Collaboration Corner: Knowing the Big Picture and Little Details of Autism

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As Autism Awareness month wraps up, I thought I‘d share my learning moments from working 15-plus years with my students on the spectrum, their families and my dedicated co-workers who support them:

  • Autism is a spectrum. There’s not a cure or a fix, but there are evidence-based interventions and nuances for each child that will help him or her succeed. My job (and yours) is to recognize those little details and shine a light on them.
  • I’ve developed a super appreciation for things that spin, shake, light up and squish. I also appreciate when these features suddenly become appalling and over-stimulating.
  • Sometimes the best way to get a child’s attention is to speak just above a whisper or not talk at all. Less is more and often things don’t just sound loud, they feel loud to a person with autism.
  • Sand and water play are seriously awesome.
  • Regardless of where a child is on the spectrum, you can find an activity that feels like fun and learning at the same time.
  • Candy doesn’t always taste or feel good, but hot sauce tastes delicious on French fries.
  • Take the short and long view on augmentative and alternative communication. Work on the here and now to make your clients efficient communicators, then model your expectations to bring them to the next level. Make them life-long communicators.
  • Students and families will show you when they are ready—ready to try something new, ready to accept who they are. You just have to listen, be patient and push. But not too hard.
  • Finally, having co-workers who are cued in and can step in and help at a moment’s notice is invaluable and—when in action—nothing less than a work of art.

What lessons have you learned from working with clients on the spectrum?

 

Kerry Davis EdD, CCC-SLP, is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer clinician and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer. kerrydav@gmail.com

 

 

 

 

Collaboration Corner: 5 Take-Aways to Support AAC, Apps and Language

TEchnology and augmentative and alternative communication

This past month, my colleague Sean Sweeney (AKA @speechtechie) and I had the opportunity to join forces and write about AAC, apps and literacy development. Our article will be in the next issue of SIG 12: Perspectives in Augmentative and Alternative Communication.

This gave us a great opportunity to discuss how AAC users can benefit from apps to enhance treatment outcomes. Here are five highlights:

Feature matching is important: When choosing AAC or apps for learning, the tool must meet the needs of the user. For AAC, this includes the size, layout and physical accessibility of features to maximize independent use. For apps, this includes Sean’s FIVES criteria, which examines the context, appropriateness, accessibility and therapeutic considerations for learning. Just like any other tool in your kit, if it isn’t a good match then opportunities for communication or learning are potentially lost.

Make CORE align with the CORE: Using generative language formats, including core and fringe word vocabulary, benefits the student two-fold: building in opportunities for language growth throughout the day, while also meeting those pesky Common Core Standards. For example, a first grade ELA standard CCSS.ELA-Literacy.L.1.1.c, “Use singular and plural nouns with matching verbs in basic sentences.” Using core vocabulary allows the student to meet this standard through basic sentence construction activities. A first grader may enjoy learning this through the “Collins Big Cat” series, a free app that reads stories out loud and then has the option of the student recording his voice (or in this case, synthesized voice). The app also has a more interactive component, which allows the student to build scenes and narrate his own version of the story.

Apps and AAC are powerful together: Students love the interactive nature of apps. “Toca Hair Salon” is a highly interactive hair salon studio allowing students to describe how they are going to cut, color or otherwise coif the animal or person of choice. Another simple app, “Pogg,” is a cute alien that hops, sings and performs other actions, all at your student’s direction during a session. Beyond paper flashcards, the apps give students immediate reinforcement, so then work feels less like work.

Separate communication tools from other tools: If you are going to use apps and AAC at the same time, one practical solution is to use separate tools. Toggling between apps and AAC is cumbersome, and slow session momentum. In addition, having separate systems prevents the user from confusing a communication device with other technology, which is an important distinction. If your tools look the same, change the colors of the cases. If you have students that like to surf and press that home key, enable guided access so that only the AAC app is available.

