HQ9 - 6/22

Explain what PATTAN, PIAT, and UCP are and why they are useful.

PATTAN - Pennsylvania Training and Technical Assistance Network - focuses on children - loan AAC devices to you PIAT - Pennsylvania's Initiative on Assistive Technology - Lending Library UCP - United Cerebral Palsy - resources and advocacy for people with CP

Explain how PECS basically works. What is a Logan Proxtalker? Explain two main criticisms of PECS.

PECS - Low-tech system - highly behavioristic (based on work of Skinner) - created specifically for Autistic population - have picture cards (things the child likes) that represent real objects so they can become better at interacting with others Logan Proxtalker - PECS with speech - cards have a little chip on them, that contains digitized speech that you can record - when they child wants to say something, they take a card, and when they put it on the velcro on the device, it reads the chip and will play the audio Criticisms of PECS - some clinicians think if a child masters PECS then victory has been achieved BUT it would be far better to have an AAC system with speech output (weird to go up to someone and hand them a picture card) and would be much more natural to have a voice ALSO, PECS doesn't focus much on commenting or socialization - move onto a different system afterward to work on socialization

Explain Steps 1 and 2 of PECs.

Phase 1: need two clinicians (a facilitator and the main clinician) - you have an item you know they like (ball) - keep it out of reach of the child - have a card with a picture of the item - when the child reaches for the item, the facilitator that sits behind the child (or may have them on their lap) will take their hand, put it on the card, and have them hand it to the clinician, so they can then give the child the item - later, take the item away, but the card back down, and repeat the process - train the child to find the picture to ask for the item Phase 2: don't sit right in front of them, but sit further away, put the item on a shelf, so the child will have to walk the card over to you - make it more consistent - they learn to understand to approach people

Explain Steps 3 and 4 of PECs.

Phase 3: need to know things that aren't of interest to the child (e.g. scooper to a detergent box) - and have a picture of the item - put the two cards together so they can decide what they want - they will reach for the card of the desired item - relate card picture to the target/preferred item - want them to discriminate between cards and items, and learn that what they choose is what they get Phase 4: Put some velcro on pictures, and have a notebook with these strips containing the plastic velcro part, so they can stick cards in the notebook - include phrases: I want, and items: ball - "I want ball" - sting phrases and nouns together to create sentences - simple SVO sentences to build sentence structure - give adjectives and verbs as well

Explain Step 5 and 6 of PECs.

Phase 5: Make things more functional - give them "I want" strip and give them a wide range of choices of items - they need to tell you or else they get nothing Phase 6: at this point, they are communicating not for socialization but to get what they want - want them to interact - introduce comments like "I see" or "I like" - comment on things in their environment so it expands on more than just their wants

Describe the characteristics of an emerging communicator. Explain the main intervention strategies/issues for these clients.

Profound cognitive-linguistic disoder across modalities as a result of extensive brain injury from a single large CVA, multuple strokes, trauma - Global Aphasia - may have both severe aphasia and apraxia of speech - extreme difficulty speaking, using symbols, and responding to conversational input turn taking, communicating choices with tangible objects or photos, referential skills, and clear signals for acceptance and rejection

Explain the main AAC considerations in cases of developmental apraxia of speech. Explain two methods of working with existing speech for those with some (but limited) intelligibility.

AAC: Low tech or High tech where they can touch the symbols - free apps - use to interact in difficult situations (talking to an unfamiliar person) - preset phrases (medium tech system - highly portable) - alphabet board (point to first letter of the word) speech: you don't want AAC to substitute speech - drill sounds they they tend to have more problems with - make it more automatic and consistent - have a topic board for things they like to talk about (movies, sports, hobbies) - when the topic is set, intelligibility is much better

Explain what Aided Language Stimulation is and why it is useful. What is a reason to people with autism may succeed with high tech AAC systems?

