Apr
30

What You See May Not Be What You Get

For this week's blog, I'm beyond delighted to share an incredible story of a student's communication journey to success experienced by my AEMing for Achievement grant team in Perry Township. I'd like to thank two members of the grant team, Callie Herrenbruck and Kelsey Norris, for their collaboration in sharing this story. Please enjoy!

I have this student. You most likely have one, too. This student is what I would call a communication conundrum. It’s not that this student doesn’t communicate, because he most certainly does, but when asked if unfamiliar individuals understand what he is attempting to communicate? Probably not.

Student from blog seated and smiling
This student most often communicates to express enjoyment, request preferred objects and actions, and refuse non-preferred activities and objects. He does not (YET) verbalize but will vocalize using a variety of pitches depending upon the context. He moves his body to convey his refusals and moves others to make his requests. This student’s laugh is one of the most infectious ones I’ve ever heard, but when he is upset he has significant self-injurious behaviors.

I, along with this student’s teachers, other therapists, and paraprofessionals were constantly attempting to find the “magic tool” for communication. This is where we have all thanked our lucky stars that our school district was one of the AEMing for Achievement Grant recipients, as being a part of the grant includes a communication package!

Members of our grant team and the teacher of record (TOR) met with Jessica Conrad for an in-depth problem-solving session. Several topics were discussed during the session including behavior(s), motivators, previous trials, and goals. The best part of the session was having someone from PATINS who is extremely knowledgeable about communication and communication tools, along with having access to a variety of resources, share their knowledge with the team.

Following the problem-solving session with Jessica and members of the grant team, this student’s TOR, and the rest of his team, put the suggestions to work. One of the suggestions was to use a mid-tech device (Logan ProxTalker). The device was borrowed from the PATINS Lending Library. Almost immediately, this student “picked up” use of the device to request desired objects and actions. He had NEVER done this with any other communication tool! Absolutely amazing! This student’s family then met with the team to learn more about the Logan ProxTalker-- how the student uses it at school, and what the next steps would be in obtaining his own device. Upon seeing this student use the device, they were blown away, to say the least! Watching their reaction to him using the device was one of the best moments in my career.

This student continues to appear to prefer using the Logan ProxTalker, as opposed to other communication tools to make requests. I will be honest and say that he does not love communicating with the device every day. He may even meander away when prompted to use it, but don’t we all have our days?

Student from blog seated in classroom pursing lips in disapproval
So, is what you see really what you get? ...not necessarily. If you didn’t know this student, you might see him putting cards on a machine and the machine talking. What you don’t see is the progress he’s made in being able to effectively communicate his wants and his likes/dislikes. You might not see him participating in joint attention with an adult regarding his interests, and you might not see the relief his parents show when this student demonstrates growth in his communication! Thanks again to PATINS for helping our team and this student to grow in his communication capacity. As the Starfish Story says, “It made a difference to this one!”

Written By: Kelsey Norris and Callie Herrenbruck, Perry Township Schools | Pictures used with parent permission
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Apr
01

SETTing Students up for Success and Counting Every Move for Communication


5 min read

Artist Name - SETT-Blog-Audio.m4a


Boardmaker symbol of frustrated young man with the printed word frustrated

I've been working with a student and his team. They have moved successfully albeit slowly through using the tools below. At some point a few years ago, this student was evaluated and deemed to be a candidate for a dedicated speech generating device (SGD) with eye gaze (very expensive but a key part of a communication system for the right person). His team (student, parents, teachers, SLP, OT, PT and support staff) was keen to make his SGD work for him. The student has cerebral palsy that reduced his limb movement/accuracy, so much time had already been invested AND after all, this solution was expensive.

Why change? This can be awkward. How do you bring up the topic of a significant change to access and trajectory of the student's goal/language programming? Two things; the eye gaze never really worked as well as expected AND the student became increasingly frustrated often abandoning the device. Eye gaze could be revisited but it was important to recognize that it was not working. Time to think about the S - Student, his M - Moves, his C - Clicks and his C - Chats. More about that later.

Head control/calibration were hurdles interfering with access. Using the tools mentioned below, this student demonstrated enough consistent and accurate improvement to control switches with his head and hand for scanning. His language setup was changed (Core Scanner on an Accent 1400) to work more efficiently with two switch scanning (i.e., he presses one switch to move through icons and the other switch to select his word).

He is reportedly thrilled with his new access method. He smiles more and enjoys communicating often producing spontaneous sentences.

excited preschool girl with open hands raised near her face looking at device screen

First of all, you must gather data. If you don't have data, it's just your opinion.  

I sometimes hear that students "inconsistently respond" to stimuli or questions, it "depends on how they are feeling", "if they're in the right mood", "they are being stubborn", etc. Maybe. Perhaps we have not presented motivating stimuli, observed the tiniest of responses,  offered the most appropriate access method, or given the student adequate wait time.

SETT is an acronym for Student, Environments, Tasks, and Tools created by Joy Zabala. It is a FREE resource. "Although the letters form a memorable word, they are not intended to imply an order, other than that the student, environments, and tasks should be fully explored before tools are considered or selected. Some people have tried to explore the first three separately and in order, however, that is nearly impossible because the first three are closely linked." The SETT Framework is so important, it's at heart of our process for the PATINS AAC Consultation Request form.

