Communication
Wednesday, November 30, 2011
Carly's Voice
This is a worthwhile video to watch. It will make you smile and cry at the same time. This video is about a young girl with autism who was non verbal. She would often have outbursts that were difficult to control. She had therapy from a very young age and they saw little progress. She had no speech and was not able to communicate at all. At the age of eleven she went over to a computer and began typing words. Her first word was hurt and than help. Right after that she had gotten sick so she was trying to express that she was not feeling well. It is amazing how this girl began to communicate through her computer and not just for her wants and needs but her feelings and how she perceives the world around her. It is yet another example how people with autism have so much to say but simply need the means to say it. It is an amazing video that I recommend for everyone to take a moment to view. To look more into Carly's life here is the link to her website.
http://carlysvoice.com/
What are the Social implications for students who Use Augmentative Communication?
Communication is a basic human need, and the ability to interact with communication partners is a critical skill for all including those who use augmentative and alternative communication (Simpson, Beukelman, and Sharpe, 2000).
We have looked at the different types of augmentative communication and what to consider when choosing a device. In doing this research I believe it is important to look at the social aspect for students who use AC. In the study conducted by Simpson et al (2000), they looked at the interactions between a student with severe expressive communication impairment with his peers, aide and teacher.
In this study we saw that the majority of interactions were between the student (Seth) and his aide. There were really no interactions with the teacher and only a few with his peers. The student relied on the aid to initiate the interactions as the aid produced 60% of the interactions and the student produced 40%. His peers would most likely not be comfortable with initiating conversations and may shy away from interacting with Seth. I think other students need to have some training in how to respond and allow time for the student to respond with thier device. It is important to allow the class to see the teacher and/or aide interacting with the student using the device.
From my experience students will often times become dependent on their aides and will be very passive only interacting when a question is posed to them and will often times avoid turn taking. I have only had experience with younger students in the lower elementary grades who are just learning to use augmentative communication devices. It would be very interesting to follow a child throughout their schooling to see how these social situations may change as they become more proficient with the device and the students are older and more mature.
Another factor to consider is that students who use augmentative communication may very well be perceived as different by their peers (Beck et al. 2000). Children who may be different in some way, whether it be thier motor skills, speech etc; are often looked on as different and therefore treated differently. Research indicates that as early as preschool, children perceive peers with physical , communication, and/or cognitive disabilities as different form themselves (Beck et al. 2000). Children will often use these differences to discriminate against thier thier peers with disabilities (e.g. children may not ask or allow, children with disabilities to praticipate in activities).
Having had the opportunity to teach in most grades in the elementary level I have observed the interactions of many specail needs students with thier peers. I have to say that I disagree with some of these findings. The research showed that attitudes toward people with physical disabilities tends to be negative in young children and to become more positive with age until the late teens. At this time, they again become more negative (Beck et al. 2000).
I have found that children in the lower grades especially primary/one are quite accepting of students who may be different. They are usually quite willing to assist the student and interact with them, they love to be the "helper". As they get older I have found that they tend to draw back from them. In the middle grades that is when students are really forming thier peer groups and often times these students are left out. In saying that I don't often see students as a 'friend' but more as a 'helper'. When it is time for free play often times students with specail needs are left out. Teachers will often pair students up for social skill training but in my experience they don't tend to from close friendships. This of course isn't always the case but it is what I have observed. I find as students get older the cognitive levels of the students with special needs and their peers tends to be a bigger difference which may be why there is not as much social interaction. As students mature they gain more empathy towards those that are different but I don't see that happening to well into high school.
One other point I think that is worth mentioning and I believe plays a big part and that is how familiar an comfortable students are with those that are different. I think that when children are familiar with interacting with those that are different. I have even found some adults who have not been around students with special needs they tend to shy away from them and they don't know how to act around them. It is common for people to be scared of the unknown. I grew up with 2 cousins with special needs and one who visably looked 'different'. it amazed me how people that didn't know her treated her and looked at her. It would really make me mad as to me she was no different.
