Include peers and siblings strategy
Social skills are vital for developing relationships as well as academic success. The relationship between siblings plays a role in developing these social skills. Individuals who use AAC are often disadvantaged because they have fewer opportunities to develop social skills. There is evidence to support sibling and peer-mediated interventions with this population.
Why is it helpful?
- They say things kids say. Their models are more likely to be something your user might want to say.
- Peers and siblings bring variety and are often more interesting than adults.
- They are often natural modelers and comfortable with technology.
- It creates an opportunity to build genuine relationships and friendships.
- They may also value their peers' opinions more.
- It gives them a chance to learn about how your AAC user communicates and the AAC system.
- They can provide helpful feedback. The AAC user will gain insight and can get practice using strategies to be more explicit.
Tips:
- A second device or a light-tech option for peers and siblings is beneficial. It's a must for AAC users who don't want others to use their devices.
- Have an engaging context. But, again, the activity should be the focus, not the AAC.
- Remember that you are not training peers and siblings to be "little teachers." Everyone is equal.
- If you need ideas, ask their peers and siblings for suggestions. The AAC system is a way to talk and connect while doing the activities.
- Just let them be kids interacting with each other. That's how they'll build genuine friendships.
Talk like a kid
Why should you do that?
- When you talk like a kid, you're more stimulating and engaging. You're more likely to get and keep their attention. You're likely to show the words they might want to use!
- If the AAC user isn't an adult, we're not trying to teach them to sound like one. Instead, we want to help them improve their language to be similar to their peers.
What do you have to do?
- When you're in a classroom or around kids your user's age, listen to the language they use. What topics do they like to talk about? Are there any favorite sayings? Then, you can include some of what you hear in your modeling.
- Don't tell them what's happening next. Instead, model comments, ask honest questions, and play pretend.
Don't be afraid to be silly or gross. Models of complaining words can also go a long way!
- Try to avoid being too repetitive, especially when talking about things that happen all the time. When you say the same thing repeatedly, it can become background noise. Mix it up! One day you can say, "TIME FOR LUNCH ."Another day try "CAN'T WAIT EAT," "FOOD NOW," or "SOMETHING WRONG!"
- If you're struggling, pull in peers or siblings to do some modeling. You can learn from them.
Model keywords
Many people may wonder if they should model using full sentences. If we model complete sentences, we'll slow the interaction down and lose the user's attention. Instead, you can model keywords using AAC and then say the complete sentence using speech.
How do we start to model this method?
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Use the method yourself with the person and others.
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Slow down. We build speed over time. When we are learning something new, sometimes slower is better.
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Make it dance. Take your cues from the situation; if the person seems to want your help getting started, okay. If not, be patient.
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Talk about what you want.
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Mess up. Showing a person how to repair a message is part of the process.
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Say the same thing over and over again. For example, if you encourage a head nod for "no," – do it repeatedly.
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Use the method in lots of different situations and places.
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Use the method throughout the day.
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Focus on keywords with lots of impact in many situations.
Use the AAC system to produce a message longer than the user's independent level. If your user typically communicates using one word, model 2-3 word messages. If you're just starting and that sounds like a lot for you, that's okay! Model one-word messages. Get comfortable, and you'll be modeling above your learner's level with a bit of practice!
Expand on the message by saying the full sentence using speech after you have modeled it. This strategy keeps the interaction moving at an appealing pace.
It also allows the AAC user to hear the language within a complete grammatical sentence. Then, as the user's skills develop, you can start to model longer sentences and targeted grammar skills.
Aided Language Input, Modeling, Natural Aided Language, Aided Stimulation - different terms refer to the same strategy
What is this?
• a strategy in which a speaker points to or selects symbols that correspond to their spoken message
• a way to provide language input that matches a learner's expected language output
• a strategy that happens within natural interactions
• a way to prove skills in the context
• a method that may support understanding for some learners
• something that should occur without expectation of expression of the learner
• a way to give AAC learners the same thing we provide typically developing speakers (immersion)
• evidence-based practice
Aided Language Input is the one strategy you should implement if you want to see progress for your AAC learner.
It goes by many names, but all the terms come down to using the AAC system to speak to your user. If we want our learners to speak using AAC, we need to show them how it's done! You can do all kinds of therapy, but you won't get where you want to go without this foundation strategy.
The truth is that immersion is what we give our children who speak. Don't beat yourselves up if it seems like more than you can do. Try to do a little. When that feels easy, add a little more.
Model in natural contexts
Modeling in natural contexts means moving away from highly structured activities. Instead, model AAC during routines (e.g., when making lunch) and activities (e.g., when playing a game).
Why is it helpful?
- It builds on what your user already knows by applying language to familiar experiences.
- The language you model is expected to feel important to the AAC user as it applies to their life experience.
- The most impressive things are often unplanned so that you can take advantage of unexpected learning opportunities.
- Generalization is not a concern because we're teaching in real-life situations.
Modeling Use and Verbalizations in Natural Contexts
Modeling the use of AAC and modeling speech provides AAC instruction similarly to how typically developing individuals learn language by hearing others speak and express themselves. Modeling also provides students with a variety of language models.
