From the Hands of Babes: Celebrating AAC Awareness Month

Little guy using his device to talk to mom.

October is Augmentative and Alternative Communication (AAC) Awareness Month! We’re excited to celebrate because everyday, we are privileged to see the incredible difference AAC makes in the lives of the people using it and the people who love them.

We also have the tremendous opportunity to make changes within the design of the Speak for Yourself app. Not many speech-language pathologists get the chance to actually be the change they wish to see in AAC. It’s an honor and responsibility that we don’t take lightly and we certainly don’t take it for granted.

So, as always, we are celebrating AAC Awareness Month and asking you to join us in our “From the Hands of Babes” Campaign!!!

Being “Aware”…What is AAC?

If you are reading this and you are not yet “AAC aware,” let’s change that! AAC is used when someone is not able to communicate effectively and completely using verbal speech. Some individuals who use AAC are not able to speak at all. Others have some verbal speech, but are not able to be understood or verbally express their thoughts with the complexity that they deserve. AAC can also be used to fill in the gaps when someone’s communication is temporarily impaired.

For many children and adults around the world, AAC provides a voice. It gives language to a population that is often underestimated. AAC allows them a way to add their thoughts, opinions, ideas, fears, intelligence, and humor to the world. Sometimes it’s temporary and children start talking. Other times, AAC is a lifelong means of communication. Regardless, when someone is given access and learns to use AAC, it is life-changing.

How are we celebrating?

First, we want AAC in the hands of anyone who would benefit from it! So, we are having our annual AAC Awareness Month sale! The Speak for Yourself AAC app will be 50% off ($149.99 USD) worldwide on October 10th, 11th, and 12th, 2017. You can read about what makes Speak for Yourself special compared to other options.

Here’s the fun part!

AAC users, parents, professionals, grandparents, siblings…Let’s give the people using AAC a chance to spread AAC Awareness by sharing their words!

We want to hear it “from the hands of babes.” If you’re an adult using AAC, you can interpret that as the slang (but not derogatory) “babe.”

If the AAC users you want to share are using eyegaze or head switches, and not technically their hands, we still want to hear about them!

We want to hear about ALL of the funny, heartwarming, emabarrassing, and even typical mundane things our AAC learners say.

Here’s how you can get involved…regardless of the AAC language system you are using:

  1. Tell a story, share a favorite video, or snap a picture about AAC.
  2. Make it public so that we are able to share it. (If you would prefer to be anonymous, please email it to us at [email protected] and let us know that it’s okay to share without identifying information).
  3. Post it to social media with #FromtheHandsofBabes hashtag

Here’s what we are going to do:

  • We’ll tell our stories too.
  • Each Sunday in October, beginning Sunday October 8th, 2017, we are going to randomly choose a post by using the #FromtheHandsofBabes hashtag and a random number generator. The winner will receive a beach towel with the main screen of Speak for Yourself printed on it. It can be used as a core language board for modeling or communicating near water. It can also be hung in a classroom or therapy room and used for aided language input. 
  • We’ll share some of your posts on our Facebook page, and also combine some of them together in a wrap up blog post each week.

So, let’s raise AAC awareness this month by sharing the words #FromtheHandsofBabes. Let’s share all of the funny, adorable, insightful, complex, and typical things that our AAC learners say…because they can. Because of AAC.

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Expanding AAC Vocabulary: Where Do I Go From Here?

For parents and professionals who support students using augmentative and alternative communication (AAC), deciding which words to add can be daunting. After all, there are an infinite number of words, and vocabulary is always growing.

We make up new words. We use old words in a different way. This week, a high school student asked me to add “squad” to his device. He handed me a sticky note where his mom had written “squad.” Since I have two teenagers, I knew enough to ask if he wanted it added under “FRIEND” and say, “Who’s in your squad?” (For those of you who don’t have teenagers, their “squad”or “gang” is their close group of friends.)

So, how do I know what words to add?

It’s ideal if the students are able to ask you directly to add vocabulary…and eventually program new vocabulary themselves. When students are able to spell, take note of the words they’re typing. That’s also a good indication of vocabulary that can be added.

Current box of toys in my back seat for a Sesame Street fan.

Years ago, I created this Building Language Where Do I Start? graphic to provide a map of vocabulary and language expansion from a single interest of the student. I’m linking it again because I still use it to brainstorm when I’m looking at next steps for students. This can also help when you’re trying to figure out which words to open or add. You can use it for any AAC language system. Give the student the vocabulary to talk about the things he/she loves.

Can we programmatically help expand language?

One of the advantages we have as speech-language pathologists who are also developers of an AAC language system is that we use the Speak for Yourself (SfY) app with students almost daily. The features in the app are AAC-problem-solving tools…

People don’t provide aided language input because they can’t find vocabulary? Create an easy and immediate “Search” feature.

People using AAC have to delete semi-formed messages when they get interrupted? Give them the ability to “Hold That Thought.”

People using AAC need to be able to explore a large, robust vocabulary, but not be visually overwhelmed when they’re first introduced to an AAC system? Make a one touch feature that allows them to “Babble.”

We aren’t sitting in an office making development decisions. We are on preschool floors, in children’s homes, and in high school classrooms when we make many of our development decisions. Our ideas come from our own frustration as SLPs, toddlers (although I don’t think they realize it;) and from parents, professionals, and people using Speak for Yourself who are able to directly provide feedback.

