Tag Archives: speech therapy

Augmentative and Alternative Communication (AAC) Fact Sheet & Myth Buster

by Ani Soghomonian & Bridget M. Coady, MA CCC-SLP

As a speech-language pathologist in the preschool setting, I often use pictures, devices, and language boards to help children communicate and learn language. These are known as “augmentative and alternative communication” (AAC) methods. AAC can teach language vocabulary and structure, and enhance the communication of children with special needs. Sometimes, parents express concern that these visual supports and communication devices will hinder or replace their child’s natural verbal speech. This is not true. “Are we giving up on their verbal speech?” parents ask. “But I want my child to talk,” they say. In order to address these concerns, I recently created a handout in collaboration with a speech-language pathology graduate student who worked with me at Easter Seals. The graduate student researched articles on AAC and its impact on speech and language development. Together, we translated the research into easily understandable terms. The end result was a parent-friendly, research-based fact sheet about AAC.

Augmentative and Alternative Communication (AAC)
Fact Sheet & Myth Buster
“Communication is the essence of human life” -Janice Light (1997)

 1)What is AAC?

  • A way to enhance the communication of people who have significant speech and language impairments (Light, Binger, Agate, & Ramsay, 1999)
  • AAC can have positive benefits for natural speech production—using AAC intervention will NOT inhibit the production of speech
  • A way to help language skills develop (Romski & Sevcik, 1996)
  • Includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas (ASHA)

picture icons, speech-generating devices, gestures/signs, language boards

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2) I’m worried my child’s speech production will be inhibited if he/she continues to use AAC as a way to communicate. What if AAC negatively impacts my child’s ability to learn speech?

  • AAC will actually facilitate the development of speech for many children with developmental disabilities (Romski & Sevcik, 1996)
  • This is no research that suggests AAC will hinder the development of natural speech
  • AAC is highly beneficial because it may:
    • Reduce the pressure on the child to speak verbally
      • This can reduce stress and facilitate the production of speech naturally (Lloyd & Kangas, 1994)
    • Reduce the motor and cognitive demands of speaking, and focus on the goal of getting the message across instead

3) What is communicative competence?

  • It is a child effectively communicating his/her message to the listener
  • It is the central goal of AAC intervention (Light, 1997)
  • AAC can help create effective communicators
  • It is about the people:
    • AAC is just the tool; it is the people and the interaction between them that is the main focus!
  • It is learned:
    • Children must be taught how to use their AAC system to be effective communicators
    • It is a step-by-step process that takes hard work, commitment, and instruction—that’s where SLPs and parents come in!

4) How do we build communicative competence? (5 steps)

  • Identify meaningful and appropriate opportunities for communication
  • Prepare for these opportunities by teaching the child who uses AAC
  • Ensure conversational partners provide support, such modeling use of AAC system
  • Have the child participate in these opportunities at home and in the classroom
  • Reflect on experiences and learn through them
  • It focuses on the 4 purposes of communication:
    • To express our needs and wants
    • To build relationships or friendships with others (Light, 1988)
    • To share information (Light, 1988)
    • To use social etiquette; For example, “Thank you, have a good day” (Light, 1988)

5) My child has been using AAC in speech therapy for a while now, but I am not seeing any increase in the amount of speech he/she is producing. Should I be concerned?

  • Each child’s speech and language development is highly individualized, so there is not a straightforward answer. However, research shows that some individuals who are using AAC intervention may take somewhere between 6-25 sessions to show speech gains (Millar, Light, & Schlosser, 2006)
  • Your child’s SLP will monitor the effectiveness of the AAC system on communicative competence, social interaction, language skills, and speech production.
  • Your child’s intervention will be changed as deemed necessary, and in the best interest of your child and your family.

Main Points:

  • SLPs and parents should not hesitate to use AAC with children whose speech is inadequate to meet their communication needs.
  • AAC has significant benefits for developing the language skills and communicative competence of many children.
  • AAC can have positive benefits for natural speech production—using AAC will NOT inhibit the production of speech!

