AAC Implementation Plans Preparing for Successful Communication Center

AAC Implementation Plans: Preparing for Successful Communication Center on Technology and Disability Webinar December 5, 2017 www. CTDInstitute. org

We want to hear from you! At the end of the webinar, please fill out the brief survey http: //www. surveymonkey. com/s/CTDCafe. Events When you complete your survey, visit the link provided to get your Certificate of Participation. www. CTDInstitute. org

Introductions My name is Laura Kessel. I am: • A Speech-Language Pathologist (SLP) • An AAC Specialist • An Assistive Technology Professional (ATP) certification holder • Happy to answer questions! You can reach me at laurakessel@aacspecialist. net www. CTDInstitute. org

Poll I’d love to know if you are: • • • A parent A service provider A service coordinator A teacher Working in a related area Anyone else? www. CTDInstitute. org

for today: 1. Creating an AAC Implementation Plan 2. Data collection based on an AAC Implementation Plan 3. Resources to draw on www. CTDInstitute. org

Quick Definitions: AAC According to ASHA: • “Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. ” Who is it for: • Any individual who requires visuals or gestures to be paired with speech for receptive language input to be understood • Any individual who is struggling to communicate face-to-face via speech in one or more situations www. CTDInstitute. org

What’s an AAC Implementation Plan? A document drawn up by an AAC user’s team that: • Defines successful AAC use • Defines signs that troubleshooting is required • Describes all communication systems in detail • Describes all strategies that apply to AAC use for this individual • Lays out individualized prompting hierarchies • Includes detailed descriptions of activities & communication targets • Includes team member roles and responsibilities www. CTDInstitute. org

Why do you want one? • Provides a training resource and reference for the team • Clarifies expectations across settings • Reduces confusion around which team member to approach with a given concern • Encourages data collection • Brings the team together for in-depth AAC discussion (or several!) www. CTDInstitute. org

How do you make one? • Get administrative support (if possible) • Collect as many team members as you can • Use Plan template as a framework for discussion • Determine potential communication targets in each environment • Draft and distribute www. CTDInstitute. org

AAC Implementation Plan: Defining Success • Teams may not know what to look for! • Needs to be customized for each individual Example: The AAC system and strategies will be considered effective if the individual demonstrates: • Increased independence • Increased comprehension of communication partner’s messages via Aided Language Stimulation • Increased vocabulary use www. CTDInstitute. org

AAC Implementation Plan: Troubleshooting • Teams may not know what red flags to look for! • Needs to be customized for each individual Example: The AAC system and strategies will need to be reassessed if the individual demonstrates: • Reduced social engagement or participation • Decreased vocabulary use, or lack of vocabulary growth • Decreased independence www. CTDInstitute. org

AAC Implementation Plan: Communication Systems Need to include: • All high- and low-tech systems used by the individual • How the individual accesses each AAC system • Include visually or auditorily attending to Aided Language Stimulation if appropriate • Any required accessories (e. g. , switches, mounts) • How often the system should be used www. CTDInstitute. org

AAC Implementation Plan: Communication Systems Probably should include: • Any passcodes that all team members should know • Where the system is stored when not in use • Who owns the system and whether it travels between settings (e. g. , home, school) • Any no-tech strategies and how to carry them out www. CTDInstitute. org

AAC Implementation Plan: Communication Systems Example: System Where should it be? How is it used? i. Pad with Proloquo 4 Text Attached via flexible mount to the front center edge of the student’s wheelchair tray when in use. In Ms. ___’s middle desk drawer, plugged in and charging, when not in use. [Student] accesses the Throughout the i. Pad to communicate school day via typing and word prediction. He scans with one switch. APPlicator switch the APPlicator switch interface should be interface and Velcroed to the cover of the i. Pad case when microlight switch in use. The switch should be positioned at the tape X on the wheelchair tray. Both items should be in Ms. ___’s middle drawer when not in use. See attached instructions on setup. [Student] is able to throughout the move his right index school day finger up and down slightly to press on the microlight switch. The scan pattern is customized. Guided Access passcode 2976 www. CTDInstitute. org When is it used?