One of those ideas has been implemented in the newest release of Speak for Yourself (version 2.9).

Introducing Babble History!

Version 2.9 of Speak for Yourself has several editing improvements, including the option to continue editing when you enter a duplicate word. But an exciting change is the addition of Babble History!

Babble History helps you answer the “Where do I go from here?” with actual data! The History Feature of Speak for Yourself will now give you some direction…based on the vocabulary that’s being explored! Here’s how it works:

  • For optimum use of this feature, Babble and the History feature should both be unlocked.
  • The Babble History option is part of the History Feature pop up. When you go into the History, you’ll notice a third option at the bottom of the pop up that says Babble.

Speak for Yourself History screen with new Babble History icon circled.

  • When you touch the “Babble” section of the history, you’ll get a log of words that are NOT currently available in the vocabulary configuration. In other words, it gives you a list of words that had to be accessed by toggling Babble “on.”
  • It also tells you the main screen word and how many times those words in Babble have been used.

AND it gives you the ability to open those words directly from the History feature!

Turning Babble on and off is indicated in the History Data. If you are someone who emails the raw history data to yourself, the “Closed” words activated through Babble, are indicate in the CSV file with a (c) in the field. Here’s a screenshot:

A screenshot of the raw history data from Speak for Yourself. The (c) indicates that the word is closed and was activated in Babble.

So, how can Babble History help you?

Now that we’ve run through all of the technical information, let’s get back to the original goal…knowing what vocabulary we should add. Answering the “Where do I go from here?” question.

Our hope for this type of data is that it will give individuals using SfY a way to direct their own vocabulary growth. If a student is so motivated that they go into Babble multiple times to access a word, it’s a strong indication that the word should be opened.

Take a look at this example:

Sample of words in the Babble History of Speak for Yourself.

If this were my student, and I saw that (s)he accessed 6 vehicles, I would open all of those words and bring some vehicle-related activities to our next session. I would probably also open “THAT” and “YOU” since they were each used three times. Especially since there are not a lot of other words listed. This does not look like a sample from a student who has turned Babble on and slapped the screen with both hands. I mean, not like that happens or anything…;)

Of course, no programming solution is going to replace strong clinical instincts and knowledge of your child/client. Our goal is to discover and integrate tools that make it  easier for you to be informed. When your job is easier, people using Speak for Yourself are more likely to be successful communicators. We want their voices to be strong and clear…and most importantly, THEIRS!

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You Haven’t Lost Your iPad App

Like many of you, I’ve been paying attention to the devastation in Texas following Hurricane Harvey. In the aftermath, there have been relief efforts to meet the needs of people living in the affected areas. If you lost an augmentative and alternative communication (AAC) system in the hurricane or if you’d like to help people who lost AAC,  USAAC has set up a website for AAC Relief.

Even if you were not in the path of the hurricane, this information might help you. There may be a time that your child’s iPad gets knocked into a pool. Or maybe you put the iPad on top of your vehicle to buckle your child into his car seat. As you pick up speed, you catch a glimpse of something in your mirror and hear the thud of your child’s AAC system meeting the road. Stuff happens. Electronics (and books) get damaged.

But once you purchase an iPad app, you do NOT lose it.

If something awful happens to an iPad within the first two years, it’s covered if you elected AppleCare. Take it to an Apple Store, and they’ll repair or replace it. If it’s not covered, refurbished iPads are available. The $200-$500 cost of an iPad is significant, especially if it’s unexpected. Also, especially if your family has lost everything in a natural disaster. However, it is financially accessible when compared to the $5000-$10,000 cost of a traditional direct access dedicated device.

The good news is that if you are using an iPad-based communication app, you have not lost that app. It is safely stored in the cloud and tied to your iTunes account. Once the iPad is replaced, download the previously-purchased app from the cloud.

Here’s how it works:

  • Set the iPad up with the same iTunes account used to purchase the communication app.
  • Go to the App Store badge icon on the iPad.
  • Touch “Purchased” along the bottom of the screen.
  • Find the app to download. It should have the picture of the cloud and arrow, if you’ve already bought it.
  • Touch the cloud and arrow symbol to download the app onto the iPad.

That’s it! You have your AAC app back. Additionally, this process works if you have multiple iPads in your home and you want to put the AAC app on each of them.

My last hopefully helpful suggestion is to make sure you back up the vocabulary setting! If you’ve done that, you can import that vocabulary from Dropbox, iTunes, or email (for Speak for Yourself), and your AAC system is up and running!

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“I Don’t Want To”: 5 Ways to Encourage Refusal for Students With Complex Communication Needs (CCN)

Message window of Smarty Symbols from the Speak for Yourself app with the words and symbols saying “I don’t want to.”

This is important. It’s important if you know and love any child. But it’s crucial if you know and love a child with complex communication needs (CCN). If you’re looking for a summer goal for your children or students who are using augmentative and alternative communication (AAC), this would be a good one.

A couple of weeks ago, I was working with a student in her home. We had been working on a Father’s Day project for a portion of a few sessions.

We used predictable chart writing with the stem “I like when my dad…” Then I found pictures based on her answers so that we could put them together in a book. On this day, it was time to put the book together. It was the last time I was going to see her before Father’s Day.

BUT…and this is the important part:

When I said, “Let’s put the book together for Daddy!” my 4-year-old medically complex student with emerging verbal skills said, “No. I don’t want to.” Calmly and as clear as could be. With direct eye contact. Like she said it all the time.