Additional Information:

References

Light, J. (1988). Interaction involving individuals using augmentative and alternative communication: State of the art and future research directions. Augmentative and               Alternative Communication, 4, 66–82

Light, J. (1997). “Communication is the essence of human life”: Reflections on communicative competence. Augmentative and Alternative Communication13(2), 61-70.

Light, J. C., Binger, C., Agate, T. L., & Ramsay, K. N. (1999). Teaching partner-focused questions to individuals who use augmentative and alternative communication to enhancetheir communicative competence. Journal of Speech, Language, and Hearing Research42(1), 241-255.

Lloyd, L. L., & Kangas, K. (1994). Augmentative and alternative communication. In G. H. Shames, E. H. Wiig, &

  1. A.Secord(Eds.),Humancommunicationdisorders (4th ed., pp. 606–657). New York: Merrill/Macmillan

Lloyd, L. L. & Kangas, K. (1944). Augmentative and alternative communication. In G.H. Shames, E. H., Wiig, & W.A. Secord (Eds.), Human communication disorders (4th ed., pp 606-657). New York: Merrill/Macmillan.

Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with          developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research49(2), 248-264.

Romski, M. A., & Sevcik, R. A. (1996). Breaking the speech barrier: Language development through augmented means. Brookes Publishing Company, Maple Press Distribution Center, I-83 Industrial Park, PO Box 15100, York, PA 17405.

 

My Crazy Fulfilling Year at Easter Seals

by Shannon Mahoney

After graduation, all Speech Language Pathologists (SLPs) must complete a Clinical Fellowship Year (CFY). The “year” is approximately nine months of working at their first job under the supervision of a licensed SLP. After this time, and with all the approved documentation, a Clinical Fellow (CF) receives a Certificate of Clinical Competence showing they are now a certified SLP; no longer in need of supervision. I recently completed my CFY at Easter Seals of SEPA. In the beginning I called my CFY a Complete Failure, but with the help of my fellow SLPs, an amazing classroom staff, and supportive supervisors, I now consider it the most Crazy Fulfilling Year of my life.

The transition from years as a student to a working adult was a jarring experience and I felt overwhelmed when I started treating students at our Early Intervention Center. There are so many people that can be involved within one single case, such as service coordinators, special instructors, speech/occupational/physical therapists, regular education teachers, parents, behavior specialists, and various support staff. As part of the team, I was initially unaware of the amount of communication and correspondence necessary to help my students succeed. I can only imagine what a parent must feel like going through the “system” as well.

As an early intervention provider, we are sometimes the first contact families have had with special education services. Being part of their satisfaction with the program and ultimately, the progress of their child’s abilities was a daunting task at first. However, with the passion of each of my coworkers and the respect and appreciation from each of my families, I slowly began to become comfortable and confident in my clinical decisions. They helped me turn what I thought of as a complete failure, into one crazy fulfilling job. Working at Easter Seals has been the proudest moment for me because every single staff in this organization has the best interest of our students as their number one priority.

Our classroom teachers are constantly working to create engaging lesson plans using their skills to adapt tasks that our children can interact with and increase the students’ academic skills. My classroom teacher fought for the rights of each of her students if she felt they needed a different education setting or more supportive services put into place. She instilled in me a sense of passion for this job and the unyielding dedication to her students that all of our staff possess. My supervisor and director provided the most hospitable working environment that showed me how important it is to welcome families and make them feel comfortable during uncertain times. The other therapists in the building taught me the essentials of being a good clinician and that learning does not end; even if we are no longer considered students ourselves.

In the end, I learned more during my first 9 months at this institution than a person could have gained from years of schooling. The knowledge that I have been imparted from by my coworkers is invaluable because every day I saw people doing what they love. Even with a rough start, I can now say that I love what I do. I believe it is because of the values instilled in each employee at Easter Seals that makes this place so special. It is my hope that our families also see the passion and devotion that I see every day when I come to work. They are the reason we are here, and their children are why we all love what we do.

