Saturday, August 13, 2016

CCN Alphabet - L is for Language of Control

To get this series going again, I have decided to jump around the alphabet instead of follow alphabetical order. I wanted to share that in case anyone is wondering what happened to the letters F through K. They will come. As I am completing posts, I am linking them in the original post in the series which can be found by clicking here.

The idea for this topic comes from the book Enhancing Communication for Individuals with Autism: A Guide to the Visual Immersion System by Howard C. Shane, Emily Laubscher, Raif W. Schlosser, Holly L. Fadie, James F. Sorce, Jennifer S. Abramson, Suzanne Flynn, and Kara Corley. The information on the Language of Control and the language functions that reflect the Language of Control comes from this book and the thoughts and ideas are a combination of some of the thoughts and ideas from this book as well as ideas from other sources and my experience. I also wanted to think through how to use core boards or the individual's core based language system with some of these ideas.

Often we tend toward using visual supports from a "behaviour management" perspective. It's important to not get too caught up in this as it can serve to inhibit spontaneous communication. Rather, but we should reframe this and look at visuals and language supports from a self-advocacy and opportunity for expressive and receptive language growth lens.

As outlined in the book mentioned above, the Language of Control is related to "control functions" that allow the individual to influence his or her surroundings by inspiring others to act. These functions are (1) protesting and refusal, (2) organization and transitions, (3) requesting, and (4) directives. These functions are controlled based rather than conversational in nature because their goal is to influence the behaviour of another rather than to initiate a conversation exchange.

Protesting and Refusal: According to this book, protest is a "behaviour that expresses objection or disapproval of an activity, event or person", while refusal is a "behaviour that expresses rejection of an object, activity, or event suggested or initiated by another person." Most children have a non-symbolic way of communicating protesting and refusal so the idea is to work toward a more symbolic (and often adaptive) way of protesting or refusing.

The language of protest and refusal is rooted in core words. The core words that are associated with protesting and refusal include "all done" or "finished", "stop", "no", "more", "help". "Take a break" is an important phrase that should be taught as well.

When working with students around the language of protesting and refusal we should (1) explicitly teach the words, (2) model the use of the words. and (3) ensure that the words are always easily available to the individual.

When we teach core vocabulary we need to do it "during meaningful interactions throughout the school day" (Project Core Website). At 12:15 of this Dynamic Learning Maps PD video there is a great demonstration around directly teaching core words to a group of students. I will be posting a separate post soon with some ideas around strategies for teaching the words included in the language of control. Modeling the use of the words is related to reading the individual's cues and modeling the language around it. Example: Modeling the capitalized words without expectation that the student will say them: "It looks like you DON'T LIKE that and that you are ALL DONE." Ensuring the words are easily available to the students means having their system there but it might also mean having these specific visuals available in different ways (i.e. having them tapped down to a work space or included right on a visual schedule).

Although protesting and refusal are primarily about expressive language, it is also important to be aware of the times when one cannot immediately honor an individual's protest or refusal as being able to cope with this requires receptive language skills. Visual supports such as first-then displays, timers and countdowns, a "surprise" visual, and social stories can be used to facilitate receptive language. To be effective, there may need to be some explicit teaching around these. Ideas related to that specific teaching will be included in the blog post mentioned above.

Organization and Transitions: This book defines organization as "the act of arranging elements into an orderly, functional structured whole" and transition as "the process of changing from one state, stage, activity or environment to another." Memory, attention, time management, problem solving, initiating, sequencing and prioritizing are all skills that are important to organization. Developing these skills cannot be done without also developing the receptive language understanding that is necessary for the skills. The visual supports that we put in place for the underlying skills can also serve as an opportunity to work on language development.

Specific things we should be thinking about when teaching organization and transitions includes completing multi-step directions, sorting and organizing materials, following a schedule, understanding and using measures of time, moving from a preferred activity to a non-preferred activity or vice versa, dealing with changes in familiar routines, dealing with a delay in receiving an anticipated item or activity and tolerating unexpected events.

