Sunday, June 28, 2015

CCN Alphabet: Aided Language

Aided Language Stimulation (ALS) is a "language stimulation approach in which the facilitator points out picture symbols on the child's communication display in conjunction with all ongoing language stimulation. Through the modeling process, the concept of using pictorial symbols interactively is demonstrated for the individual" (Goossens, Crain, & Elder, 1992).  This approach is based on the assumption that children with complex communication needs will learn to use their devices or language systems through natural interactions in a language immersion environment just as other children learn to communicate using spoken words.

In order to use an ALS approach, the student and communication partner needs to have available to him/her a language system that has enough generative language vocabulary to be able to say whatever that students wants to say at any given time.

The following video outlines a few key concepts related to ALS:

When we model the use of a student's language system, students learn how to use real words in real situations throughout their day, a wide range of reasons for communicating (as we model more than just asking for our wants and needs throughout the day), how to put words and word parts together to provide more clarity to what is being said, how to use the actual device (example: navigating through the folders in the system), and how to repair communication breakdowns or errors. Students come to understand language and communication over time through observation and interaction.

Learning to use a communication system for both the student and the communication partner is like learning a new language and so it is important to also have a systematic approach for teaching and focusing in on language and communication skills. Two possible approaches are (1) Focused Aided Language Stimulation to teach and reinforce new words, or (2) Aided Language Stimulation based on focusing in for defined periods of time on different functions of communication.

Focused Aided  Language Stimulation

Focused language stimulation (Dirkinson, Cote & Smith, 1993) is an approach that involves direct teaching of new words followed by intentional and repetitive use of those words in a variety of natural contexts. The general approach to focused language stimulation is outlined is this  PrAACtical AAC blog post as follows:
  1. Introduce the new word(s) using focused aided language stimulation.
  2. Teach the new word(s) with explicit instruction activities. 
  3. Elaborate on the new word meanings with engaging practice activities. 
  4. Provide repeated exposure to the new word(s) on an ongoing basis.
  5. Check for understanding and reteach, as necessary.
One place to start with Focused Aided Language Stimulation is to teach the most commonly used words, known as core words (look for further explanation of this when we get to V - Vocabulary). Below, I have included a few links to sources that can be used to better understand and to provide resources for the teaching of more common core words.

Dynamic Learning Maps Video on Core Words: The beginning of this video offers some great background information about core vocabulary. At the 10:30 mark, the first 40 recommended words in groups of 4 are shared. This list could serve as a way to decide on which groups of words to introduce first when doing Focused Aided Language Stimulation. Between 11:50 and 20:30, there is discussion and several demonstrations related to direct teaching of core words.

AAC Language Lab Core Word Starter Pack: Includes lesson plans, books and activities that can be used to interactively teach some of the first core words. Many of the words are "mediating words" - words that allow the student to gain control over his/her environment.

PRC Core Vocabulary Studies and Core Word Activities Handout: Information and ideas for teaching and incorporating 11 high power core words in to a variety of natural activities.

AAC Core Word of the Week Packages by Jenna Rayburn: This is a link to a blog post by Jenna Rayburn where she outlines what her Core Word of the Week Packages are.  These packages include materials and ideas for focusing in on a new word each week. At this point, she is still developing them. The blog post links to the Teachers Pay Teachers store where the first kit is available. Note that there is a cost associated with getting this packages.

My TobiiDynavox Website Core Lesson Plans: For those who are using the Compass App or the T-series devices, there are core word lesson plans related to the first 30 core words on the support website. Included for each word is a parent letter, ideas for teaching the word, printable books that can be used to reinforce the word, and ideas for implementing the word in to a variety of activities and school subjects.

Beyond teaching the first 10-40 core words, Focused Aided Language Stimulation can be used for any words. As a parent, the idea that using a communication device is similar to using a new language really hit home with me a few weeks back.  My son is 16 and in the past year, as a result of moving to focusing on having access to a robust language system, core vocabulary and generative language approaches, he has started to play with language a lot more. I am also seeing him trying to explain more of what he wants to say to me. Some time ago, he managed to explain to me that he wanted to go to a hotel by pushing a series of words - "want", "car", "swim", "sleep" and then going upstairs and getting a suitcase and bringing it down to me. I figured out he needed the word hotel on his device and he is now able to ask repeatedly to go to a hotel.  A few weeks later, he came to me again and was trying to tell me something else. He then put a series of words together "want", "car", "hotel", "eat", "no sleep". Because we have been doing this guessing game over so many things lately, I was able to fairly quickly figure out that he wanted to go to a restaurant as we often go out to eat when we are at a hotel. The word restaurant was already in his system but he had not yet mapped the symbol/location to the meaning of the word. Once I showed him, he was then able to use that word when he needed it. The reality is that he has known the difference between the spoken word restaurant and hotel for many years (as he could demonstrate the difference by signing eat or sleep when the word was said) but he had not yet learned how to say restaurant in the new language that he is learning. For me, this experience spoke to the need to ensure that I am doing some focused teaching or modeling of words that are associated with the activities and discussions that he is involved in. When thinking about school, it speaks to needing to think about the vocabulary associated with the classes he is taking and ensure that he can say it in the language that he is using (the AAC system).  

Aided Language Stimulation - Focusing on Functions 

Aided Language Stimulation can be overwhelming for communication partners because it is like learning a new language and learning a new language can be frustrating. Having a systematic plan that involves manageable steps assists both the student and the communication partners in the process. The above approach of focusing in on words is one way to get started. Another way is through focusing in on functions, teaching the words associated with a given function and then being intentional about modeling that function for a set period of time. Once their is comfort with that (i.e. it becomes more natural), then move on to a new function.