But she doesn’t say it all the time. 

I tried to stay cool and casually said, “Oh. Okay.” But her nurse’s eyes were wide with amazement and excitement, and I felt it too. So I said, “I’m so glad you told me that!” She looked up and smiled.

My little student was playing with orbeez (the tiny balls that you put in water and they grow and feel kind of slimy, smooth, wet, and cold). She didn’t want to stop what she was doing. My agenda and impending Father’s Day wasn’t her priority.

So I asked her slightly older sister to put it together for their dad. And she happily obliged.

We played with orbeez.

Child sitting on the floor with her back to the camera, books spread out in front of her and a baby doll by her side.

One of the most important things you can teach a child with complex communication needs is refusal. I’d been modeling it for months. Every time it looked like she wasn’t excited about my plans for the session, I’d model some variation of “No.” “No. Not that.” “No thanks.” “No, I don’t want to.”

The week before that, she turned her head away from me, and I modeled “go away!” and moved about 5 feet away from her. She looked at me with amusement then said it again, and I moved farther away.

Last week, as soon as I walked in, her smiled beaming, she pointed her finger and said, “Go away!” I immediately ducked out of her sight. Her mom looked shocked and said, “Be nice to Heidi!” until I said, “We’ve been working on it. She’s controlling her space.”

There are so many times when a child with complex medical needs doesn’t have a choice. Necessary procedures and tests are often uncomfortable or scary. Dietary restrictions remove food options. Medicine has to be taken. It all HAS to be done or there are potentially fatal medical consequences. There is no room for negotiation.

But she doesn’t have to glue pictures in a book.

When we give our children with CCN the right to refuse the little things, we build the foundation for them to refuse the more serious things. We protect them from compliance. Here are some suggestions to foster your child/client’s refusal skills:

Model refusal even if you don’t think they’re “ready.” 

We talk a lot about the importance of core vocabulary and having a robust language system. We talk about teaching our children/students various functions of communication. But the communication functions don’t have to be introduced in order from requesting to labeling to commenting…They can overlap. When a student requests chips, you can give them the chips and model, “you WANT CHIPS NOT PRETZELS.”

Make sure they have a way to express refusal.

If they’re using AAC, be sure they have access to refusal vocabulary (stop, don’t, no, not, go away). Model the nonverbal communication as well. Push the pretzels away. Shake your head “no.”

This is a good opportunity to add and model some pre-programmed phrases or sentences as well. Give them an assertive way to quickly refuse something with some polite options…and some stronger options. Sure you can say, “No, thank you,” when someone offers you something you don’t want. However, for situations that call for something stronger, “I said no!” or “Get away from me!” may be necessary. Give them a way to be strong and assertive and then work on teaching social etiquette.

We want our children to be sweet and polite, but more importantly, we want them to be strong and safe.

Reinforce refusal

Don’t expect a performance without practice. When children are going to perform, we give them a chance to rehearse on stage and practice their lines. There are dress rehearsals so that the performance feels familiar. Give your AAC learners a safe time and place to practice their “lines” so that when they need them in real life, they’re prepared. Make sure they know what’s supposed to happen when they say “no.”

When a child refuses something that isn’t crucial to his/her survival or safety, reinforce it. Missing an art project won’t make or break a child’s educational experience.

Validate refusal, even when it’s not an option. 

When an activity has to be done, acknowledge that they don’t want to do it and give choices when you can. For example, “I know you don’t want to work. We have to do counting or reading and then we can play. Do you want to do counting or reading?”

If your child/student gets upset, and you think they may be having comprehension issues, modeling and/or First/Then visuals may be helpful along with your explanation.

Be vigilant

Teaching refusal may take a lot of modeling, reinforcing, and explaining. Do it anyway. Once your children get it, they’ll really get it. They may even overuse it. But when they need to be able to say, “I don’t want to,” you won’t regret that you taught them to be assertive.

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The Results: Augmentative and Alternative Communication (AAC) Modeling Implementation Intention “Experiment”

Last month, for Better Hearing and Speech Month (#BHSM), we challenged you to participate in an “experiment.” We wanted to know if the body of research that exists for Implementation Intentions would work to increase AAC modeling/aided language input. **If you don’t need the background, skip to the Participants or Results section.**

We asked you to make room for AAC modeling within your week. Research shows that if you carve out a specific time and place for an important activity, you’re significantly more likely to do it! It’s true of exercise, doctor appointments, and writing. Inherently, we know this. We put reminders in our calendar to put Frontline on the dog, change the air filter in the heater, or get our teeth cleaned.

So, for the first two weeks of May, we asked you to make an appointment to model AAC for the important AAC learners in your life.

Many of you participated, and twenty-four of you generously took the time to answer our survey questions after the two weeks. This post will share the results of those survey questions (except for the irrelevant t-shirt-related questions of course:).

Background

Modeling for individuals learning to use AAC devices is critical. Immersing AAC learners in the language you are expecting them to speak is one area where AAC professionals are in agreement. Evidence based research also supports the use of aided language input as an intervention strategy. Actually, if you are working with an AAC professional or speech-language pathologist who does NOT include aided language input as part of their AAC  implementation plan with your child, you should probably seek a different professional. It’s that important: Speak AAC to teach AAC.