Model, model, model through apps and AAC: Finally, apps provide the opportunity to model AAC live, and in unpredictable ways. You have more opportunities to explore and learn together. Don’t have curling iron as a fringe vocabulary item when using your “Toca Hair Salon” app (it’s not there, believe me)? Show your student how you can give clues to what you mean and talk it through using what is available on your AAC: “Let’s see, it’s a tool, it’s hot and it makes your hair curly…what is it?

There’s your abridged version and takeaways…log in to your SIG 12 portal for more info, and to get CEUs….ASHA renewal is right around the corner!

 

 

Reference

Sweeney, S. & Davis, K. (2014). In press. Reading, writing and AAC: Mobile technology strategies for literacy and language development. SIG 12: Perspectives in Augmentative and Alternative Communication. American Speech Language and Hearing Association.

 

 

Kerry J. Davis, EdD, CCC/SLP is a speech-language pathologist in the Boston area. She holds a special interest providing services to children and adolescents with complex communication profiles, including AAC. Davis is a volunteer SLP and consultant to Step by Step Guyana, a school for children with Autism in South America.

 

Collaboration Corner: AAC & AT: 5 Tips, Myths and Truisms

AAC

 

Look around at every stop light and you will see the soft addictive glow of smartphones. Minivans off for a family vacation are burgeoning with tablets and some other thumb-numbing form of entertainment.  For more particular consumers, any technology prefaced with an “i” will do.

For people with complex communication needs, tools for learning and speaking have become more affordable and accessible.  But this easy access is not without its challenges.

It’s true that augmentative and alternative communication (AAC) platforms have made it into the cool kid circles, but this can make it more confusing for families and therapists to make informed decisions. Beyond You Tube and Candy Crush, it is important to remember the why and how of AAC and assistive technology (AT). Here are some points to ponder before getting too bedazzled.

  1. “AT and AAC are the same thing.” Not so much. While AAC falls under the umbrella of assistive technology, it requires a specific skill-set. Just as “related service provider” or “allied health services” includes SLP services, I would not assume the job of my physical therapy colleagues and start recommending orthotic devices. Same with AAC and AT; both tools aid and assist, and include low tech (such as a pencil grip, picture schedules) and high-tech interventions (anything that plugs in). The difference here is who is involved: AT includes a wide range of professionals well-versed in making recommendations, from special education teachers to AT certificate holders. AAC does not. In AAC, the “C” stands for communication. It is within our scope of practice per ASHA guidelines. As far as I know, it’s not under the domain of other disciplines. Period.
  2. “I don’t get it, he has an ipad, he should be able to (fill in your random ability here).” A large reason for device “abandonment” is a mismatch between the tool and the user. As SLPs your job is to consult with other experts to make sure it fits the child’s needs in terms of accessibility; fine motor, vision, and positioning are just a few considerations. AT, particularly high-tech AT, requires additional considerations, with the primary focus being, does it aide and assist?
  3. “Everybody has one.” ‘Nuff said. Social pressure should not guide recommendations. AAC is prescriptive. I know it can be difficult, but stay strong and focused on what is appropriate and effective.
  4. “He is so good at using technology, so then why can’t he…?”  My 10 year-old can use keys to unlock the door, but I wouldn’t give him the keys to drive to the store and pick up milk. Technology is a tool. AAC is a tool that requires explicit teaching. SLPs and parents are teachers that guide the process. Here is where it is important for us to educate, model and educate some more. As evidence-based practitioners, we need to take data. Data guides us on what’s working to guide what needs to be changed. For my students with autism spectrum disorder, it has been so helpful working with, and learning from, certified behavioral specialists, and come up with a system that everyone can use.
  5. “She uses it at school, and home is a time to relax, not work.” Consider the social circles of communication partners described by Deanna Wagner and colleagues (2003):
    diagram(adopted from Wagner, Daswick & Musselwhite, 2003)

    Becoming a confident communicator means practice: practice at home, practice with friends and friendly acquaintances, familiar and unfamiliar people, and within the context of different places. Don’t aim for perfection. Just aim for opportunities to practice!

Kerry Davis EdD, CCC-SLP,is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer speech pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer.