Another important tool to set the groundwork is the Every Move Counts, Clicks and Chats sensory based approach (EMC3). It is available to borrow from the PATINS Project Lending Library. EMC3 is a sensory-based communication program. It is based on the idea that everyone communicates in some way. The COUNTS Assessment explores sensory, communication, and symbols. The are seven sensory areas: vestibular, proprioceptive, tactile, visual, auditory, olfactory, and gustatory. The CLICKS Assessment looks for purposeful switch use. The CHATS Assessment is used to collect communication skills. It states that "Assessment results are seldom 'final'. Needs, abilities, and environmental demands change over time."

A third tool useful for SETTing students up for success is to establish a baseline for communication skills and determine goals. The Communication Matrix is an online/questionnaire tool for anyone in the early stages of communication. The first 5 assessments are FREE. Communication is more than just receptive and expressive, students also need methods to refuse, obtain items, socialize, and gather/share information. These functions of communication can be measure/quantified by using the Communication Matrix.

Hand in hand with these pieces is understanding the absolute need for flexibility, continuous learning, and ongoing assessment with students. It is a fluid process that can and should be revisited periodically as the student changes, technology changes or when things stop working as well as they had in the past.

SETT your students up for success. Use the SETT, EMC and Communication Matrix to better understand the student, environment, tasks/needs, sensory responses, access abilities AND communication skills. THEN consider the T - Tools to empower your students and goals for success. If the tools don't seem to be working, collect data and try something else!

If you would like to learn more, check the PATINS Project training calendar or reach out to a PATINS Project Specialist for more information.

The PATINS Project Tech Expo is fast approaching - Thursday, April 15, 2021. It's FREE. Get registered!

Additional resources:

SETTing Up Successful AAC Use - Lauren Kravetz Bonnet, PhD, CCC-SLP

The Dynamic AAC Goals Grid DAGG-2

Symbol Assessment

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Nov
28

This Blog Post is Full of Curse Words

This Blog Post is Full Of Curse Words Icon for various forms of AAC with the large black font reading
About once a month I have to answer a really important question:

“Why is that word on his talker?”

“That word,” is our euphemism for any number of words: body parts (slang and clinical), fart sounds, curse words, words that are culturally irrelevant, childish, or inappropriate for a child [of his age/place where he is/supposed cognitive level]. And someone, somewhere, decided to program it on this child’s Augmentative and Alternative Communication (AAC) device as if encouraging the child to use inappropriate language.

I get it. When I imagined the magical moment of helping a student find her voice with the fancy new Sound Generating Device, I wasn’t expecting her first two-word phrase on her device to be “poop butt” repeated over and over again for the next three days, either.

I get it, I really do! We’re professionals trying to create engaging and enriching environments for our learners and the literacy activity has been derailed because we taught him how to make plurals on his talker and now he loves pluralizing the word “as.”

We admit we’re impressed, but we can’t let that slide.

In moments of “enriched language” that flusters me I take a deep breath and remember:

I am not the language police.

A larger-than-anticipated part of my job has been talking about cuss words. And promoting cuss words. And explaining the functional importance of having access to cuss words. And listening to and programming cuss words into communication devices. And explaining why adults can't delete cuss words and "adult vocabulary" from a kid's voice. And listing all culturally relevant cuss words. And finding good visuals for cuss words.

If my professors could see me now.

So what happens if she talks out of turn, pressing the buttons on her communication app? The same thing that happens to all the other students talking out, of course.

What happens when she won’t stop saying “poop butt”? The same thing you would do for any other child who says it. We don’t duct tape kids mouths, and we don’t take talkers away.

What happens when she uses swear words in class? The same thing that you do for any other student who cusses in class. We can’t forcibly remove words from a speaking child’s vocabulary. We teach, we consider the variables, and we provide natural consequences. We don’t delete words from the communication device.

It is work worth doing, with clear expectations, communication between school and family (and sometimes with the office door closed and the volume down really low as you check to make sure “#$!@” is pronounced correctly). The communication device is a voice, not a school textbook or a representation of just the words you hope or anticipate they’ll use today. It’s their access to their human right to communicate, and sometimes communication is colorful, shocking, or uncomfortable.

Do you agree or disagree with me? Let me know in the comments below, with any language you like.*

*natural consequences apply

The icon AAC in my title image is from ARASAAC, a no-cost Creative Commons license resource for symbols and icons to represent all words (even “those words”).
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Recent Comments
Guest — Alyssa Haller
I read these blog posts every week, but this one has to be my favorite! It is so true, at times hilarious and frustrating! Explain... Read More
Thursday, 29 November 2018 08:26
Jessica Conrad
Thank you Alyssa! I agree it can be so hard to change minds. We need to have patience, compassion, humor, and allies in all corner... Read More
Thursday, 29 November 2018 21:47
Guest — Cheryl Fletcher
love this. Clients will find a way to make “those words” anyway like she and it! We should make a collection of client creativity ... Read More
Saturday, 01 December 2018 10:16
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