In August, I had the distinct (and more than slightly scary) opportunity to participate in my first podcast. The topic was “Creating Communication Opportunities for Students with Complex Needs,” and the interviewer was Char Boshart, SLP extraordinaire and creator of Speech Dynamics , where Char shares her endless wealth of knowledge on all aspects of articulation and school-based therapy (more on her later). The podcast was made for SpeechTherapyPD.com and will be aired at 7 PM on October 4, after which I will be live to answer your questions. My jitters were understandable, given it was the first time I was interviewed and recorded, but I was quickly put at ease by Char, who, among many other talents, is an excellent interviewer. I am also fortunate to call her my friend and mentor, having established a connection through workshops and the web over the years.
So, how did it go? Well, I guess, given this was my first time, it went rather well. For one thing, all of the technology worked, so that was a huge relief! It was weird, I must say, sitting at my dining room table with a laptop, headset, and elaborate microphone on a stand (thanks to my son, a professional musician). But we eased through all that to get to the discussion at hand: how to get students who have significant communication impairments to communicate more. I have done 3-day team trainings on this very topic, so you can imagine that I had to jettison a lot of information to fit into the 50-minute format. There is so much excellent information out there regarding presuming competence, aided language input (modeling), considerations for AAC system and vocabulary selection, expanding messages using core and fringe vocabulary, and ways to measure the efficacy of an AAC system, that I figured the podcast listeners didn’t need to hear me spout more of the same.
Instead, my focus was on how to change adult behavior and intervention strategies to increase a student’s participation in and communication during daily routines. I chose this focus because I find that adult behavior can be the #1 barrier to communication for our students with complex learning needs. This barrier manifests itself in a number of ways: low expectations of the student’s abilities; a focus on what a student can’t do, rather than finding ways to enable him so he CAN do; a lack of training with instructional assistants; instruction that follows the traditional teacher-led agenda, rather than taking the lead from and building on the students’ interests; a lack of routines that have a clear beginning, familiar steps, and a clear ending; a mismatch between the adult’s spoken message and body language, facial expression, and tone of voice, and a lack of awareness of how important these nonverbal cues are to a student; characteristics of adult behavior that have the unintended consequence of creating passivity and learned helplessness (or, at times, aggression); failure to recognize behavior as communication; and — one of the most important, in my view — inconsistent or absent use of pausing with a prompt hierarchy. Pausing is a challenge for most adults, even well-trained SLPs, and we often do not give the students time to process, formulate a response, and then deliver that response in a way that is understood by others. The use of a prompt hierarchy with pausing keeps adults aware of how much assistance they are providing by moving from a least-to-most progression of prompting, which, in turn, promotes an increase in student independence. As mentioned in the podcast, videotaping and then viewing the interactions of adults and students can be extremely powerful in raising awareness in adults of their interactional style.
For those adults who are resistant, for one reason or another, to a student’s use of an AAC system (yes, there are adults like that; I see them all the time, and that is a BIG barrier), I recommend an assignment I gave my graduate students when I taught in the special education departments of two colleges: be absolutely silent for 24 hours. You can tell people ahead of time that you will be doing this. You can wear a tag that says “I can’t talk today.” You can use any other means to communicate (text, paper/pencil, sign/gesture), but you cannot talk. It’s important that the 24 hours include typical activities of daily living — work, social activities, errands in the community. Without exception, my grad students were profoundly shocked by their own experiences and the behaviors of family, friends, colleagues, and community members during this experiment. And, without exception, I’m sure that each of these grad students changed their perceptions as to the importance of AAC and the need to break down barriers to its use, largely through making changes in adult behavior and expectations.
Throughout the podcast, which seemed to pass by so quickly, I tried to provide real-life examples and suggested two books with a powerful message for anyone who interacts with children or adults who have severely limited expressive communication: “My Stroke of Insight” and “Ghost Boy,” both previously mentioned in previous posts and in my post, “The Therapy Voice.” I also touched on the importance of scripting routines to be sure that (1) communication opportunities are built into each daily routine, including transitions, and (2) that routines are done consistently, no matter which team member is involved. Other important points I hope got through, albeit briefly: how to move beyond choice-making to include all functions of communication and the importance of visual supports for receptive and expressive communication.
What I didn’t have time to share are some amazing resources for ways to build and expand communication in routines and how to help all team members to become more effective facilitators of expressive communication. Below are some of the resources that I encourage you to explore and share with your team (hint: a great way to spend your next PD day!). You’ll notice that PrAACticalAAC is referenced often — an incredible wealth of information that I’m barely touching on here!
Autism Classroom Resources: Functions of Communication and How to Expand
Autism Teaching Strategies: Free social skills materials
Autism Teaching Strategies: Visual supports to build appropriate non-verbal behaviors
PrAACticalAAC: Using Video to Teach Vocabulary
PrAACticalAAC: Scaffolding language
PrAACticalAAC: S’MORES and Partner-Assisted Input
PrAACticalAAC: Be the FUN in FUNctional Communication (goals and spreadsheets)
PrAACticalAAC: Selecting and teaching new words
PrAACticalAAC: Creating communication opportunities for the older learner
PrAACticalAAC: Autism and AAC: 5 Things I Wish I Had Known
PrAACticalAAC: Supporting Reluctant Communicators
PrAACticalAAC: Using Aided Language Input to Build Communication Opportunities (scripting)
PRC AAC Language Lab: yearly subscription, plus free resources, Language Stages and goals for teachers and SLPs, activities for parents
Kidz Learn Language Blogspot: games with core words, summer activities and much more
AAC Intervention Tips of the Month from Caroline Musselwhite
Saltillo’s Chat Corner: ideas for Saltillo speech-generating devices, but that also can be used by any AAC system
Keep Talking by Call Scotland: a 70+ page book that you can download -free! – full of ideas on how to increase communication throughout the day
News-2-You and Unique Learning System: lots of ways to build communication around these subscription-based materials
Using Video to increase communication:
Increasing communication with peers:
Thank you for all you do to support the communication needs of our complex students! I hope you enjoy the podcast on Oct 4 and will look forward to talking with you at its conclusion. Please visit SpeechTherapyPD.com for more information. Stay tuned to this blog for upcoming posts on the amazing resources offered by Char Boshart and the use of LessonPix for visual supports.