Collaboration Corner: Must-Have Books for Building Language and Literacy

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I can’t believe it’s September! For those of us in public schools, that means re-organizing and replenishing our bag of tricks. Books of course, are an easy and engaging way to expand language.

If parents are looking for some ideas on stocking up their bookshelves (or yours) this list may help.

I also rely upon my librarian colleagues for other ideas. If I can find the board book version of anything, I usually opt for that version; board books are durable and allow you to do things like add pictures with a little bit of Velcro for matching, like this:

1horsepic

For very young children, or children with language delays, I generally use a couple (or five) quick pointers when perusing the bookstore:

  • Engaging pictures that aren’t too visually complicated but have a clear character and setting.
    • Targets: Who, what, where, when questions, descriptive language.
  • Books with repetitive words and phrases.
    • Targets: Oral/expressive language and literacy skills through  predictable text patterns and repetitive lines.
  • Books that aren’t too long, maybe 10-12 pages.
    • Target: Maximize engagement for short attention spans.
  • Books that can allow the adult to target core language concepts, either through text or illustrations.
    • Target: Syntax, vocabulary.
  • Books that enable the adult to expand beyond the text.
    • Targets: Commenting, labeling how a character feels or what they are thinking.

There are many books from which to choose, but here are some good starters for your collection:

  • Good Night Gorilla: Peggy Rathmann
  • The Very Hungry Caterpillar: Eric Carle
  • Have You Seen My Cat?:  Eric Carle
  • Good Night Moon: Margaret Wise Brown
  • Blue Hat, Green Hat: Sandra Boynton
  • Where’s Spot?: Eric Hill
  • Go Away Big Green Monster: Ed Emberley
  • Big Red Barn: Margaret Wise Brown
  • Good Dog, Carl: Alexandra Day

Not every book on this list follows every guideline perfectly,  but all allow for a positive learning experience that supports child language and preliteracy development.

Have an inspired school year colleagues!

 

Kerry Davis EdD, CCC-SLP, is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer speech-language pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this post are her own, and not those of her employer.

 

Collaboration Corner: 10 Easy Tips for Parents to Support Language

ice cream

As we make our way through the lazy days of summer, schedules change, and things relax. My usual theme is collaboration; parents can be one of our biggest assets in promoting language development. Parents of young children usually want to know what they can do to support their child’s language development in the absence of a structured day. Though I teach children with disabilities, I find I continually revisit the following tips with parents of young children regardless of whether a child is typically developing or needs a little more support. Here they are in no particular order of importance:

  1. Pay attention to body language, when a child is looking toward or reaching for something, they are communicating. Talk about what they are reaching for, “Oh, you want the bubbles!”
  2. Avoid the “say this” tendency. Don’t pressure the child to speak; keeping the experience positive is important. Instead, model what the child might say when he/she is ready.
  3. Take time to sit and read with your child every day. Label everything you see, and encourage them to point to the words and pictures as you talk about them. Books with repetitive lines are great.
  4. Be playful. Sing songs. Use lots of inflection. With familiar songs, leave some of the words out and see if your child will hum or sing the words.
  5. Provide limited choices when you aren’t sure what your child wants. Holding out 2 items, lessens the stress of having too many choices.
  6. Talk with your child about what you are doing, then provide the opportunity for your child to reciprocate. “I’m making some cookies, do you want to help?”
  7. Use first/then language to guide behavior, and then be consistent, “First you need to eat, then you can read.” Use this language even when moving between activities that are preferred or less preferred.
  8. Use pictures: Take pictures of your child’s day and talk about what is coming up next, or make a photo album of fun activities (vacation, going out for ice cream) to talk about.
  9. Remember language is everywhere, even if you child doesn’t understand everything you are saying, he or she needs the exposure. Car rides, walks outside, blowing bubbles are just a few examples. Describe what you see, and ask questions, e.g, “I see a cow. What does a cow say?”
  10. Simplify your props. Sometimes the simplest toys can bring out the best language. Summer is full of such opportunities: A spinning toy, taking a turn kicking a ball, bubbles…all can support your child’s development, simply by talking to them.

Kerry Davis Ed.D., CCC-SLP,is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer speech pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer.