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Week 3: Overview of AAC Intervention
Terms in this set (58)
-dont wanna get hung up about knowing symbol
-best way to learn it is through ALS
-dont want them to think AAC is not going to work
Three Components of AAC intervention
-Intervention = much more important
-when we are doing intervention, carve out small piece to take data but focus on teaching, not repeatedly testing
1. Select and personalize the AAC system to meet the specific communication needs of the individual
2. Teach skills and strategies to the individual who will use AAC
3. Teach strategies, communication partner skills to those supporting the individual
for today and tomorrow
Communication needs will change over time.
1. Today's decisions should meet the immediate needs and match current capabilities
2. Tomorrow's decisions should consider future opportunities and needs
-literacy is critical and equalizer and helps them make messages!
-ALS: dependence increases over time (voice banking)
Why is it important to plan AAC intervention for today and tomorrow?
-people change in abilities
Functionality and adequacy of communication and knowledge, judgement, and skills in four domains
1. Linguistic: language skills, vocabulary
2. Operational: device on and off, navigating pages
3. Social: interacting with others
4. Strategic: repairing and avoiding breakdowns in communication
-Goals grid: separates out ability levels with skills for goals
(look at this)
-Developing skills in ones' native language
-Language therapy in traditional sense
-Syntax, object, verb, etc.
-Flexibility to use words
-Learning and using vocabulary (increasing size and complexity)
-Sentence structure: learning to use words generatively and with increasing syntactic complexity
-"Language code" of AAC system (e.g., symbols, content, etc)
-knowing what words are in each category
-using generative language so they aren't relying on preprogrammed messages (not everything is predictable!)
-all about precision
-don't put on "performance"
-aphasia or ALS: linguistic won't be as high on the list
Linguistic Competency cont.
-Melvin builds sentences
-never too late because he was in his 30s
Toddler uses iPad to communicate for the first time
-all other buttons were hidden
-putting together words and going up to message bar
-acknowledging multiple communication methods
-not modeling as much in the activity
-open it back up
-skills related to the maintenance and operation of the AAC system
-accessing the system (touch, scanning, eye tracking, etc.)
-positioning the system
-adjusting the volume
-charging the device
-programming the device (can be combined with language, like knowing how to save messages to buttons)
-troubleshooting common technical problems, etc. (like knowing when to ask for help)
-using device for home access (google or alexa; see Melvin video)
-opens up world of independence
-skills needed to communicate effectively and in socially appropriate ways to:
-interact with others
-introduce a topic
-change a topic
-communicate about a variety of topics
-use a variety of communicative functions
-tool so they can communicate socially
-makes them a true communication partner
-positively or negative
-everyone involved in interaction with not only the teachers but each other
-not stressful in any way
-eliciting independent use of the devices and encouraging each other
-no right and wrong
-flexible - there wasn't a set agenda
Social Conversation Topics
-value of having a topic category around an event, situation, etc.
-can talk with preprogrammed messages
-importance of preprogrammed messages (don't have time to build everything from scratch)
Social - ask peer for swing
-shows us that they are taking the time to teach Evan that you need to communicate and ask for what you want
-Patrick in bowling
Tell a joke
-Will and Bridget
-asking questions while watching NHL
-Equal role in the conversation
-friends sitting on the couch
Social Seniors and AAC users
-programming was important
-setting up social script on devices
-interact with others and gain attention
-leading the narrative and made her own connecting comments
-clinician provided nice cues, used aided language stimulation
-set Brenda in positive light
Strategies to prevent or repair communication breakdowns
•AAC user doesn't understand
•Communication partner doesn't understand
-think about interaction and ways to make it better
Strategic use of tools
•Jerome used a play topic to find something different
-no idea what he was trying to tell you
-dress up to play fireman: firetruck
PLANNING AND IMPLEMENTING AAC INTERVENTION
-Review situations and environments strategies
The Process for Determining Goals
-Review situations and environments that have been identified as priorities
-analyze strategies required to participate effectively
-review current capabilities and compare to skills required to participate
-identify gaps in skills
-To determine goals: think about what is necessary for them to participate
-Review current capabilities: similar to what you would do with any intervention
-The device is a tool, not work
Why is it important to operationalize AAC goals?
Why is it important to operationalize AAC goals: it is a tool not work
-allows the team to evaluate the effects of intervention, note progress, and make necessary adjustments to improve intervention as required
-each goal: targeted strategy or skill, the means of communication, the partners and environments, and the targeted criterion for performance
Choosing Instructional Procedures
The process of determining HOW to teach skills
•Responsive social pragmatic intervention
•Modeling: sometimes referred to as ALS, the most powerful way to teach someone how to use AAC
•Milieu or incidental teaching
Get ready to learn ...
•What is modeling?
•What are the benefits of modeling?
•How can we effectively model?
•What resources are available?