AAC Implementation Plan: Communication Systems Example: [Student] utilizes a family-owned Nova. Chat 8 with a Chat. Power 60 layout. Access: • She activates speech output via direct selection of buttons with her left thumb. She also accesses the device through visual attention to Aided Language Stimulation from the SLP, teacher, and her para. Locations and Storage: • The student carries her device with her at all times via the handle. The device is stored in her locker during the weekly pool trip. The device travels between home and school in a protective bag along with its charger. www. CTDInstitute. org

AAC Implementation Plan: Communication Systems Example continued: [Student] utilizes a low-tech topic board at the pool. Access: • She points to symbols with her left thumb. She also accesses the system through visual attention to Aided Language Stimulation from her para. Locations and Storage: • The low-tech topic board is only used in the pool setting due to concerns about the safety of the high-tech device. It is stored in her swim bag when not in use. www. CTDInstitute. org

AAC Implementation Plan: Strategies Need to describe: • All strategies being used with the individual in detail • Which team members are responsible for implementing a given strategy • The situation(s) under which each strategy should be utilized www. CTDInstitute. org

AAC Implementation Plan: Strategies Strategy Examples: • Least to Most prompting hierarchy • Most to Least prompting hierarchy • Descriptive teaching • More info available here: https: //goo. gl/ezqji 3 • Core Vocabulary • Motor Planning www. CTDInstitute. org

AAC Implementation Plan: Strategies Strategy Example: • Aided Language Stimulation • Research based: https: //goo. gl/5 Ysf 46 • A communication partner interacts with the AAC user using the AAC system or a duplicate system. • The communication partner constructs messages by selecting symbols while also using his/her speech to say the utterance. • More info on this handout: https: //goo. gl/j. Rr 7 N 3 Aided Language Stimulation in action. Used with permission from the Uncommon Sense blog www. CTDInstitute. org

AAC Implementation Plan: Strategies Example: Strategy When to Use Team Member(s) Responsible Aided Language Stimulation throughout child’s day (see attached handout) All team members Least to Most Prompting Hierarchy teacher, SLP, family, para during designated activities, with vocabulary the individual has demonstrated increased independence with www. CTDInstitute. org

Poll Based on what we’ve talked about so far, I’d like to know if you have ever made an AAC Implementation Plan: • Yes, I have • No, I haven’t • I’ve made something similar but not quite the same • Other? www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies • Should be individualized for each AAC user • Should be described in detail within the Implementation Plan and updated as needed • May want to include photos or other visuals if helpful for consistency or training purposes www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies Examples: • Most to Least prompting hierarchy • starts with the most support and fades the help given over time • Least to Most prompting hierarchy • starts with less support, then increases support until the individual succeeds www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies Least to Most example: Secure visual/auditory attention prior to providing/expecting a response Following the question or statement, if the student is stuck, give only as much prompting as needed: • Pause for at least ___ seconds • Gesture toward the device • Give an indirect verbal cue (e. g. , “It would help me out if I could hear what you’d like to do next”) www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies • Gesture towards the specific vocabulary or navigate there (e. g. , open the Places page in the app if the question was, “Where would you like to go? ”) • Use other means of indicating specific vocabulary: light pointer, occluder. • Give a direct verbal cue (e. g. , “I need you to tell me on your device. ”) www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies • Give a Direct Model of the utterance you want the student to say (navigate back to page you were on if necessary) • Give a direct verbal prompt (e. g. , “tell me ____”) • If permitted by the student/their family, a physical prompt such as hand-under-elbow, hand-under-hand or hand-overhand might be used. www. CTDInstitute. org