Meet Janiya and Dymir

Janiya_Damir_web

Janiya and Dymir are brother and sister, they would also call themselves best friends. The first few years of their lives were unstable and challenging for Janiya, 11 and Dymir, 12, who also have developmental delays. Today, with the support of their loving mother and the therapists at Easter Seals, they are doing fantastic. Janiya and Dymir are students at a cyber charter school and once a week Janiya receives Speech and Occupational Therapy, Dymir was also receiving the same therapies until recently. With the help of Easter Seals therapists, they have both improved their fine motor skills and their speech, which has led to greater self-confidence. When they come in for therapy, they literally run into the building, which is a wonderful testament to their experience. When they aren’t in school or therapy, they are doing typical kid stuff. Janiya is a Girl Scout and loves to dance. Dymir is a Boy Scout and he especially loves the camping trips. Together, they enjoy riding their bikes and seeing who can bounce the highest on a pogo stick. Janiya wants to be a police officer when she grows up and Dymir wants to be a firefighter. They have an energy that is inspiring and captivating and we can’t wait for you to meet them!

Meet Janiya and Dymir at Walk With Me on June 4th. Visit our Walk With Me website to register or learn more.

Early Intervention from a Parent’s Perspective

My daughter was adopted from an Armenian orphanage at 10 months of age. She had no use of her right arm because her nerves were severed as a result of a birth injury.

Picture one

Just before her 1st birthday, she had nerve graft surgery at Shriners Hospital for Children in Philadelphia. Following surgery, she began PT, OT, and Language/Play therapy through Easter Seals. I had previously learned of Early Intervention through the adoption community and contacted them as soon as we returned to the States.

Picture two

The evaluation was nonthreatening and, in many ways, reassuring. The evaluators played with my baby and talked with me. I had confidence in their assessment and the support that they would provide. My daughter actually enjoyed the evaluation process, and once she qualified for services, I was an active participant in the goal setting. They listened to my concerns and addressed them.

Therapy continues to be an extremely positive experience on numerous levels. My daughter engages happily with her therapists, who accommodate our schedule and work with her both at home and/or her daycare program. Services began at home and moved on to daycare when she did. Not only do they fit therapeutic ideas into our routine, such as playtime and bath time, but they also demonstrate ways in which her daycare teachers can reinforce her goals.

Picture three

My daughter started therapy in late August, and I am very encouraged by the progress she has made thus far. Her therapists truly care about her, and they persevere through her cranky moments, as well as celebrate her accomplishments. Through play, they are helping her reach her potential, and it is gratifying to witness their dedication and commitment. I am so grateful for the quality of care that my little one is receiving through Early Intervention Services and Easter Seals, and I commend them for providing, so graciously, such vital therapies. It is a blessing that these services exist to enhance the quality of life for children with special needs.

Activities to help facilitate your child’s social skills:

By Elizabeth Haftl, M.S. CF-SLP and Ryanne Giordano, M.A. CF-SLP

There are 2 parts to social skills:

Interpersonal skills: are the ability to perform competently in social situations which is important for peer acceptance and social adjustment.

Learning related skills: are the ability to self-regulate and act competently in social classroom tasks and learning situations.

In general, children’s interpersonal skills have been linked to social outcomes whereas learning-related skills have predicted academic success.

Social Skills Developed from 0-12 months:

  • Differentiates between tones of voice (angry, friendly)
  • Smiles back at caregiver
  • Follows caregiver’s gaze and demonstrates joint attention skills
  • Participates in vocal turn-taking with caregiver
  • Vocalizes and gestures to get attention and request
  • Plays simple interactive games such as peek-a-boo

By 12-18 months child should:

  • Requests and gains attention by pointing and vocalizing
  • Says “bye” and other ritualized words
  • Protests by shaking head, saying “no”
  • Aware of social value of speech
  • Demonstrates sympathy, empathy, and sharing nonverbally