-Modeling is touching the system while you speak
-isn't something you plan, do it on the fly
-shows them how to use the device
-shows other CP how to model
-Asking the user to copy what you just did is NOT a part of modeling
-Just model it for them
What is Modeling
Modeling is using the communication system while YOU interact and talk.
-knowing content in system
-you need to know whats in the system to model
-teaching communication partners in the area
-little checks along the way to make sure they are comfortable doing this
-never say "now you do it", "your turn"
-don't want to say tell me with your device
Partner Augmented Input
Aided Language Stimulation
-showing the user what it looks like to use AAC
-how to interact with communication partner
-kids are eager to touch the device
-more mainstream and acceptable
-Learns location of vocabulary
-Slows down speech rate
-Emphasizes key words and ideas
-Interacts more naturally
-Shows them where things are in the system
-doesn't just impact the person
-Might lead to more vocabulary and vocabulary programming
-become more intentional about what you are saying
AAC Communicators need to see and hear other people speaking in their modality
-a lot of different models is important
By 18 months
-45 hours of language?
-5,000 hours with rate of 8 hours a day from birth
-has been supported
-we need the device integrated and modeled in the everyday
-repeated practice over time make kids observe them
-promotes social closeness
-modeling on the device as she was talking
-wasn't prompting him to imitate very production
-she talked through her navigation and why they are in each folder
-didn't have to model every word
Get EVERYONE Involved
Phillip's sister modeling
-using spoken language and ALS
-two words on the device
-she had him copy her a few times
-moving to the blocks!
-positive way for her to spend time with functional communication
-ownership that everyone has in the family
•Use your voice and the device Model key vocabulary
•Model looking for vocabulary Mistakes are good
•Model throughout the day
•Keep modeling a positive experience
-easy, it is okay if they do not have your attention right away
-not anyone imitating
-don't want them to take child's hands and push it on device
-not one right thing to say
Low-Tech Core Boards
Core First Learning
-books to use with devices
Lotsacomptons. (2018, September 18). AAC Core Vocabulary [Video File]. Retrieved from https://www.youtube.com/watch?v=WxKdYKjgjt8
-modeling and natural interaction
-free core word book
-model a specific word
-keep reinforcing "want" with the hats
-they were all interacting with each other while using the device
Video Example - Modeling
Encourage independence by providing a least-to-most prompt strategy.
-hand over hand is not the best
-subtle gestures without using your voice
-not one right answer
How would you determine whether to use a least-to- most OR most-to-least prompting strategy?
-Which prompting hierarchy is most appropriate depends on the individual, the targeted strategy or skill, and the environment.
-For example, if the individual is passive and seldom participates, it may be more appropriate to use a least-to-most prompting hierarchy to avoid prompt dependency.
-On the other hand, if the individual is highly impulsive or the skill is especially challenging (e.g., learning to read words), it may be more appropriate to use a most-to-least prompting hierarchy so that the individual does not spend a lot of time making errors during instruction.
-If the individual is learning to use AAC as a communication replacement for challenging behaviors, it is most appropriate to use a most-to-least prompting hierarchy so that the individual does not learn to chain the challenging behavior with the AAC communication replacement (e.g., so that the individual does not learn to scream and bite first and then select the AAC symbol to request a break)
-looking at pictures beforehand, added their own language interactively
-modeling intention and gist
-want to make sure they have access to vocabulary
-she gave him different options
-core vocabulary helped to increase the understanding of the story
-proper positioning for being able to use communication device properly
Video examples of good intervention
https://www.dropbox.com/home/linnea%20vi deos/6875?preview=6875 6.00-6.40.mp4
https://www.dropbox.com/hom e/linnea%20videos/6875?preview=6875 0.40-1.20.mp4
https://www.dropbox.com/home/linnea%20videos/6875?preview=6875 6.50- 7.44.mp4
https://www.dropbox.com/home/linnea%20 videos/6875?preview=6875 3.30- 4.15.mp4
https://www.dropbox.com/home/linne a%20videos/6875? preview=(original)+ IMG_6875.MOV
Video notes: Missy's First Day
-paired with signs
-exploration with jokes
-what she wanted to say, took control
-lots of humor
The AAC intervention evaluation should measure...
•The acquisition, generalization, and maintenance of intervention goals.
•The effectiveness of intervention on communication function.
•The effectiveness of intervention on participation.
•The satisfaction of the outcomes of the intervention by the AAC user, family and other communication partners.
Why is it important to evaluate the effectiveness of AAC intervention?
answers the question: is the AAC intervention really making a difference?
-allows for improvements in intervention as required to maximize outcomes and to plan future intervention
Therapy session with Gio (3 min)
•Variety of skills in one activity
Therapy session with Brandon (2.4 minutes)
•Brandon uses topics to interact in a therapy session
Therapy session with Ethan and Lindsey (3 min)
Day 1 of Missy with AAC (set up) 3.45 min
Therapy session with Missy (3 min)
Danica and her mom talk 3 min
Discuss one thing you learned today.
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