AAC Implementation Plan: Prompting Hierarchies • Some additional examples and handouts regarding prompting hierarchies can be found here: • https: //goo. gl/SGTfw 8 • https: //goo. gl/B 9 hk 3 E • https: //goo. gl/Uz. Fsm. L www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets As a team, describe in detail: • Activities to highlight • Communicative function(s) for each activity • Type(s) of AAC being used during an activity • Specific communicative expectations during a given activity • Communication partner(s) and their role www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Picking activities to highlight: • Focus on regularly occurring, consistent activities • Think about the vocabulary or pragmatic functions you want to target • Which activities make sense? • Consider utterances the individual already says during a given activity • Can they be expanded or shifted to something more appropriate? www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Example activities: • Morning Meeting • Going to the coffee shop or another community outing • Playing a game or with a toy • Class • Work • Meal times • • Music Therapy Shopping Cooking Taking public transit Going in the car or van Speech Therapy sessions OT and/or PT sessions www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Choosing a communicative function for the activity: • Want to list all that apply for a given activity • Ideally, you are targeting either: • A few functions across all the activities listed in the plan • Best for individuals that are refining a few skills or who are new communicators • A wide variety of communicative functions, a few different ones for each activity in the plan www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Communicative function examples: • Requesting • • Commenting • • Directing others • • Gaining the attention of others • • Protesting • • Asking questions • Answering questions Greeting/leave-taking Group participation Choice-making Labeling Sharing information www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Types of AAC being used during an activity : • List all communication methods that might be used during a particular activity, including no-tech if relevant • e. g. , ASL signs, idiosyncratic signs, eye pointing, changes in body posture, low-tech visual supports, individual’s AAC system, etc. • You want to clarify which of the tools you discussed earlier in the plan apply within a given activity www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Communication expectations: • Should be stated explicitly • e. g. , with specific utterances or a clear description of the type of utterance • Should align with the stated communication focus for the activity • Should be written in the manner most helpful for the extended team • e. g. , may need to write out how to locate vocabulary in an utterance, including silent navigational hits www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Picking activities/utterances to highlight: • May want to draw on existing resources, e. g. , : • Core vocabulary and play routines document from PRC https: //goo. gl/r 2 UR 6 G www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Thinking about activities/utterances to highlight: • May want to draw on existing resources, e. g. , : • Speak for Yourself’s brainstorming worksheet www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Picking activities/utterances to highlight: • Dynavox’s Observing the Classroom Environment Form, https: //goo. gl/3 sdjmp www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Communication partner roles: • Who is expected to be present during the activity? • What are they each expected to do to help the student experience communicative success? • e. g. , Aided Language Stimulation? Least to Most Prompting? www. CTDInstitute. org

AAC Implementation Plan: Activity-based Targets Example: Activity Conversational carryover in the classroom after practicing with the same topic in speech Function 1. Greeting 2. Take turns listening/sharing (group participation) 3. Self-advocacy AAC in use i. Pad with Proloquo 4 Text app Expectations 1. Listen to another person or story 2. Ask an open ended or clarifying question 3. Make an appropriate comment 4. Utilize pragmatics to maintain conversational control and work on conversational repair strategies www. CTDInstitute. org Communication Partner(s) & Role SLP, speech interns, teacher, and fellow students SLP and teacher provide least to most prompting as needed

AAC Implementation Plan: Activity-based Targets Activity snack in inclusion classroom Function 1. Commenting 2. Asking whquestions 3. Participating in conversational exchanges with peers AAC in use i. Pad with LAMP: Words for Life app Conversation wheel visual Expectations 1. “[I] + I have + ____, ” “[I] +I like ___, ” “[I] + [knot symbol] + I don’t like ___, ” “I’m all done, ” comments on taste, size of bites, etc. 2. “What do you have? ” after looking at a peer 3. Various questions/answers from the conversation wheel visual used with the group: “How are you? , ” “What’s your favorite color? ” etc. www. CTDInstitute. org Communication Partner(s) & Role teachers, peers Teacher uses least to most prompting hierarchy as necessary Aided Language Stimulation is provided by SLP or teacher

AAC Implementation Plan: Activity-based Targets Activity bathroom Function 1. Request AAC in use Expectations i. Pad with Touch. Chat with Multi. Chat 15 1. [needs category] + www. CTDInstitute. org I need to use the bathroom Communication Partner(s) & Role Teacher, paraprofessional Initially, the message should be modeled by staff at scheduled bathroom times before escorting the student to the bathroom. Any spontaneous activations by the student should be honored immediately.

