By Linsey Zanchetti, SCSU Student
My name is Linsey Zanchetti and I am a graduate level student completing my 6th year certification in Assistive Technology at Southern Connecticut State University. This summer, I am completing an independent study with the guidance of Dr. Lauren Tucker, targeting core language approach and modeling with augmentative or alternative communication (AAC) devices for parents and for paraprofessionals. Individuals who are complex communicators may utilize an AAC device in order to improve their functional communication. The success of the introduction and implementation of an AAC system for an individual involves a collaborative teamwork approach (Goldbart & Marshall, 2004; Karlsson, Johnston, & Barket, 2017; Brock, Seamn, & Downing, 2017). This team includes paraprofessionals who are involved in the daily activities of individuals who use AAC devices within the schools and families who are providing natural modeling opportunities within the home. While many parents frequently feel overwhelmed with novel AAC devices, paraprofessionals also experience minimal training which impacts their use of the device within the school setting for school-aged children.
This summer I am planning to conduct two separate training sessions—one for families via Zoom and one for paraprofessionals in person at a special education school in Orange, CT. The focus on the training is to provide a research-based introduction to explain the benefits of using a core language approach with AAC and then explain the best way to model language with an AAC device. Core vocabulary is a set of words consisting of verbs, adjectives, pronouns, articles and conjunctions that make up approximately 80% of what we say. Conversely fringe vocabulary is vocabulary that is specific to an individual or a situation and makes up approximately 20% of what we say. Utilizing a core vocabulary approach helps to allow an individual who uses AAC devices to communicate more efficiently particularly when they are using direct selection to access their device.
Individuals who utilize a multi-modal approach to communicate, including using an AAC device, rarely have the opportunity to see the same modeling when they are beginning to communicate. Modeling intervention strategies have shown significant improvements in the language output for individuals who use AAC devices, however, it is important to identify specific strategies used by various communication partner when developing training programs. Researchers have found that allowing children the opportunity to access and use the device in multiple setting while modeling the use of that device is a key instructional strategy (Campbell, Milbourne, Dugan, & Wilcox 2006; Briggs Carter, & Gilson, 2019). Using communication partners to model the communication through the use of the AAC device is a unique way to allow the communication partner to use the AAC system to model expressive language within natural interactions (Sennott, Light, McNaughton, 2016).
The trainings will provide a brief background on AAC, core vocabulary, and modeling. Participants will then interact to brainstorm communication opportunities within their daily routines. For example, communication temptations will be described and video examples will be provided to promote integration into daily routines. A communication temptation is when an adult sets up the environment to tempt the individual to communicate. For example, during snack time providing only a small amount of the desired snack, requiring them to ask for more. After participants brainstorm opportunities to integrate core vocabulary and communication opportunities, modeling will close the presentations. To facilitate the adoption of modeling, I have created an acronym to help families and paraprofessionals remember key aspects of modeling: SAME (See/Slow, Always, Model, Expand). This simplified model is derived from other approaches in the field (Kent-Walsh & McNaughton, 2009) and redesigned to be more accessible to families. See/Slow emphasizes making sure that the individual is looking at what you are doing when you are modeling with the device. Always focuses on having AAC available all the time and integrating it in an as many opportunities as possible. Model without expectations: making statements, describing things, and restating messages. Finally, expand your model approximately 1-2 words above their use. The goal of SAME is to develop a mnemonic to easily integrate AAC into the home and school routine. Following the Zoom trainings, families and instructional professionals will have the opportunity to attend a follow-up, open-ended training session to answer any questions and to provide ongoing support.
Our goal is to build confidence in families and paraprofessionals to model the language and to help individuals who are complex communicators be exposed to using core language and their AAC devices in all opportunities. We want to build the confidence in order to reduce the abandonment rates for families when introducing AAC devices and to help support the communication partners to be as successful as possible. When school-aged children are introduced to these types of devices, providing adequate training and support to the educators and paraprofessional working with them throughout the school day is vital for the success of the system.
The TouchChat app was recently trialed through EASTCONN’s AT Lending Library by Chris, a transition-age student with Autism Spectrum Disorder. Several AAC options were ruled-out prior to Chris’s device trials, after matching specific software design features to his abilities and needs. For example, Chris had demonstrated his ability to make requests to meet his needs and he had a large, receptive vocabulary. Yet, he was often impatient, so he benefited from automatic navigation and grammar guidance to produce full sentences quickly. Trials began with Chris observing the examiner using an 8-inch dynamic display, speech-generating device (SGD) with synthesized voice-output running research-based AAC software, called TouchChat. TouchChat is designed and manufactured by Saltillo for individuals who need efficient access to a robust vocabulary with a mix of single words, phrases and complete sentences. It is an app for iOS only, not Android devices. Chris’s support coach said he needed the smaller size of the 8-inch iPad, as compared to his current, 10-inch SGD. Chris enjoyed using the custom messages in the About Me page to express how he liked ketchup and other favorites. He quickly demonstrated the ability to imitate a model, and even learned to sequence three buttons independently to express, “I want to play music.” As a result of Chris successfully trialing several assistive technologies and devices, his school district could determine which device would best meet his needs.
In order to determine how we were going to implement the device at different opportunities throughout the student’s day, the educational team looked at what the student’s typical day looked like as well as her individualized educational programming. It was decided that we would start with the following commands; “Alexa, what’s the weather in (town).” This would allow the student to report the weather to the class during morning meeting. “Alexa, set a timer for (time)” and “Alexa stop the timer”—this would allow the student to set a timer while completing cooking tasks as well as while performing various other life skills activities where a time limit or a simple reminder is needed. “Alexa, play music by (preferred music artist)” would allow the student to engage with her peers socially and enjoy the leisure activity of listening to music. Finally, “Alexa, play calming sounds” to allow the student access to self-calming techniques rather than relying on an adult to anticipate and initiate the calming strategy. The student’s AAC tool (iPad mini with TouchChat HD-AAC app running MultiChat 15 Student vocabulary), which already contained a folder to access voice command, was customized to meet the communication needs.
For the past 36+ years, Carolann Cormier has worked as a speech-language pathologist (SLP) and an expert in assistive technology (AT) and augmentative and alternative communication (AAC) throughout the state of Connecticut. Since 1995, Carolann’s career has spanned many different work environments, including public schools, summer camps, the Department of Developmental Services (DDS), children’s hospitals, colleges and the Capitol Region Education Council (CREC). Carolann has presented nationwide, has also published numerous professional articles and written a guide to AT for students with Autism. She has also accomplished so much professionally, having earned a variety of advanced degrees and certifications. However, Carolann’s professional success is far greater than the sum of its parts: It’s her positive influence on students and families that is the true mark of her personal and professional legacy.