Again, we need to think about the language that is important and ensure that we are teaching, modeling and making symbols available. We should consider (1) prepositional words like "in", "on", "away", "up", and (2) time-related words like "first", "then", "later", "wait"...etc., The action and descriptive words outlined in directives section below overlap in to the area of following schedules, sorting and organizing.

There are a lot of visual tools that can be used to support receptive understanding in this area. We need to be cautious that our primary goal with these tools is not that of compliance as that can have va very negative impact on language and communication growth.  These tools will be furthered explained in another post but they include things like visual schedules (including learner constructed schedules), first-then visuals, countdown boards, task or activity schedules, social stories, video modeling, and symbols like "surprise" or "wait".

Requesting: Requesting is defined as "expressing a desire for objects, activities, people, affection, attention, recurrence, assistance, information and/or clarification."

When thinking about requesting, we need to be cautious around believing that there is language understanding if an individual is using a scripted phrase like what would be used in PECs. A scripted phrase is no more meaningful than a single work and doesn't represent generative language. As this book points out, PECs focuses primarily on requesting but there is little opportunity for language development as it consists of mostly nouns, it uses carrier phrases rather than generative word-by-word language, and the individual words represented by the symbols are not actually taught.

As we expand requesting skills, it is important to also focus on descriptive language as having descriptive language allows an individual to request things that may not be represented in their system or are not directly in sight. This doesn't mean we make the individual describe everything they are requesting, but rather that we embed descriptive approaches naturally so that the individual is coming to an understanding of these words through seeing them modeled and used in natural contexts.

Directives: Directives is "explicit instructional language used to control the behaviour of another." Underlying a directive is an implicit understanding that a specific order or command will be carried out. In regards to the "language of control" we are looking at the ability of the individual to expressively give others directives. This does involve receptively understanding the language of directives.

This book outlines the most common directives as being either control based (sit down, quiet, no running), routine-based (get, open, put away, stand up), instructional (cut, circle, point), or play-based (roll, throw, blow, pop). There are many opportunities for teaching vocabulary and generative language (putting words together to create meaning) within directives. Understanding and using verbs, prepositions and descriptors is particularly important. Many of the most important words are included in core language lists. It's also important to recognize that not following directions may be related to receptive language (understanding of what these words mean as individual words and in combination with other words). Not following directions may also be related to things like attention, memory, or inability to organize multiple steps. or just being too overwhelmed/stressed in the moment to be able to follow the direction. When an individual has difficulty with following directions we need to step back and think about weather we are properly scaffolding.

This book offers suggestions around teaching directives by moving from video modeling of the directive to a static picture from the video to incorporating symbols and putting them together to represent the directive. As I read through it, I was thinking of some ways to modify it and embed it with teaching of core words and/or Predictable Chart Writing.

Another suggestion they offer related to play is to create topic displays that allow the user to manipulate symbols in to phrases or sentences. I could see the value in this but as I read through it I also thought about the need to move it over to modeling on a language system so that the words that were being used didn't just disappear when the activity was done. This is also got me thinking about incorporating the idea in teaching core words and/or Predictable Chart Writing.

You can advance these topic displays from simple statements to more advanced by adding in different elements. If used, they recommend using them around highly motivating activities. I'm including pictures of how a "Bubbles" topic display could be expanded over time. Note that there is a line on the side included to "comment" on the activity. As well, these displays can include a "sentence strip" at the top that is either color coded or not in which the symbols and be moved up to create a phrase or a sentence.




Final Thoughts: The communicative functions outlined here are far from the only communicative functions that individuals should be learning but they are important ones to learn in the middle of learning others. As mentioned at the beginning these ones are very restricted in regards to learning conversational skills. 

Ultimately, being explicit about teaching students the language of control positions them to active agents in their lives. It is also important and important step in social/emotional development that positions individuals to engage in organizing and problem solving as if one is unable to consistently exercise control over their own life they will become passive and helpless and are at an even greater risk for abuse.  

