STRATEGIES FOR SUPPORTING AAC USE

Cathy Binger, Ph.D., CCC-SLPUniversity of New Mexico

All Roads Lead to ECHO ConferenceWyoming Institute for Disabilities, 2016

Disclosures

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¨ I have received ¤ Funding from the ASHFoundation, NIH, and internal

grants at UNM to support this work. n NIH grant: 1R03DC011610

¨ I have received travel expenses from the Wyoming Institute for Disabilities for serving as your speaker today.

AAC Strategies: Overview

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� Framing AAC and Communication

� Language Goals for Children who use AAC

� Techniques to Improve Expressive Communication

Framing AAC and Communication

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AAC is a TOOL, not a Goal

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◦ GOAL ◦ Improved daily life

communication

◦ TOOL ◦ AAC

◦ GOAL ≠ AAC

� AAC is about COMMUNICATION

What are the Outcomes?

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Increase/Improve

Participation

Academic/ employment

outcomes

Social skills

Language skills

� AAC use is never an outcome in and of itself

� Devices cannot accomplish anything in and of themselves◦ Nothing magical about

using aided AAC

� Devices are TOOLS to reach the same goals as clients who rely on speech

Language Goals for Children using AAC

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Focus, Goals, & Context of Communication

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• Improving daily life communication Focus• Very similar to non-AAC clients; e.g.,

• Expand sentence length• Expand vocabulary diversity, etc.

Goals• We will discuss AAC devices within the context

of communication• NOT the features of each device in isolation

Context� AAC is much less intimidating when viewed this way!

Goals for Children who use AAC

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Social skills• Turn-taking,

commenting, asking questions

• NOT just requesting!

Vocabulary• Vocabulary size &

diversity

Sentence structure• Grammatical

markers such as plural –s and progressive -ing

• Message length and complexity

Example Goals

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• Dakota will label 5 different insects and snakes and 5 new verbs (e.g., crawl, hop, slither) accurately during science center over three consecutive days

Early vocabulary-

building

• Jasper will take at least three commenting turns with his peers during free play time using an appropriate communication mode (e.g., using pre-programmed phrases such as “That one is fast!”)

Social skills

• Margarite will use at least 5 grammatically complete sentences when giving an oral presentations in science class

Sentence-building

Techniques to Improve Expressive Communication

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Intervention techniques to Improve Expressive Communication (e.g., Binger, Kent-Walsh et al., 2008, 2010; Binger & Light, 2007; Kent-Walsh, Binger, et al.,2010)

(c) Binger 2015

Prompts

• Aided modeling• Spoken modeling• Expectant delay• Open-Ended or WH-

question asking• Direct spoken prompting• (Physical prompting)

Responses

• Contingent responses• Imitations• Recasts

• Can be spoken and aided

Sample Communication Board: Sentences with Prepositions and Adjectives

(c) Binger 2015

Early Sentence Productions with Prepositions

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¨ Child H Video 1¤ Motivation situation¤ Prompts

n Natural set-up and cueing¤ Responses

n Spoken and aided model

¨ Child H Video 2¤ Motivating situation¤ Prompts

n Natural set-up and cueingn Spoken modeln Direct spoken prompt: “Tell Cow where he is.”n Expectant delay

¤ Responsesn Natural consequence

Early Sentence Productions with Prepositions

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¨ Child H Video 4¤ Motivation situation¤ Prompts

n Spoken model + direct promptsn WH questionn Spoken choices: “Under? Behind? Next to?”

¤ Responsesn Spoken confirmation within an natural consequencen Aided model

¤à Lots of help with forming this new, more complex structure

Early Sentence Productions with Prepositions

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¨ Child H Video 5¤ Motivating situation¤ Prompts

n Natural cuen NO higher level cues here; doesn’t need them

¤ Responsesn Spoken model/ imitation

Did you see…

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¨ How much FUN this can be!¨ How expecting more = getting more¨ Encouraging immediate correction of errors¨ Encouraging use of grammatical markers¨ Speed of learning to use the markers¨ Impossibility of producing such sentences without

AAC

Challenge your Clients

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¨ Provide them with the communication solutions they need¤ Motivating contexts

¤ Appropriate vocabulary¤ Expectation for success

¨ Expect them to keep improving

¨ Increase expectations every time they improve

Selected References

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Binger, C., Kent-Walsh, J., King, M., Webb, E., & Buenviaje, L. (submitted). Early sentence productions of five-year-old children who use augmentative and alternative communication.

Binger, C., Kent-Walsh, J., King, M., & Mansfield, L. (submitted). Early sentence productions of three- and four-year-old children who use augmentative and alternative communication.

Kent-Walsh, J., Binger, C., & Buchanan, C. (2015). Teaching children who use augmentative and alternative communication to ask inverted yes-no questions using aided modeling. American Journal of Speech-Language Pathology, 24, 222-236. DOI: 10.3109/07434618.2015.1052153

Binger, C., Kent-Walsh, J., Berens, J., Del Campo, S., & Rivera, D. (2008). Teaching Latino parents to support the multi-symbol message productions of their children who require AAC. Augmentative and Alternative Communication, 24(323-338).

Binger, C., Kent-Walsh, J., Ewing, C., & Taylor, S. (2010). Teaching educational assistants to facilitate the multi-symbol message productions of young students who require AAC. American Journal of Speech-Language Pathology, 19, 108-120.

Binger, C., Maguire-Marshall, M., & Kent-Walsh, J. (2011). Using aided AAC models, recasts, and contrastive targets to teach grammatical morphemes to children with developmental delays who use AAC. Journal of Speech, Language, and Hearing Research, 54, 160-176.