSUN.pdf.
Baker, B. (2009). How Minspeak® Allows for Independent Communication by Giving Anyone Access to Core Vocabulary. Semantic Compaction Systems, Pittsburgh, Pennsylvania. http://www.minspeak.com/CoreVocabulary.php#.WHVh4lfw_ow.
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References
Banajee, M., DiCarlo, C., & Buras-Stricklin, S. (2003). Core Vocabulary Determination for Toddlers, Augmentative and Alternative Communication, 2, 67 - 73. Retrieved on January 10, 2016 from: http://www.aacandautism.com/resources/commonwords.pdf
Berkowitz, S. (n.d.). Literacy for students with complex communication needs. Retrieved from: http://www.iser.com/resources/complex-communications-needs.html.
Dewart, H. & Summers, S. (1995). Pragmatics profile of everyday communication skills in children. Retrieved on December 2, 2017 from: https://communicationmatrix.org/Community/Posts/Content/8154.
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References
■ Flener, B. & Nygard, J. TactileTalk Toolkit and TactileTalk Guidebook for iPad: Strategies for Functional Communication and Literacy. www.closingthegap.com,dec.2016/jan.2017
■ Goossens', C., Crain, S., & Elder, P. (1992). Engineering the preschool environment for interactive, symbolic communication. Birmingham, AL: Southeast Augmentative Communication Conference Publications
■ Hatch, P., Geist, L., &Erickson, K. (2015). Teaching core vocabulary words and symbols to students with complex communication needs. Presented at Assistive Technology Industry Association (ATIA) Conference. 2015. Retrieved from https://www.med.unc.edu/ahs/clds/files/conference-hand-outs/atia_2015.pdf on November 1, 2016.
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References
Hatch, P., Erickson, K. & Geist, L. (2016). Core vocabulary AAC instruction for students with significant cognitive disabilities. . Presented at Assistive Technology Industry Association (ATIA) Conference. February 5, 2016
Hill, K. (2001). The development of a model for automated performance measurement and the establishment of performance indices for augmented communicators under two sampling conditions. Dissertation Abstracts International, 62(05), 2293. (UMI No.3013368). Retrieved on January 4, 2017 from: http://www.minspeak.com/documents/5-HillList.pdf.
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References
Hill, K. (2001). The development of a model for automated performance measurement and the establishment of performance indices for augmented communicators under two sampling conditions. Dissertation Abstracts International, 62(05), 2293. (UMI No.3013368). Retrieved on January 4, 2017 from: http://www.minspeak.com/documents/5-HillList.pdf.
Kortsten, J.E., Foss, T.V., & Berry, L.M. (2007). Every Move Counts, Clicks and Chats: Sensory-based strategies for communication and assistive technology. EMC.
Klieman, L. (2003). Functional communication profile: Revised. Austin, TX: Pro-Ed Inc.
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References
Porter, G. (2012). Pragmatic organization dynamic display (PODD): Introductory workshop manual. Glen Waverly, Victoria, Australia: Cerebral Education Center. Roman-Lantzy (2007). Cortical visual impairment- An approach to assessment and intervention. New York, NY: AFB Press.Rowland, C. (2013). The Communication matrix for parents and professionals. Retrieved from: www.communicationmatrix.org
Zangari, C. & Wise, L. (2017) Tell me program: AAC in the Preschool Classroom, Verona, Wisconsin: Attainment Company.
What is LAMP? The Center for AAC and Autism. Retrieved on December 2, 2017 from: https://www.aacandautism.com/lamp.
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Questions and Comments
Feel free to contact us anytime:
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