Saturday, July 23, 2016

Quote of the Week: Playing Nice

"By processing information from the environment through the senses, the nervous system continually evaluates risk. I have coined the term neuroception to describe how neural circuits distinguish whether situations or people are safe, dangerous, or life-threatening. Because of our heritage as a species, neuroception takes place in primitive parts of the brain, without our conscious awareness. The detection of a person as safe or dangerous triggers neurobiologically determined pro-social or defensive behaviors. Even though we may not always be aware of danger on a cognitive level, on a neurophysiological level, our body has already started a sequence of neural processes that would facilitate adaptive defense behaviors such as fight, flight or freeze. 

A child's (or an adult's) nervous system may detect danger or a threat to life when the child enters a new environment or meets a strange person. Cognitively, there is no reason for them to be frightened. But often, even if they understand this, their bodies betray them. Sometimes this betrayal is private; only they are aware that their hearts are beating fast and contracting with such force that they start to sway. For others, the responses are more overt. They may tremble. Their faces may flush, or perspiration may pour from their hands and forehead. Still others may become pale and dizzy and feel precipitously faint. 

This process of neuroception would explain why a baby coos at a familiar caregiver but cries at the approach of a stranger, or why a toddler enjoys a parent's gentle embrace but interprets the same gesture from a stranger as an assault. We can see the process at work when two toddlers encounter each other in a playground sandbox. They may decide that the situation and each other are safe if the sandbox is familiar territory, if their pails and shovels have roughly similar appeal, and if they (the toddlers are about the same size. The toddlers may then express positive social engagement behaviors - in other words, they may start to play.

"Playing nice" comes naturally when our neuroception detects safety and promotes physiological states that support social behavior. However, pro-social behavior will not occur when our neuroception misreads the environmental cues and triggers physiological states that support defensive strategies. After all, "playing nice" is not appropriate or adaptive behavior in dangerous or life-threatening situations. In these situations, humans - like other mammals - react with more primitive neurobiological defense systems. To create relationships, humans must subdue these defensive reactions to engage, attach, and form lasting social bonds. Humans have adaptive neurobehavioral systems for both pro-social and defensive behaviors. 

What allows engagement behaviors to occur, while disabling the mechanisms of defense? To switch effectively from defense to social engagement strategies, the nervous system must do two things: (1) assess risk, and (2) if the environment looks safe, inhibit the primitive defensive reactions to fight, flight or freeze."

Source: The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication and Self-Regulation by Stephen W. Porges

Tuesday, July 5, 2016

Thoughts on Stuart Shanker's New Book - Self-Reg: How to Help Your Child (and You) Break the Stress Cycle and Successfully Engage with Life

In the first paragraphs of this book, Stuart Shanker states "There isn't a single child who, without understanding and patience, can't be guided along a trajectory that leads to a rich and meaningful life. But stereotypes of the 'difficult child' color our views, as do our own hopes, dreams, frustrations, and fears as parents. Don't get me wrong: Some children can be a lot more challenging than others. But often our negative judgments of a child are just a defense mechanism, a way of shifting the blame for the trouble we're having onto the child's 'nature'. This can make a child more reactive, defensive, defiant, anxious, or withdrawn. But it doesn't have to be that way. It never has to be that way." 

And so a book that at first seems to be about managing children's "behaviour" begins. But as I have learned more about self-reg and read through this book, I first began to see self-reg is is related to "stress" and then, through digging deeper, it seemed that even under that, self-reg actually creates a framework of healthy development across a life span... for everyone (not just children). The five domains of self-reg are all areas that we need to be aware of and attend to when it comes to the healthy development of children but also to our own healthy development.

In the book, Stuart Shanker outlines the five steps of self-reg.

Step 1: Read the Signs, Reframe the Behaviour
Step 2: Become a Stress Detective
Step 3: Reduce the Stress
Step 4: Reflect to Develop Self-Awareness
Step 5: Respond to Figure Out What Your Child Finds Calming 
If we, or others are functioning in a state of hyper- or hypo-arousal, we will not be in a position to grow/develop/learn. By figuring out the unique stressors of ourselves or an individual and working ourselves or with the individual to find ways to return back to a state of calm and focused, we are positioning ourselves and others to develop, grow, and learn. The barrier to growth/development/learning is ultimately "stress" in any one (or usually a combination) of the five domains. Scaffolding then becomes about setting up the conditions to ensure that stress is healthy and productive rather than inhibitive.