Aided Language Stimulation - communication partner, parents, teachers that interact w the child will not just speak, but will point to picture symbols or use signs while they are speaking - that way they can see how their system could be used - show the shortcuts, improve rates/use of the system high-tech devices - work quite well with Autistic population - they appreciate the highly structured device - may be effective (Unity) - especially if it has a static display

Describe an intervention strategy for generative message communicators that can write.

Assisting individuals with aphasia to use prediction software built into their high-tech AAC systems, or word processing applications to generate written notes - incorporate prediction, choices and prefabricated sentences into a simplified email program for generative AAC writers who cannot manage the processing demands of a regular email interface

*Explain 2 examples of the type of communication for which children might show poor behavior. Explain why frequent partner behavior may reinforce poor behavior in one of these examples. Give an example of a helpful message for each of these 2 types of behavior problems.

Attention seeking behaviors - someone screams, they tend to get attention, so give them some attention-seeking phrases to use quickly "Can you help me? Pay attention to me." Acceptance/Rejection - "I need a break," or "all done" use these phrases instead of screaming - "no more" for rejection and "I want" or "More" for acceptance - give them a button that will say the phrase when they hit it Screaming is reinforced - so they scream to get something Or screaming = time out = people will leave you alone

Describe the characteristics of a stored message communicator. Explain two main intervention strategies for these clients.

Can learn to independently locate messages that have been stored in advance with their low/high tech system - have enough executive function and initiation ability to learn to consistently access entire phrase or sentence messages in specific contexts Message storage: low-tech notebooks or wallets Role Play and Practice: if an indicvidual targets the post office as an environment for better communication, initial sessions could consist of identifying messages, storing them, and then practicing how to use both spoken and AAC messages with a script

Explain 2 AAC strategies for emerging communicator who has aphasia, and 2 strategies for the communication partner for these types of communicators.

Communicator: Reference familiar photos and albums by pointing or demonstrating appropriate facial expression when participating in a dyadic reminiscing activity Communication Partner - create a simple scrapbook or album (1-2 pics of important life events per page with ket word labels) Communicator: Participate in turn-taking within the context of familiar visual games (tic tac toe/war) Communication Partner: provide contingent feedback for communicators referential, joint attention, affirmation, and rejection signals (oh you are looking at the pink nail polish so that is what you want)

What do FAPE, LRE, ADA, and IDEA stand for? Briefly explain what they mean.

FAPE - Free Appropriate Public Education - school systems could not deny children with disabilities - they have to take and serve these children LRE - Least Restrictive Environment - all children should have as much educational services as they are entitled to in the least restrictive environment (not separated or in a different system) ADA - Americans with Disabilities Act - any new buildings need to include ramps and seating for those with wheelchairs or are handicapped IDEA - Individuals with Disabilities Education Act - school systems have to start supplying any assistive technology to students that need them

Explain three strategies to make AAC systems fun and functional. Provide an example of each of these strategies.

Games - Simon says, musical chairs - help to participate in class activities Jokes - "What did the judge say when a skunk walked into the courtroom?" "Odor in the court!" - make AAC fun and gives user personality Funny sounds - can use in all types of situations - can record sounds or download from the internet (Spongebob)

Describe the characteristics of a contextual choice communicator. Explain the AAC strategy of yes/no to tagged questions; what should the partner do?

Have more capabilities than emerging - but are unlikely to communicate successfully unless they have substantial AAC and partner support - indicate basic needs by spontaneously pointing to items - easily recognize visual symbols such as photos, labels, written names and signs - aware of daily routines and schedules Partners add the phrase yes or no to the end of y/n questions and model the head movements - narrow pool of choices of how to respond within the context of the situation

Explain the 3 steps for using AAC to help control unacceptable behavior

Identify the functions of the unacceptable behavior - are they screaming because they want something? Do they want attention? Do they want a break? If you cant figure out what they want, then help them to communicate for what they want Introduce functionally equivalent responses - quick and easy to perform - "I want a cookie" "Can you pay attention to me?" then communication partner needs to reinforce by getting them what they ask for Evaluate the reinforcers for unacceptable behavior and for functionally equivalent responses - see what people do for the unacceptable behavior - do they scold them? Do they give them a time out? Do they ignore screaming? Need to teach them a more appropriate way to respond to unacceptable behavior

Describe the characteristics of a generative message communicator. Explain two main intervention strategies for these clients.