However, it’s not always easy. Life is busy, and children who have complex communication needs often have complex medical needs as well. Some days, it’s hard to find the time to add one more thing. So when I heard a podcast guest talking about implementation intentions (it’s number 52 on the list:Minisode Monday #43), I immediately thought it may be an effective way to plan to increase modeling for our students who are learning to use AAC. This post has the background about the implementation intentions research.

With this experiment, we were hoping to answer two questions:
1. Will scheduling time for aided language input at a specific time and location increase exposure of AAC for the students who use it?

2. Is scheduling implementation intentions for AAC modeling a helpful strategy for individuals who support AAC learning?

Methods

The methods for this “experiment” were not super scientific, but I’m sharing it in the format of a research article because, it could actually be replicated.

  1. Information about implementation intentions was shared in the form of a blog post and shared on social media. That post also contained an announcement that more details would follow and t-shirts would be given away for participating in the survey.
  2. A blog post detailing the “experiment” was published and shared on social media. The post invited anyone using AAC to participate regardless of the language program that was being used.
  3. Participants were given the following instructions/challenge:Give AAC modeling a place to live within your day. Carve out the time to show your child/student(s) that communication is a priority. Put it in your schedule. We’re asking you to plan to communicate and connect with your student(s)/child(ten) who are using AAC. If you’re already doing that, that’s wonderful!
    1. Commit to modeling for (at least) 15 minutes a day for the next two weeks.
    2. Decide on a time and place that *should* give you 15 minutes of modeling time with the AAC user(s) in your life.
    3. Decide on a contingency plan. Unexpected things happen all the time. Plan around them for success.
    4. Complete the form below. Write it on your dry erase board in your kitchen. Put it in your calendar. Put a sticky note near the place you plan to model. Whatever you decide,  publish your intention so that you will see it every day for the next two weeks.

    Modeling intention form to put your plan in writing.

We asked participants keep track for 2 weeks and complete a brief survey letting us know if it worked or not!

4. Each day for the two weeks, I published a “modeling motivation” on the Speak for Yourself Facebook page. Those modeling motivations were compiled in this blog post following the two week experiment.

5. At the end of the two weeks, a survey was published and shared in this post and participants were given five days to complete the survey. We gave t-shirts to participants for taking the time to complete the survey, regardless of their results.

**Participants

Participants self-selected for this experiment. It’s likely that many more people in the AAC community actually participated, but 24 followed through with completion of the survey. Survey response rates are traditionally low, but the most accessible means of data collection for a social media driven experiment by an inexperienced researcher. Participants included 14 parents of AAC users, 9 professionals whose caseload mostly consists of people using AAC and 1 (one) non-parent family member.

Here is the data for the participants:

What best describes your current relationship with AAC?

Data_Q1_role (to view above as a PDF)

We also asked for the age of the AAC users that the parents, professionals, and family members are supporting. Here is that data:

How old is/are the AAC user(s) in your life?

Data_Q2_AACuserage (to view above as a PDF)

**Results

The two questions we were trying to answer were essentially an attempt to increase AAC language immersion for students who use AAC.  We wanted to know if the broad body of research on implementation intentions has beneficial applications for AAC modeling. It is also my general impression that a commitment to modeling increases familiarity with the language system, and that comfort level increases modeling. We all like to feel successful.

For that reason, one of our survey questions was: My knowledge of the app/device has improved over the past two weeks. Respondents could choose strongly agree, agree, I don’t know, disagree, or strongly disagree. Of the respondents, 19 of them (79%) chose strongly agree or agree, indicating that their knowledge had improved.

My knowledge of the app/device has improved over the past two weeks.

Data_Q7_deviceknowledge (to view as a PDF)

One of the survey questions asked about daily goal modeling times. Fifty (50%) percent of respondents set a goal to model 15 minutes a day. That was the amount of time I suggested in my post. Now I’m wondering if it would have made a difference if I suggested a longer amount of time. It may just be that 15 minutes seems like a manageable amount of time to make a daily commitment. Guess we’ll never know. Anyway, here are the results:

What was your daily time target for AAC modeling for the past two weeks?

Data_Q3_targettime (to view as PDF)

Then we asked if it worked. Did you stick to your plan and/or use your backup plan? Of the 24 respondents, 100% said they modeled more than they usually do. Pretty exciting, right? Of those, 54% said that they stuck to their plan or used their back up plan, but that they modeled the amount of time they planned.

Which statement best describes your AAC modeling over the past two weeks?

Data_Q4_diditwork (to view as a PDF)

We also asked about weekly time spent modeling prior to using an implementation intention approach. Eighty-eight (87.5%) of respondents said that they spent less than one hour modeling in a typical week prior to this challenge. Here are those results:

In a TYPICAL week, prior to using this AAC implementation intention strategy, how many total minutes did you spend modeling/using AAC in front of your AAC user(s)?

Data_Q5_PREminutesofmodeling (to view as a PDF)

Then we asked: How many total minutes were spent modeling during the two week experiment using implementation intentions? For comparison purposes, I changed those numbers into weekly totals. Here are the raw responses from the survey:

How many total minutes did you spend modeling or using AAC in front of you AAC user(s) over the past two weeks?

The system was not able to graph the open-ended question. I did it manually. Here are those results:

Weekly AAC modeling time with Implementation Intentions

Modeling with Implementation Intentions (to view as a PDF)

Discussion

When participants used implementation intentions to schedule their AAC modeling time, 87.5% said that they modeled more than an hour per week. Prior to using implementation intentions, only 12.5% of the participants said they modeled more than an hour per week.