In the book, each of the five domains (biological, emotional, cognitive, social, and prosocial) are explored. What are the potential stressors unique to that domain? What does healthy development starting at birth look like in that domain? What can we do to reduce stressors and position our children for growth in that domain?

The book helps with gaining a deeper understanding of the unique stressors (both obvious and hidden) that we and our children experience moment to moment and it looks at what we can do through the lens of the growing awareness of how our brains work.

Monday, July 4, 2016

Some Thoughts After Attending the Pittsburgh AAC Language Seminar Series

Last week I traveled to Pittsburgh to attend a Pittsburgh AAC Language Seminar (PALSS) to learn more about core vocabulary, descriptive teaching, language development and the use of Minspeak language systems. The seminar itself was held in the Semantic Compaction Systems (SCS) office in Pittsburgh and all seminar attendants stayed in SCS guest houses. The days were filled with learning and the evenings with time to process, socialize and connect. It was both an incredibly learning and a wonderful social experience.

As with any learning experience, it will take me some time to piece together what all this new information means when converted in to practice. There was definitely a lot that applied specifically to Minspeak but there was also much that can be applied more generally to thinking about language development for students with complex communication needs.

The Goal is Language Acquisition

The emphasis throughout the seminar was about focusing on language acquistion when working with individuals with complex communication needs. We spent some time looking at Brown's stages of language development. We looked at how we can support students with complex communication needs to go through the same stages of language development as those without... moving from saying single words (juice, mine, again) to combining two words (more juice, that mine, go again) to adding in more clarity through development of syntax and morphology (more juice please, that's mine, let's go again).

We also looked at core language. This was not an new concept to me but it is always good to have it reinforced how important it is to focus in on a limited number of high frequency words that can be used to support communication in all environments.

I walked away from the seminar thinking about how important it is to be aware of language development when working with students who are at various stages of using AAC. A few ideas that I wrote down to explore, think about, revisit or refine include the following. There may be future blog posts on these.

Communication Circles and Out and About Groups - A couple of years ago I was doing a few communication circles. This year I didn't do any.  After going through the activities we did at this seminar, I'm thinking it's time to start them up again.
Recasting - We talk about modeling at a lot but in this seminar there was an explanation of both modeling and recasting. Recasting is about taking what the individual has said and saying it back a litter further along the language development continuum.
Using Icon Family Trees for Interventions - We spent a bit of time with this and I would like to further explore the idea as there are a lot of rich connections that could lend themselves to some fun language intervention activities. 
Literacy through Unity Curriculum - I want to get my hands on this :).
Use of materials from the AAC Language Lab based on stage of language development. I need to go back and revisit this. 
Promoting Success in the Classroom

I really appreciated that there was time dedicated in this seminar to what supporting a student who uses AAC looks like in reference to curriculum (program of studies). We spent some time looking at the Descriptive Teaching Model (DMT). With this approach, rather than programming key terms from different curriculum areas, the key terms are used as part of the question and then core vocabulary that is on the device is used to answer the questions. This was not entirely new to me as we have done a bit of it but going through and looking at it again reinforced for me the importance of tapping in the curriculum to support language development.

We also spent some time looking at Blooms Taxonomy and thinking through how we could answer questions or have discussions using core vocabulary at every level of Blooms. This was an important reminder to not limit communication to the  lowest levels of just recall as if you have core words,the vocabulary is there to do it all.

Motor and Cognitive Automaticity

We spent time doing hands on learning with Unity 84. What was most interesting with this is that towards the end of the seminar, we were asked to "sky talk" and say some of the things we had been learning throughout the two days. After only a small amount of time practicing, we were all able to go to the general area that was needed to say a variety of different words. Because we were using the same standard 84 icons that were always in the same spot to say all these words, we had learned the general or specific area of almost all the icons.