AAC experts recommend constantly exposing individuals to use AAC to adults and peers. Model accordingly to how the individual is expected to communicate via verbal (speech) and nonverbal communication (e.g., AAC, facial expressions, tone).
The following strategies illustrate how to implement modeling within natural contexts:
① Prepare the AAC device or communication book in advance, including symbols for key vocabulary that they will need for the upcoming activity. Concurrently, model language via speech and AAC. Speak while selecting symbols on the individual's AAC device or communication book. For example, when the child uses crayons during playtime, the teacher might say, "you are drawing with a purple marker," while touching the DRAW, PURPLE, and MARKER symbols.
② Model the key targeted vocabulary for a given activity. The communicative partner can choose a symbol on the individual's AAC device while verbally identifying it and then expanding on the selected words.
For example, let's say that a child places a baby doll in the toy crib. First, the child's communicative partner could name the symbols for BABY and CRIB while touching or pointing to the pictures on the child's AAC device. Then they could expand on the verbal model by stating, "the baby is sleeping in the crib."
Tips:
- If you feel overwhelmed, pick one routine or time of day to focus on to start.
- Alternatively, choose a pragmatic function (e.g., commenting) to focus on. Try to increase how many times you model in a day.
- Build on your successes. It doesn't need to be perfect. Just connect with your learner using AAC.
Model with their perspective in mind
One way to get the most out of your modeling is to model with your user's perspective in mind.
What do you have to do?
- Observe the AAC user closely. What are they attending? What do they seem interested in? How do they seem to feel about what's happening?
- Model language on the AAC system that relates to what you observed. You could make a comment that shows their reaction to something that happened. Don't be afraid to model complaints if they seem to be complaining about using other strategies.
- Watch their answer to your models. Do you notice more attention? A sigh or sense of relief? If so, you're on the right track! If not, that's ok. Keep modeling!
Why is it helpful?
- It provides a language model that is likely to be useful or necessary to your learner.
- The AAC user is more likely to pay attention when models relate to them.
- It shows you understand or want to understand.
- It keeps you focused on their personal experience, not just your own. Remember, this is all about connection and how to build relationships.
Follow the AAC user's lead
Let's face it - many children at the earliest stages of communication development are pretty self-centered. They want to play what they want to play and, therefore, want to talk about what they want to talk about.
I recommend leaving your agenda mainly at the door and preparing to engage with what the child is interested in and what they are trying to communicate about that interest. How do you know what they are interested in? Well, usually that's what they are looking at or what they are doing at that moment!
What the child is showing interest in and his non-symbolic communication signals (e.g., facial expressions, gestures, behavior) represent their message. So, they are the best place to start when wondering what to say and model on your AAC supports.
Following the child's lead might mean doing the same thing many times or perhaps moving more rapidly than you'd like from one activity to the next - but that's okay, this isn't about you!
Following the child's lead may also mean creating social games and play environments that offer many opportunities to participate in a high-interest activity. If your AAC user likes to watch things that light up or spin, have a lot of different ways available to do this.
How can you incorporate this theme into your session materials and activity plan if she likes Sesame Street? Following a child's lead may also tempt the child to interact by imitating sounds, movements, or words, even if the child is engaging in what is perceived as "self-stimulatory" behavior.
By researching building imitating skills, we understand that imitating what a child is doing gets them interested in you. Eventually, they would also start imitating what you do.
This strategy is helpful because:
- Everyone is more interested and motivated when working on their schedule. All communicators learn to communicate on their schedule before following someone else's.
- It indicates to the AAC user that they have a meaningful role in the interaction.
- Having control means active participation, and it's essential for learning.
- When you model AAC relating to your user's chosen activity, you will be more likely to demonstrate language that is important to them.
- It will give you insight into the AAC user's interests. Then, you can help grow those interests by offering similar activities in the future.
How can you do it?
- Take a moment just to watch the AAC user. What are they looking at? What do they seem to find attractive?
- Use AAC to talk about what the user is attending to or doing.
- Give your user extra time to initiate or respond. Remember that communication takes many forms. Respond to any communication, not just speech or AAC. If the user uses a different strategy, use AAC to reflect what they expressed.
- Position yourself at the user's physical level and face them.
- Offer choices. Options give the AAC user control and a way to direct the activity.
- If the AAC user gets upset or seems stressed, stop and take a minute to examine again.
Are you still following their lead? Have you started directing things? What are they communicating to you? Recognize their feelings using AAC.
- Your connection with the AAC user is the most important. It's okay if the user loses interest or moves on to something else. You can follow them or take a break.
Verbal Referencing
Here is another important strategy for teaching AAC: Verbal Referencing.
Verbal Referencing is a method in which a communication partner or assistant describes what a learner is doing and their interpretation of the learner's action. Verbal referencing is incredibly powerful for those learning to use AAC when used in conjunction with aided language or modeling.
What to do?