Prior to scheduling time to model, no one said they modeled more than two hours per week. However, after using implementation intentions, 45.83% of participants said they modeled more than two hours per week.

Conclusion

So, what does all of this mean? Scientifically, there probably are not enough participants to come to an actual conclusion about the impact of implementation intentions on aided language input. And that’s fine. My purpose was not to create evidence-based research.

The purpose was to see if scheduling time to model AAC helps those of you who support children who use AAC. For the people who participated and answered the survey, it did. Maybe it will for you too.

The purpose was to see if carving out a time and place to focus on using aided language input increased the children’s exposure to AAC.  For the people who participated and answered the survey, it did. Maybe it will for the children in your life too.

More than 24 children benefited from the increased AAC modeling for those first two weeks of May. Professionals shared the challenge with other professionals so that clients experienced increased modeling throughout their days. Entire families participated and “argued” over preferred AAC modeling times.

Regardless of the efficacy or validity of this “experiment,” there is a large body of evidence-based research for implementation intentions that sounds an awful lot like common sense: If something is important, schedule the time and place to do it. Aided language input is an evidence-based, valuable strategy for AAC learners.        

AAC modeling is important. Give it a place to live in your routine.

(Survey Monkey was used to create the survey and graphs.)

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Looking for Some Augmentative and Alternative Communication (AAC) Modeling Motivation?

How many times have you heard that using aided language input is a key strategy to teach the augmentative and alternative communication (AAC) learners in your life? If you follow AAC blogs and groups, participate in AAC professional development, or read AAC articles, the answer is probably “a lot.”

We ran an AAC modeling implementation intention “experiment” the first two weeks of May for Better Hearing and Speech Month (#BHSM). For more details, check out this link.  As part of the “Make Room for AAC Modeling ‘Experiment,” each day for the fourteen day challenge, we shared a #modelingmotivation on the Speak for Yourself Facebook page.  For those of you who weren’t able to participate in “real time,” I thought it might be helpful to have some modeling motivation any time you want it! SO here is the information that was shared over the two week “experiment.”

DAY 1

Today’s motivation is the Jane Korsten quote that many of you may have already seen. (I’m attaching the graphic that Rachael Langley created.)

If you’re reading this quote for the first time, many people (especially parents) say they feel overwhelmed…Like they’ve already lost years of language exposure for their child.

But instead, let it motivate you to start increasing their exposure to an expressive language system now. Your children have been listening. They hear language all day, every day. They know the words.

Based on Jane’s numbers, if you have a six year old, he has heard 17,520 hours of spoken language. That time hasn’t been wasted. He’s been listening.

Using aided language input on an AAC system makes expressive language accessible. It provides a way for someone using AAC to participate in the conversation happening around them.

Show them how it’s done…and start today!

Day 2

If you missed yesterday in the Make Room for AAC Modeling “Experiment,” start today! I’ve left a few days between the end of the experiment and the survey to allow for a back up plan. 😉

Today’s #ModelingMotivation is a post I wrote more than 3 years ago. It gives a detailed explanation about how to model one more word than your child/student is using independently.

You don’t have to be perfect, and it doesn’t have to be overwhelming. Have fun and enjoy the time talking with your child!

“One of the more common, and important, Augmentative and Alternative Communication (AAC) implementation strategies is Aided Language Input or modeling.  It would be overwhelming to use your child’s/client’s device to model EVERY word you are saying verbally…for you and the child!  Here’s the good news, you can successfully use Aided Language Input without overwhelming anyone!”

Day 3

How is everyone doing?

My time spent with students is generally already carved out for aided language input, but yesterday, I knew the class was going on a walk during the time I would be there. It’s not a walk around the school. It’s a walk through the town to a store. There are traffic lights, crosswalks, dogs, cars, and other people. There’s a lot going on and it’s usually a difficult time to model.

In the spirit of this challenge, I planned to do it anyway. Everyone else was talking as we walked down the street. The student’s 1:1 aide is excellent so the student’s safety was covered.

The “place” I planned to model was when we stopped. So I modeled things like “waiting,” “red light,” “go now,” “need stop,” “walk school.” The student vocalized and watched the cars and lights changing.  She didn’t seem to care about the modeling, but she also didn’t tell me to stop (which she does if she wants me to stop:).

She never used the device herself as we were walking, but she didn’t clear the message window either (which she does pretty vigilantly).

Occasionally, as she was walking she’d slide her hand down to the device hanging at her side. Without looking at it, she’d touch the message window, causing the device to speak the modeled words.

Something important to remember about AAC modeling is that you’re not always going to get immediate results. She didn’t use any of the words I modeled yesterday independently. BUT she seemed to enjoy walking and talking.

Using aided language input lays the groundwork that communication is a positive experience, and you can use AAC anywhere. Take the pressure off of yourself and the AAC learner. Know that when you use aided language input, you’re not only teaching words. You’re teaching them that you want to hear their voice…everywhere.

Day 4

Today’s #modelingmotivation is a throwback post from PrAACtical AAC. 

“Everyone can do it. This is not a strategy reserved for highly trained professionals. Some of the best implementers I’ve ever seen of this strategy were paraprofessionals and family members. Even peers can get in on the action. Learning from friends? Yes, please!”