Although I understood the premise of having a minimum number of icons that you combine in different ways to make different words, it wasn't until we did the sky writing without the device there that I realized how much I was relying on both the repetitive motor planning and the associations of the symbols to the words to become automatic. It was also interesting to note that some will rely on both the association and the motor plan while others will just rely on the motor plan.

Note: The seminar, lodging and meals are free and there is support for travel as well. They are held monthly. I highly recommend the experience. Click here to find out more. 

Thursday, December 24, 2015

One Word 2016

It's early. Just past 5:30 a.m. This has always been my favorite time of day. For the most part, the world is still quiet and asleep and it's easier to connect to one's thinking. 

The beginning part of the 2015-16 school year brought with it many changes both personally and professionally. 

My son began high school. This is his last transition within the school system and it went incredibly smoothly. I'm seeing him continue to grow and blossom and am realizing how quickly he has grown up which just makes me cherishing the times that we are together all the more. At the same time, adulthood is looming and I'm thinking often now how I can support him to transitioning to an adult life that is his own.

My job hasn't really changed but it changes each year simply because the students I work with and the classrooms I work in change each year. This means each year, I see both a bigger picture and a more focused picture. There are exciting steps forward and frustrating new barriers that need to be figured out that present themselves on a regular basis. 

Each year for the past several years I have spent some time during Christmas break reflecting and looking forward... not so much because of the "new year" that is ahead of us but more because it seems to be the first time that since the beginning of September that I have time to step back, catch my breath and think a bit. It's a great time to analyze how things have gone in the first months and where they might go through the rest of the school year. Each year as I reflect on this, it seems, on some levels, that the vision becomes less and less defined... and on other levels that it becomes more focused. 

As my job has evolved and Mikey (my son) has grown up, I am coming to realize more and more that parenting, teaching and living are not actually about having a lock-step plan that I can be perfectly implemented. I thought that would make things predictable and that predictable equated to "safe". I thought that it was the kind thing to do to try to head off any problems and hurdles before they happened. I thought that it would make the path smoother. 

I'm not sure if I would have come to understand things differently if I had stayed in my own classroom where I could continue to set it all up before hand; Where I could design and script learning and life experiences in a way that I decided was "right". I no longer can do that as I am not the classroom teacher. In the middle of struggling with this and with questioning how I support Mikey moving forward in to adulthood, I began to more deeply understand the opportunity that is embedded in how things have evolved and changed. 

A few years ago when this journey of shifting away from a self-contained approach began, I believed we would see better social and academic outcomes for the students if they were included in general education classrooms and activities. I believed that the peer group that exists in the general education setting meant that there were opportunities and experiences in the general education classrooms that could not be created in self-contained settings. I believed that we would work harder at figuring out modifications, communication systems and assistive technology in a general education setting because it was necessary for participation in that setting whereas in in a self-contained setting you can just shift gears and do something different that the student can already participate in. All of this has proven to be true in the years that have passed... but there have been other things that have emerged through the process. 



Which brings me to my one word for 2016... and the word is simply "with". I have always believed it is critical to listen to the students that we are working with. I have always believed it was important for them to have a voice. I have always believed that the end goal was tied to such concepts as self-determination, autonomy, empowerment. But working with students in spaces that are "not my own" and the fact that my son will need to leave the sheltered world of school in a couple of years deepens my understanding of all of it. It helps me to see not only that we need to work with (rather than for or on or to) the student but also that all of us in the student's circles need to work with each other. 

Empowerment, self-determination, autonomy are not actually about independence. It's about community and relationship. Community and relationships create safety and the conditions for thriving. Being empowered isn't about who builds the path so much as it is about who directs the building of the path. Being empowered means that when things go in the wrong direction or roadblocks present themselves protective factors exist to get through, around or even to turn in another direction if that is what makes sense in the end. For anyone, disability or not, our strongest protective factor is the web of authentic equal and understanding connections to and around us. When we operate from a standpoint of working "with" we are building a web of connections. When we operate from a standpoint of doing "to" or "for" or working "on" we are building a top-down set of single, often unequal connections. 

So my word is "with" and this year to stay true to it, I'm aiming to blog about it on a regular basis :).