The PODD (Pragmatic Organization Dynamic Display) language system lends itself nicely to this approach as the pragmatic branch starters at the beginning of the book can be used to decide which function to focus in on for each stretch of time.  The picture below shows the different communicative functions that might be focused on from page 2 of a PODD book.

So for example, for the first few weeks, teams might just focus in on making complaining comments by using the "do something" branch and then following the links to state what they want to do or what they are going to do. For the next few weeks, they might focus on "Somethings wrong" and then when things go wrong (or when things are set up to go wrong) that branch can be used to talk about it.

Not all language systems are arranged in the same way as PODD but the different reasons we use to communicate can still be used to frame the introduction of new aspects of the language system a student is using. The Pixon project contains 12 learning modules that each focus on a different communicative function. Each module outlines core words to focus in on as well as provides ideas on teaching and using the words in a variety of natural contexts. Below are links to two different manuals that include these 12 modules with a few minor differences to them. The first module is very similar to the many of the links as that module is related to mediating and focuses in on many of the same words as what make up the first 11-40 core words.

Pixon Language and Learning Activity Notebook (PLLAN)

Pixon 60 TouchChatHD App Clinical Manual

So how does this play out in actual practice?  

Four years ago, when we at the tail end of being a self-contained classroom, we had the staff in the room, parents, and some home support workers trained in PODD and after this, we began our first attempted at Aided Language Stimulation. It was not a smooth process and there has been a lot of learning of learning in the past four years... and there is still much to be learned... but as we have dipped our toes in to it, the benefits of this approach are being seen. What is also being seen is that it is a process and that it is important to have some sort of systematic approach in place that will allow the communication partners to learn to do aided language stimulation.  Finally, it is becoming clear that this is a method that can only be used if the needed vocabulary is actually available.  

Jane Farrall just posted an excellent article outlining the process implementing the use of iPads in a specialist school where she talks about moving from having the iPads available to use of Aided Language Stimulation to the use of Focus Aided Language Stimulation and the impact that it had on the development of language and communication skills in the students in the classroom. Check it out on her blog here!

Friday, June 26, 2015

CCN Alphabet - Sharing What I'm Learning About Supporting Students with Complex Communication Needs

It's hard to believe another year has come and gone. There were many times this year when I sat down to write a blog post but then the words just didn't seem to come.  It wasn't that there was nothing to write, but perhaps more than so many of the things that I have been thinking about for the last few years starting to become consolidated in practice and in the time I wanted more to step back and experience it and let it evolve rather than to wrap too many words around it. 

When I adopted my son 16 years ago, I knew that we were beginning a "special needs journey" but I did not know that we were also beginning a "complex communication needs journey". In those early days, I imagined a very different life for both him and I as his childhood years have unfolded.  

When I made the decision to move from "general" to "special" education 9 years ago, I also knew I was on a new journey, but, again, I was unable to imagine what parts of that journey would become my North Star. 

There are events that stand out now looking back but more so then the events, what stands out is a deepening awareness of how our knowledge evolves; How the way we see things changes as what we know and experience changes.  

Up until five years ago, the work I was doing around communication with students with complex communication needs was pretty restricted to things like sign language, PECs, eye-gaze boards with only single layers, yes/no choices...etc. The work we were doing around "literacy" with this population was also restricted mostly to "literacy experiences" but we dabbled a bit in sight word reading programs. The school experiences of the students that I worked with were also restricted a majority of the time by the walls of our self-contained classroom. 

The journey began with feelings of discomfort that I could not put my finger on, and then opportunities began to open up - a 2-day PODD training by Linda Burkhart, Literacy and AAC courses by Karen Erickson and David Koppenhaver, Communication and Literacy workshops by Caroline Musslewhite, taking my Masters in Inclusive Education and Neuroscience, support from some to educational practice away from a self-contained classroom and toward supported inclusion in age-appropriate general education settings, Alberta's Literacy for All initiatives...etc. Through it all, the awareness of importance of literacy, language, and communication in reference to a person's autonomy and quality of life has grown.  

In the middle of this growing awareness are explorations on how to make it all happen...which leads to more learning and more awareness. We have, by no stretch of the imagine, figured it all out. I'm pretty sure we have still just only seen the very tip of the iceberg.  But we are also making progress and learning a few things along the way.

This summer, I want to do a series of blog posts and share what I (as a result of many interactions with students, parents and professionals) have been learning and thinking about supporting students with complex communication needs (CCN).  I thought to frame it in an alphabet style and do 26 posts - one for each letter of the alphabet - sharing these thoughts.  Tomorrow, I will start with A...

Links to Completed Posts in this Series
B is for Behaviour
C is for Communication Process
D is for Descriptive Language
E is for Engagement
F is for Facilitators
G is for Generative Language
H is for "Helping"
I is for Inclusion
J is for "Just in Time"
K is for Keyboard
L is for Language of Control
M is for Motivation
N is for Narrative Development
O is for Opportunities
P is for Play
Q is for Qualified (Presume Competence)
R is for Robust Language System
S is for Self-Determination
T is for Talk About
U is for Urgency
V is for Visual Supports
W is for Wellness
X is for Fix (Communication Repair)
Y is for Yelling
Z is for Zone of Proximal Development