18-24 months:

  • Uses single words to express intention
  • Uses single and paired words to command, indicate possession, expresses problems, and gains attention
  • Participates in verbal turn-taking with limited number of turns
  • Demonstrates simple topic control
  • Interrupts at syntactic junctures or in response to prosodic cues

2-3 years:

  • Engages in short dialogues
  • Verbally introduces and changes topic
  • Expresses emotion
  • Begins to provide descriptive details to enhance listener understanding
  • Clarifies and asks for clarification
  • Uses some politeness terms or markers
  • Begins to demonstrate some adaptation of speech to different listeners

3-4 years:

  •  Initiates play with other children regularly and participates in make-believe play
  • Participates in simple board games (share and take turns) with minimal adult interaction needed
  • Understands that others can want different things
  • Engages in longer dialogues and terminates conversation
  • Anticipates next turn at talking
  • Uses fillers—such as yeah and okay—to acknowledge a partner’s message
  • Begins code-switching and uses simpler language when talking to very young children
  • Makes conversational repairs when not understood and corrects others

4-5 years:

  • Adjusts the complexity of their communication style depending on the age of their conversational peers
  • Understands and uses humor with their peers
  • Enters a conversation, takes 2 turns on the same topic, changes the topic, and leaves the conversation.
  • Answers questions in school
  • Develops basic understanding of Theory of Mind
  • Shifts topics rapidly

When reading a story choose a book that includes repetitive lines to have your child say

Provide the child if they are nonverbal with a means to say the repeated line at the appropriate time in the story line (Big Mack, using their device, etc.)

 Examples of books with repetitive lines:
  • Pete the Cat books by Eric/Dean Litwin
  • Brown bear brown bear what do you see by eric carle
  • Green Eggs and Ham by Dr. Suess
  • The little caterpillar by eric Carle
  • The Little Old Lady who swallowed a trout by Terri Strout
  • Chicka Chika Boom Boom by Bill Marin Jr.
  • The Little Old Lady who wasn’t afraid of anything by Linda Williams

Choose songs that include repetitive lines to have your child say:

¨  Examples of songs with repetitive lines:

  • Old McDonald
  • Five Little monkeys
  • Itsy bitsy spider
  • Twinkle Twinkle little Star
  • Fire truck song
  • Happy and you know it
  • Wheels on the bus

Board games are great for facilitating social skills:

¨  Variety of social skills can be addressed during these games depending on where the child is developmentally.

  • Sharing
  • Requesting a desired item from an adult and/or peer.
  • Waiting your turn
  • Requesting for a turn
  • Learning to wait for a turn

¨  Board games are also a great way to help expand your child’s language (i.e.: requesting for a specific color game piece) and work on different concepts (i.e.: colors and shapes).

  • Some examples of great board games to play:
  • Cranium Cariboo
  • Pop-up Pirate
  • Candy Land
  • Don’t wake Daddy
  • Hi-ho cheerio
  • Connect 4

Playing with a ball is great for working on….

  • Requesting for turn with the ball.
  • Sharing
  • Grabbing the attention of the intended listener
  • Verbs
  • Child learns to wait for turn

Increasing social skills on the playground…

  • Asking friends to go on tire swing together
  • Asking for turns on bike/cars
  • Touching a picture to request turns on swing, etc. for nonverbal communicators.
  • Play group games:
  • Hide and seek
  • Tag
  •  Jump rope

Elizabeth Haftl has been a speech therapist for 1 year, working in a variety of pediatric settings in Delaware, Maryland, and Pennsylvania during her graduate school practicums and as a clinical fellow. She graduated from Towson University in Maryland in May of 2013. She has been with Easter Seals in the Delaware County Division working with children in the Reverse Mainstream, Autistic Support, Multiple Disabilities, and Developmental Delay classrooms. Her favorite aspect of her current job is the ability to create positive changes in the lives of the children she is working with.  Beth loves to kick box and enjoys going to amusement parks.