Day 5

If you’ve been getting “stuck,” today’s #modelingmotivation might help you problem solve your aided language stimulation approach. This is a quick 2 page hand out from Assistive Technology Australia.

If you’re having a difficult time modeling or feel like you’re in a rut, consider changing something in one of the areas they mention. The more you do it, the easier it gets!

Day 6

Today, I’m sharing some phrases you can model. Today.

This post contains lists of two, three, and four word core word utterances that you can pretty easily apply at some point throughout every day. This is our most often pinned post on Pinterest. I hope it gives you the #modelingmotivation you need today!

Day 7

We’re halfway through the 2 week plan to carve out the time and place to model AAC for the people in your life who are using.

For those of you who are motivated by evidence-based research, here is a research article.

“The most important clinical implication of this study is that a 3-week intervention program in aided language stimulation was sufficient to facilitate the comprehension of at least 24 vocabulary items in 4 children with LNFS (little or no functional speech).”

Day 8

As we begin the second week, today’s #modelingmotivation is a post by Kate Ahern about the importance of language rich immersion in AAC.

“Even if they were adults with full receptive language, a lifetime of experience in the world and average cognitive abilities AND they spent ALL 30 hours a week at school fully engaged in AAC learning (including during transitions, meals and hygiene activities) it would take approximately six months to get to basic communication mastery.”

Day 9

Today’s #modelingmotivation is a research article looking at a naturalistic approach and modeling. 

Here are some of the key takeaways from the article (in case you don’t have time to look at the full study).

The third one is my favorite…even if the child doesn’t use the SGD, YOUR use of it can result in language gains!

* “using an SGD within an effective naturalistic developmental behavioral intervention may facilitate longer and more frequent reciprocal communication interactions, leading to gains in verbal and nonlinguistic communication skills” (p. 11) in 5-8 year-old children with autism.

* In the SGD group, significant differences were seen in spontaneous communicative utterances and initiating joint attention.

* “…the gains made by children… could be explained by the therapist modeling SGD use, with or without child SGD use” (p. 12).

Day 10

This article has a lot of great information for #modelingmotivation!

“The attitudes, beliefs and knowledge of the student’s communication partners are pivotal in the success story of any kind of Augmentative and Alternative Communication (AAC).”

Day 11

Today’s #modelingmotivation is a post that has a couple of videos of me using aided language input. Sometimes it helps to actually see it happening (and see the things I do imperfectly:).

This post also talks about the layers of modeling and how students sometimes need a lot of exposure before they decide to reach out and touch the device.

Feel free to link your favorite AAC modeling videos in the comments (it doesn’t have to be on the Speak for Yourself app).

Day 12

Here are some new ideas, as we’re winding down to the end of this 2 week challenge/experiment.

So, for today’s #modelingmotivation, this is an older aided language stimulation information sheet. It has some great suggestions and some more in-depth details about variation in modeling approaches.

If you’re feeling like your modeling has become a little stagnant, check it out!

Day 13

Today’s #modelingmotivation is this video by Christopher Bugaj that explains modeling and gives some good examples of phrases to model.

It’s also easy to understand if you’re trying to explain why aided language input is important to peers, siblings, and people who may not be familiar with AAC.

Day 14

For today’s #modelingmotivation this is a great summary handout that explains aided language input, gives some examples of how you can model, and cites research.

We made it! Today is the final day of the two week challenge/”experiment” about modeling implementation intentions!

Thanks to all of you who have participated and shared your experiences! Stay tuned for the results!

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Survey: Augmentative and Alternative Communication (AAC) Modeling Implementation Intentions

Predictable chart writing on a dry erase board went in a slightly different direction. Teaching anything requires flexibility.

Yesterday, we wrapped up our two-week Make Room for AAC Modeling Implementation Intentions “Experiment.” 

This post includes a link to the short survey to see if using the research on implementation intentions was helpful to increase the use of aided language input for our AAC learners. The survey also includes questions about your size and where to send the t-shirt being given for participation*. The survey will be open from 9:00 AM EST on Monday May 15th, 2017 until 11:59 PM EST on May 20th, 2017.

If you are reading this after May 20th, 2017, feel free to use the format of the “experiment” to plan for your AAC modeling. Choose two weeks and commit – with specifics – to using aided language input.

Thank you to all of you who have participated and shared your stories, either publicly or privately. It’s nice to know that you’re out there and find the information helpful!

CLICK HERE TO TAKE THE SURVEY

*Shirts are only being sent within the United States to the first one hundred respondents. We apologize for any disappointment.

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Make Room for Augmentative and Alternative Communication (AAC) Modeling “Experiment”

Two children sitting in the field each looking at their own device in front of them.

Augmentative and Alternative Communication (AAC) modeling is important. Ask any AAC-knowledgeable speech-language pathologist, teacher, researcher, parent, or AAC app developer. Aided language input is common ground in the field of AAC, regardless of the language system you’re using. So if you support someone who uses AAC, this “experiment” applies to you.

If you use AAC, the aided language input piece may not be applicable, but feel free to choose something you’d like to improve within your AAC use and target it using this approach.

As I write this, I have that butterflies-in-my-stomach feeling. This is out of my comfort zone. I’m not a researcher, but I am a research fan and follower. I imagine it’s the feeling that a Garth Brooks fan would have if he/she were suddenly thrown onto stage at his concert and handed a microphone. Well, maybe not that extreme. Even if you sing “Friends in Low Places” really well on karaoke night, it doesn’t make you Garth Brooks.