• describe the communication behavior you see
• say what communication behavior means to you
• model the corresponding language on the AAC system
You can verbally reference what you observe your child doing and how you will respond to this.
Examples:
• You're turning your head to the side. You're saying 'no.'
• You're looking at 'help' and looking back at me. Do you want me to help?
• You're pointing to 'house and garden.' I'll turn to that page.
This type of verbal referencing mainly assists children who do not receive clear sensory feedback about their body's position in space or have difficulty controlling their body movements.
You have to give them clear feedback about what you see their bodies do. It is essential for developing your child's consistency and clarity in indicating 'yes' and 'no.'
Verbal referencing can be used by the communication partner when modeling using the PODD communication book. For example, as the person modeling communication, you can state how and why you operate the PODD book.
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As you look for a symbol on a page, you can say, "I'm looking, I'm looking," as you systematically move.
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The word's not on this page, "I'd better turn the page," as you point to 'turn the page.'
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You can verbally reference your use of 'yes' and 'no' as you model your child's access method.
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You do this by first providing partner-assisted scanning as usually would, "people, actions, descriptions." Then, you verbally reference your response, "I'm nodding my head, I'm saying 'yes.'
Verbal Referencing means talking about what you see your AAC learner communicating. Many AAC users early in their AAC journey use non-symbolic means of communicating. For example, they use body language, facial expressions, and gestures.
Some of these "communication behaviors" can be very subtle or highly specific to that individual. Some users may not yet realize that these "communication behaviors" mean something to the people they interact with. They also may not know what language on their AAC system would get their plan across more clearly.
Encourage Initiation
One of the ways to minimize a need for prompts and cues is to concentrate on initiation. It doesn't mean the initiation of any particular word or intent but initiation in general.
Look for any initiation
• closely observe your learner and look for "initiation behaviors."
• for some learners, it's obvious (handing over items, pushing things away). For others, it's subtle (eye gaze to an object, small movements in response to an object).
Teach initiation
• think about how your learner could initiate the use of their system (go-to device, touch book, rails arm, vocalize).
• explicitly include the initiation procedure you're targeting in your models.
Respond to any attempts to initiate
• reinforce communication by always responding to initiation by the learner.
• attribute meaning whenever possible (even if you think it's accidental).
• if you don't understand, say so! Just by responding, you're managing their attempt as meaningful.
Declarative language
Declarative = Any relational or functional language.
These programming languages describe relationships between variables in terms of functions or inference rules. The interpreter applies some fixed algorithm to these relations to produce a result.
How you speak to the AAC user can significantly impact how they experience the interaction.
Constant questioning can increase anxiety and make the interaction less pleasant!
It would help if you used comments and statements to model language. Choose words to create a comfortable, appealing interaction. You can talk about the same things, but you have to say them a bit differently.
Repetition with variety
Repetition with variety is a teaching strategy in which a target skill or idea is practiced repeatedly, but every time with average differences.
Repetition with variety is one key to more positive outcomes. The idea here is to create practice opportunities that are not boring or tedious by holding the skill constant but varying other aspects of the instructional experience. Again, it's incredibly useful in AAC learning.
Why is it helpful?
- Repetition without difference often leads to boredom and disinterest. In contrast, repetition with variation can increase curiosity and engagement.
- Learners need multiple presentations and occasions to practice to get new skills.
- Previous experiences can build success and confidence, which support motivation.
- Repetition with variation allows the AAC user to build on what they learned previously.
Here are some ideas that may help:
➊ Pick the right time for repetition: Repetition can be a valuable part of the learning process when used thoughtfully. However, repetition for practice is something we avoid in conversational interactions and other exchanges where shared meaning and connection are the priority.
➋ Get playful: One way to build in repetition is to create a game to do this or re-purpose an existing game with new rules and materials.
➌ Explain the rationale: For some learners, a clear explanation of why you're asking them to say something multiple times can go a long way. Once they understand the purpose of repetition, resistance may fade.
➍ Show it off: In some situations, we may want the learner to do the same thing a few times in a row with little pause time. However, for students who enjoy the attention of others, we can make this less monotonous by having the student 'show off.'
Examples:
- Teaching core words and language concepts using multiple natural contexts. For example, we "go to bed," "make the car go," and "go away."
- Learn to share information by writing a letter to a friend to tell about your vacation and writing a how-to book about something you know a lot about.
- Use two-switch step scanning to play a game, read an adapted book, and say a message using an AAC device.
Think aloud
AAC isn't necessarily intuitive. Using AAC needs strategies and problem solving that your user may not discover on their own. We can help them learn by talking about our process aloud. Include "think aloud" while you model.
Some examples are:
• "I'm going to find my word, I touch."
• "I'm going to speak my message so everyone can hear."
For example, if you read the story aloud to your students, you can conduct a think-aloud about the book. A think-aloud is a strategy you can use to demonstrate how you think about your reading text.
This helps students learn the techniques they need to utilize to understand the content they are listening to or reading. For example, you can have your student think aloud about the characters' feelings and make predictions about the story elements. Then, check if your students understand what is happening in the story.