Speakers and/or writers with aphasia who can convey some novel info on their own - they are able to formulate messsages using symbols or text and can use a combo of aided and unaided supports Low-tech - carry a small notebook with well identified topic categories (family, sports) as well as associated word lists High-tech - AAC app that allows for spelling, word prediction, combined words, and can store whole messages for some situations

Explain what is a written choice conversation for contextual choice communicators. What are the main strategies for the communication partner?

Technique requires the facilitator to generate written key word choices in addition to spoken messages that are pertinent to a conversational topic - CP says each of the written choices aloud while writing them within view of the person with aphasia - the person with aphasia points to the choices, making opinions and preferences known

*Describe the characteristics of a transitional communicator. Explain a strategy for this group for the following: introductions/topic setters, asking questions, and storytelling.

They demonstrate an abililty to use AAC symbols and supports to help them communicate - they may have fluent or nonfluent aphasia - some gesture, draw or speak to start an interaction with the CP Introductions: introduce themselves using a prepared card or message on AAC (I have aphasia following a stroke, therefore I have difficulty thinking of words and saying them. I communicate by...) Asking Questions: pointing toward CPs and asking questions (So... dont you want to know about my weekend?) Storytelling: pre-storing consecutive segments of the story in the AAC device (point in correct sequence to tell the story)

What is augmented input and why use it? Give two examples of augmented input.

To avoid communication breakdowns the CP can augment their spoken language by gesturing, writing key words or drawing - can be implemented whenever the communicator w aphasia is having difficulty comprehending conversational questions, comments or instructions EX: Partner reiterates message while simultaneously pointing to the item being discussed, or may show photos/drawings or other diagrams while talking

Explain the use of visual scene displays for people who are transitional communicators. Give an example.

VSD - organize both narrative information and potential comments and questions to extend an interaction about the topic Ex: picture of Hawaii (button says "this is our vacation to Hawaii, we tried boogy-boarding, what do you think of Hawaii?)

Explain what the Least dangerous assumption is. Explain what collaborative teaming is and why it is important for inclusion.

When you aren't sure of a child's abilities, assuming competence will cause less harm than assuming incompetence -If you assume someone can not communicate or understand, and don't provide any stimulus for them, then that can be detrimental to learning, but if you assume competence, they will still be developing with stimulus, but some vocab and information may go over their head Collaborative teaming - you meet with other teachers and make sure you are on the same page with the same goals (if some don't want to bother using AAC in the classroom, that is a recipe for abandonment) - good way to build up vocab - find out what they are teaching and put that vocab in their AAC system so they can interact in class

Describe the characteristics of a specific-need communicator. Explain two main intervention strategies for these clients.

may not wish and do not need to use aided AAC as a primary communication method to meet specific needs - speech and gestures may be adequate and optimal for most social situations (but some communication situations require high degrees of specificity, clarity, or efficiency (picking up a prescription or toasting at a wedding) Intervention strategies: may need help setting up a system to allow spoken communication over the phone (this is ___, please ask me yes/no questions, speak slowly and clearly) For communicating in a noisy area (cafeteria or banks) - often a small communication card can be prepared with a restricted set of messages that are needed in the situation

Explain the basic issues of working with people with deaf-blindness. Explain a strategy for working with this population.

some people with deaf-blindness may have cognitive impairments but not all do - need to know when they became deaf - Was it after/before they acquired language? - if they had speech before, they have a better chance of producing intelligible speech Tactile Fingerspelling/Sign Language - teach feeling of different letters/symbols