AAC Implementation Plan: Team Responsibilities You want to list out: • All team members • All aspects of AAC system upkeep and maintenance • Which team member(s) are responsible for each aspect of upkeep and maintenance www. CTDInstitute. org

AAC Implementation Plan: Team Responsibilities The Bridge School Transition Program. (n. d. ) Collaborative Teaming Matrix. Retrieved from: https: //goo. gl/qc 8 Nk. Q www. CTDInstitute. org

And THAT’s the AAC Implementation Plan! www. CTDInstitute. org

Poll At this point, do you think having an AAC Implementation Plan would be helpful to you/your team? • Yes • No • Maybe www. CTDInstitute. org

Data Collection Now what? • Document, document! • Encourage teams to collect data • to determine if the system is working or in need of troubleshooting • to determine if strategies are being implemented as laid out in the plan www. CTDInstitute. org

Data Collection Strategy implementation: Aided Language Stimulation example From AAC Meets ABA: Natural Aided Language Interventions for Individuals with Autism and Complex Communication Needs by Dr. Joanne Cafiero. Retrieved from: https: //goo. gl/HX 7 UHw www. CTDInstitute. org

Data Collection Strategy implementation: Aided Language Stimulation example From the Lexington Public Schools. Retrieved from: https: //goo. gl/o. DVx. Hy www. CTDInstitute. org

Data Collection Strategy implementation: Aided Language Stimulation example From Gail Van Tatenhove’s The Student Augmentative and Alternative Communication Profile & Portfolio. Retrieved from: https: //goo. gl/v. CXCh 3 www. CTDInstitute. org

Data Collection Strategy implementation: Modeling + Imitation example From Texas’ Region 13 Education Service Center. Retrieved from: https: //goo. gl/egz. ULX www. CTDInstitute. org

Data Collection Strategy implementation: Core Vocabulary Checklist example From Gail Van Tatenhove. Retrieved from: https: //goo. gl/TDmrdt www. CTDInstitute. org

Data Collection AAC use example From the Lexington Public Schools. Retrieved from: https: //goo. gl/o. DVx. Hy www. CTDInstitute. org

Data Collection AAC use example Modified from a data collection sheet available through CAIU. Original retrieved from: https: //goo. gl/DQfg. T 4 www. CTDInstitute. org

Data Collection Language Sampling example From Gail Van Tatenhove’s The Student Augmentative and Alternative Communication Profile & Portfolio. Retrieved from: https: //goo. gl/v. CXCh 3 www. CTDInstitute. org

Data Collection AAC use example From Kate Ahern’s Teaching Learners with Multiple Special Needs, https: //goo. gl/14 n. Epk. Original data sheet retrieved from: https: //goo. gl/Xxo. RG 6 www. CTDInstitute. org

Any Questions? www. CTDInstitute. org

Acknowledgements With the greatest thanks to Audra Francisco, M. S. , CCC-SLP and Amy Golding, M. A. , CCC-SLP, for sharing their AAC Implementation Plan templates with me. www. CTDInstitute. org

Image References Slide 19 – Nieder, D. G. (2014). Modeling for my kids [JPEG]. Retrieved from http: //niederfamily. blogspot. com/2014/10/more-resources-monday-aidedlanguage. html Slides 7, 16, 22, 30, 33, 42, 56 - Pictograms’ author: Sergio Palao Origin: ARASAAC (http: //arasaac. org) Licenses: CC (BY-NC-SA) Property: Aragon Goberment www. CTDInstitute. org

References American Speech-Language-Hearing Association (n. d. ). Augmentative and Alternative Communication (AAC): Information for Consumers. Retrieved on March 5, 2017 from http: //www. asha. org/public/speech/disorders/AAC/ www. CTDInstitute. org

“Assistive and Instructional Technology Supporting Learners with Disabilities” The Center on Technology and Disability is funded by the U. S. Department of Education, Office of Special Education Programs (OSEP) under award #H 327 F 130003 – 13 A. www. CTDInstitute. org