In this interview episode, SLP Rachel Madel shares tips for school-age AAC users.
Time Stamps
0:00 Introduction and Lighting Round
10:47 How did you get interested in AAC?
15:07 Case Study (2nd Grader Conner)
28:11 How do we do a high tech AAC assessment? Where do we start? What resources can we access to do this AAC eval?
32:32 How do you judge success in an AAC trial? How do we know if what we are trialing is working? What are we looking for?
41:58 Defining “robust AAC,” and giving examples of systems that are robust
43:18 Resources to use during an AAC evaluation
47:15 What are some motivating activities you use in your session?
50:50 Ideas for students who line up and stack toys by color - how can an SLP engage in that activity when that’s what is motivating?
56:00 Ask communication partners - if a child had consistent access to a way to communicate - what would they say?
01:07:00 7 Takeaways for AAC use, wrap up
Key Takeaways
Often used app - Peppi Wonderworld (Rachel calls it the “Dragon Game” with her kids)
Sarah’s recommended shows: Under the Vines (Acorn TV)
Rachel’s recommended show: Atyipical
Limitations of communication board - it doesn’t have auditory output (when kids hear the word that helps their learning, and they may even imitate the word the device says)
Examine: What does a child’s spontaneous language look like? What are they saying without imitation/non-prompted language?
If you think about the child’s entire day (or session with you) - what is the percentage of time they are using spontaneous language (without adult support or prompts)?
The students we work with may be very prompt dependent - even if they are verbally using language - perhaps they only talk to respond or with a prompt. How do we get kids out of prompt dependence? Think about goals to target initiation and implementing supports (like AAC).
For kids with verbal speech, ask what a child says on their own - if it’s not much, this student is a candidate for AAC; because otherwise they are just responding or waiting for a prompt.
We don’t always know what kids want to say! AAC gives them more options to initiate and ask for what they want - looking at an array of options and deciding on what they want to say.
Giving high levels of verbal prompts doesn’t always help with initiation - with AAC we have more options for varied prompts to get to independent communication - we can pause and tempt, point to the device - and use more visual prompts to scaffold the learning supports towards independence
For Conner: trial high tech AAC, focus on independent initiation
Where to start with AAC eval? Look for a lending library in your area, if you are an SLP with a license you can typically reach out to companies to say you are trialing their technology and request a free license, get familiarity for what systems are used in your area
“Half the battle of AAC is getting the adults (around the child) to use it.” Rachel Madel
If you trial a system ask yourself - Is it robust? Is this student using it with success? If the student isn’t using it with success perhaps it isn’t because we didn’t choose the right system but because we aren’t modeling and supporting the child throughout the day (modeling, explicit teaching). Have we found something motivating for the child to communicate with us?
Ask yourself - what is this child’s most favorite thing? Ex) if they love songs, give examples of his favorite songs, then model “play” Cocomelon (model the next step play + song if he’s already saying song) - sometimes teaching a specific thing (like a song title) is more motivating than core words (like eat, play) - in these initial stages of AAC, we want to focus on specific, highly motivating things - and then move quickly to core. If we start with core, it may not “stick” with our learners, and we can get more independent initiation with really exciting, specific things on their device.
Resources for AAC evaluation for emerging communicators: Communication Matrix, DAGG-2 (Tobii Dynovox) for tracking progress over time for current AAC users (free), and ultimately - find things that the child is motivated to talk about, and give it a try!
When deciding what to teach - how are they communicating to you now? Ex) if they are leading you by the hand work on look or requesting, if they are pushing things off the table work on rejecting. If you weren’t there, what would they do? That’s a routine that is motivating and we could try integrating communication and shaping our goals based on their interests and motivations. Doing a parent and/or teacher interview can also help you gain information here. Have some toys out and take a step back and observe the student in your room - what does the student gravitate towards? Think of things that are similar to that and shape your goals and activities from there.
One goal idea - target protesting: go away, stop, don’t touch my stuff, no, not
For a student stacking colors - this shows he likes order, pattern and colors - what are other activities that have those elements? Try those activities (ex - baby piano). Sometimes if a child lines up toys by color they want to do that solo, but you can take those preferences (colors, order) and change it slightly to introduce a motivating activity (like baby piano app)
“My turn/your turn” is hard to teach kids, and they often don’t want to do turn taking anyway, so that may not be a good early target (but of course depends on the kid), you may want to work on “give” instead because it’s more salient
Consider sabotaging the pattern ex - if they are ordering an alphabet puzzle, and SLP has letters SLP “accidentally” gives the wrong letter and then models rejection, you can model “different,” no it doesn’t work there but yes it fits here
Ask communication partners - if a student had consistent access to communication - what would they say? Work on teaching those words, because those are the words they want to communicate. In this specific situation, what does the child want to say?
“You can do this…everyone feels like AAC is a huge and vast area of our field, and that is true…it’s impossible to know everything there is to know about AAC…I think that just recognizing that whatever it is that you can start doing right now for your students with complex communication needs, that is enough” Rachel Madel
“The biggest mistake you can make is not getting started because you feel like you don’t know enough…we can’t wait…you can do this, and you can get started” Rachel Madel
More on Rachel: www.rachelmadel.com, Talking with Tech podcast, Instagram
Episode Summary - 7 Key Takeaways: use what you have (what AAC systems is your community using?), observe the child (what are they doing without outside demands) and make AAC a part of that - this should guide your therapy targets, do a communication partner interview (what does the child love, if the child could say something now, what would they say), think about ways to work beyond requesting and ways to disrupt the pattern to use core words like “give” and “different,” add one more - model what the child is saying and adding a core word or early developing phrase to model the next step of language (the key to this is tracking spontaneous language so we know what to build on), think about language therapy - don’t get too caught up in the fact that it is AAC and lean on all the language development information you already know this is just language therapy with the added layer of modeling on an AAC system (while being strategic about what vocabulary we are targeting)
Links:
Seasonal Boom Deck Bundle: https://bit.ly/3rRjUl8
Due to technical difficulties with the audio, we were unable to create a transcript for this episode.