Here’s my disclaimer: This isn’t a perfect scientific research experiment. If you’re an excellent researcher, there are going to be glaring things that are wrong with my design or my method, or the survey. Please forgive all of that because my goal in this is not to be a renowned researcher. All of that being said, I’m loosely using the words “research” and “experiment.”

My goal is for parents and professionals to find a way to support the people they know and love who use AAC. When I hear about strategies that work in other areas, I try to apply them to real life. Research in any field is only six degrees of separation* from AAC for me.

So it should come as no surprise that when I heard James Clear talking about implementation intentions on a podcast about social science, I immediately thought of AAC implementation intentions. (I wrote about the implementation intention research in this post in more detail earlier in the week.)

It sounded…easy. If this research works, AAC modeling will increase with a quick, minor change in your routine. Pretty exciting, right!?

Here’s the Plan!

May is Better Hearing and Speech Month (BHSM), and the theme this year is Communication: The Key to Connection. Let’s do a little research about modeling AAC using motivation and planned implementations.

Here’s what I’m asking of you

Give AAC modeling a place to live within your day. Carve out the time to show your child/student(s) that communication is a priority. Put it in your schedule. We’re asking you to plan to communicate and connect with your student(s)/child(ten) who are using AAC. If you’re already doing that, that’s wonderful!

  1. Commit to modeling for (at least) 15 minutes a day for the next two weeks.
  2. Decide on a time and place that *should* give you 15 minutes of modeling time with the AAC user(s) in your life.
  3. Decide on a contingency plan. Unexpected things happen all the time. Plan around them for success.
  4. Complete the form below. Write it on your dry erase board in your kitchen. Put it in your calendar. Put a sticky note near the place you plan to model. Whatever you decide,  publish your intention so that you will see it every day for the next two weeks.

Modeling intention form to put your plan in writing.

The second thing we’re asking is that you keep track for 2 weeks (May 1st-15th, 2017) and complete a brief survey letting us know if it worked or not! Once you complete the survey, you’ll get a free t-shirt** for your time! You can use this weekly calendar to check off if you modeled or not, or you can do it in a way that works best for you.

Modeling implementation intention weekly calendar.

Here’s what I’m going to do

  1. Every day, for the next two weeks, I’ll post a “modeling motivator” on the Speak for Yourself Facebook page. I’ll share a post about aided language input, a success story, or a research article that reminds you that modeling is important.
  2. On May 15th, I’ll post a survey asking for your results. When you complete the survey, we’ll send you this t-shirt.** (The survey will include size options and mailing address information for t-shirt sending purposes only. We won’t use your identifying information for any other reason.) The survey will close on May 20th, 2017 at 11:59pm EST.
  3. Write about the results and post them by the end of May!

Blue t-shirt that reads: I (heart) when we speak AAC.

Thank you all so much for your excitement and participation! I can’t wait to see how it goes!

*If you’re not familiar with it, six degrees of separation is the idea that everything in the world and all living things are only six or fewer steps from each other.

**T-shirts will be sent to the first 100 survey participants ONLY. Due to shipping costs, t-shirts will only be sent to participants within the United States. I apologize for any disappointment. The shirts are meant to add fun and incentive to the project.

T-shirts can be purchased (at the same price we’re paying) here. If you need children’s sizes, they can be purchased here.

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I Meant to Model Today: Augmentative and Alternative Communication (AAC) Implementation Intentions

Jess looking at me with high expectations of a good alternative to live theater.

It happens to the best of us. You have every intention of using some amazing and advanced aided language input. You imagine this wonderful interaction between you and a captive augmentative and alternative communication (AAC) user, soaking in the model of expressive language you fluently provide. But the day passes, and before you drift off to sleep, you realize that it didn’t happen. Life is busy. You got interrupted. Or maybe you were just having fun and enjoying the moments with your child. Whatever the reason, modeling intentions get pushed to the next day. You close your eyes and think, “I’ll do it tomorrow.”

Here’s the thing…tomorrow is going to be busy too. You’re going to get interrupted. And hopefully, you’re going to spend some time in everyday moments having fun and enjoying your child or student. What if the research about implementation intentions could make your aided language input intentions a more consistent reality?

As a field, professionals and researchers generally agree that aided language input is a crucial strategy in AAC implementation. Let’s see if we can use research in another area and apply it to increase the aided language input we provide!

I Meant to Model, but…

I recently spent some time hanging out with Jess, who you may know from her mom’s blog, You Don’t Say AAC. Jess is a twenty-five year old young woman who has Angelman Syndrome and uses Speak for Yourself. We had a fun day planned that was packed with her decisions. She initially wanted Burger King, but as we were driving, she decided on lobster for lunch. Sure! Ice cream? Why not?! Dried apples from the orchard market. Of course! (I had to veto Mamma Mia and Les Miserables because they weren’t playing near us.) She settled for Beauty and the Beast at the movie theater. Here’s a video of that conversation:

I intended to load her vocabulary data setting on my iPad and spend some focused time using aided language input, but two things happened. First, I picked her up in a whirlwind of excitement and ended up in the car without a wifi connection. Second, she was so talkative throughout the day that I didn’t feel like there was a good opportunity to take her device, connect it to my hot spot, and then email her user vocabulary to myself. I didn’t do it.

I modeled on her device while we sat in the car outside of the restaurant. We talked about what we could do in the hour between lunch and the movie. I modeled in the restaurant when we were figuring out the choice of sides. When her device battery died, I pulled out my iPad and modeled on the unpersonalized vocabulary in my app before handing it to Jess to use. But when the day ended, I thought, “I meant to model today.”

Implementation Intention Research

My modeling “failure” reminded me of something I had heard about research on implementation intentions. I had saved the research article, which talked about exercise. Part of the reason I saved this article was because it made me think of using the strategy in the article for implementing aided language input.

The researchers randomly divided people into 3 groups. The control group was asked how often they exercised. The second group (“motivated group”) was asked how often they exercised and also given motivational materials about the benefits of exercising. The third group was given the motivational materials and also asked to fill out a form with the “when, where, and how” of their exercise plan. After two weeks, the researchers found that there was not much difference between the control group (38% engaged in exercise) and the “motivated” (35% engaged in exercise) group. However, the third group with the clear intention plan, had 91% of the participants follow through on their exercise plan. This is not the only research about implementation intentions. This research supports an already strong body of evidence in this area.

I Tried It For This Blog Post

My MacBook screen with two sticky notes. The first (orange note) reads: “I will write uninterrupted on Thursday (4/20) from 9-11 am in the shedquarters.
The second (blue note) reads: “If I am interrupted, I’ll add that time after 11.”

…and it worked! I’ve been thinking about this blog post for at least a few weeks. I keep intending to write it and then something else takes my attention. Today, I made it a priority. I wrote it down and made a commitment to devote a couple of hours to actually doing it. And I did.

What’s the Possible Implication for AAC?

I don’t know, but let’s find out! May is Better Hearing and Speech Month (BHSM), and the theme this year is Communication: The Key to Connection. We’d like to do a little research about modeling AAC using motivation and planned implementations. It will be a better experiment with your help!

Here’s what I’m asking of you: Give AAC modeling a place to live within your day. Carve out the time to show your child/student(s) that communication is a priority. Put it in your schedule. We’re asking you to plan to communicate and connect with your student(s)/child(ten) who are using AAC. If you’re already doing that, that’s wonderful!

The second thing we’re asking is that you keep track for 2 weeks and complete a brief survey letting us know if it worked or not! Once you complete the survey, you’ll get a free t-shirt for your time! I’ll post a blog with all of the links and details on Friday April 28th, 2017, and we’ll officially get started on May 1st!

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The Aftermath: Emergent Literacy in Augmentative and Alternative Communication (AAC)

Avery sitting in a waiting room with books spread out in front of her and a baby doll by her side.

Just over two months ago, I walked into Avery’s house with an armful of books. I boldly told her and her mom that we were going to work on reading and writing. Avery had just turned four, and her mom unflinchingly said, “Sounds good to me.” Avery gasped with excitement as if I’d walked in with a new puppy or a bushel of balloons. We had been doing a lot of shared reading, but I had a fresh plan for literacy. Avery was completely on board.

I returned from the Assistive Technology Industry Association (ATIA) conference with renewed excitement. It is the kind of enthusiasm we hope to gain from professional development experiences. I attended a session called Using Core Vocabulary in Emergent Literacy Instructional Routines presented by the Project Core team. It resonated with me. I appreciated the framework for targeting and encouraging emergent literacy for users of augmentative and alternative communication (AAC). Their plan put the responsibility on the instructor rather than the student. It also fit well with the Speak for Yourself AAC app.

That hour and a half session inspired a six part series of blog posts addressing literacy using AAC and Project Core.

In case you missed it…

For those of you who have busy lives and haven’t been able to follow along every week, I thought it might be beneficial to round up links to all of the posts. So here they are:

Using Speak for Yourself with Project Core Non-Instructional Routines 

Shared Reading: Using AAC With Project Core

“I like” Predictable Chart Writing: Using AAC and Project Core

Independent Writing: Using AAC and Project Core 

Alphabet and Phonological Awareness: Using AAC and Project Core

Independent Reading: Using AAC and Project Core

I read a lot of research, but not just for the sake of reading it. The value of research is in the application of it. When I read research in any field, I think how does this apply to my life?, which generally ends up translating to how does this apply to AAC? So when there’s a framework that really smart researchers take the time to establish, it makes sense to listen.   It makes sense to try it.

The Aftermath

As clinicians, we know that what works for one child may not work for another. Even if it’s been researched. But what I will say about these emergent literacy strategies is that they were not difficult to try. They didn’t take long. And most importantly, they generalized seamlessly. It does help that Avery was already interested in books when we started. It helps that as soon as her occupational therapist knew about it, she jumped in with writing activities too. It also helps that her home is a “book rich” environment. However, none of those things are pre-requisites for literacy to emerge. You can start with one small act. Put books in your environment. Start reading out loud to your students using AAC. Model some of the words on their device. Like so many things, it starts with a first step.

Sometimes we implement things and we don’t get to know if they “worked” immediately. We don’t always get instant results and as clinicians we accept that. Our work is for the long term. But sometimes, we’re fortunate to see the impact right away. Avery’s mom texted me the picture in the beginning of this post and a short video last week (and graciously gave permission to share them). She had a doctor’s appointment, in an office full of toys (which she also used), but guess how Avery decided to spend her time…better yet, she can tell you herself! (Listen to her use of core vocabulary!)

 

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