The big question would be how do we change this? I don't think there is any easy answer to this question. we do our best to teach our children to accept those that are different and include everyone in what we do. We ust advocate for everyone so that they are included in our daily lives. Having integrated classes is very important so that students can gain that empathy towards others and treat them with respect.
A success Story
Beck, A., Fritz, H., Keller, A., and Dennis, M. (2000). Attitudes of School-Aged Children Toward Thier Peers Who Use Augmentative and Alternative Communication. Augmentative and ALternative Communication, Mar 2000; 16,1, 13-26.
Simpson, K., Beukelman, D., and Sharpe, T. (2000). An Elementary Student with Severe Expressive Communication Impairment in a General Education Classroom: Sequential Analysis of Interactions. Augmentative and Alternate Communication, Jun 2000; 16, 2, 107-121.
We have looked at the different types of augmentative communication and what to consider when choosing a device. In doing this research I believe it is important to look at the social aspect for students who use AC. In the study conducted by Simpson et al (2000), they looked at the interactions between a student with severe expressive communication impairment with his peers, aide and teacher.
In this study we saw that the majority of interactions were between the student (Seth) and his aide. There were really no interactions with the teacher and only a few with his peers. The student relied on the aid to initiate the interactions as the aid produced 60% of the interactions and the student produced 40%. His peers would most likely not be comfortable with initiating conversations and may shy away from interacting with Seth. I think other students need to have some training in how to respond and allow time for the student to respond with thier device. It is important to allow the class to see the teacher and/or aide interacting with the student using the device.
From my experience students will often times become dependent on their aides and will be very passive only interacting when a question is posed to them and will often times avoid turn taking. I have only had experience with younger students in the lower elementary grades who are just learning to use augmentative communication devices. It would be very interesting to follow a child throughout their schooling to see how these social situations may change as they become more proficient with the device and the students are older and more mature.
Another factor to consider is that students who use augmentative communication may very well be perceived as different by their peers (Beck et al. 2000). Children who may be different in some way, whether it be thier motor skills, speech etc; are often looked on as different and therefore treated differently. Research indicates that as early as preschool, children perceive peers with physical , communication, and/or cognitive disabilities as different form themselves (Beck et al. 2000). Children will often use these differences to discriminate against thier thier peers with disabilities (e.g. children may not ask or allow, children with disabilities to praticipate in activities).
Having had the opportunity to teach in most grades in the elementary level I have observed the interactions of many specail needs students with thier peers. I have to say that I disagree with some of these findings. The research showed that attitudes toward people with physical disabilities tends to be negative in young children and to become more positive with age until the late teens. At this time, they again become more negative (Beck et al. 2000).
I have found that children in the lower grades especially primary/one are quite accepting of students who may be different. They are usually quite willing to assist the student and interact with them, they love to be the "helper". As they get older I have found that they tend to draw back from them. In the middle grades that is when students are really forming thier peer groups and often times these students are left out. In saying that I don't often see students as a 'friend' but more as a 'helper'. When it is time for free play often times students with specail needs are left out. Teachers will often pair students up for social skill training but in my experience they don't tend to from close friendships. This of course isn't always the case but it is what I have observed. I find as students get older the cognitive levels of the students with special needs and their peers tends to be a bigger difference which may be why there is not as much social interaction. As students mature they gain more empathy towards those that are different but I don't see that happening to well into high school.
One other point I think that is worth mentioning and I believe plays a big part and that is how familiar an comfortable students are with those that are different. I think that when children are familiar with interacting with those that are different. I have even found some adults who have not been around students with special needs they tend to shy away from them and they don't know how to act around them. It is common for people to be scared of the unknown. I grew up with 2 cousins with special needs and one who visably looked 'different'. it amazed me how people that didn't know her treated her and looked at her. It would really make me mad as to me she was no different.
The big question would be how do we change this? I don't think there is any easy answer to this question. we do our best to teach our children to accept those that are different and include everyone in what we do. We ust advocate for everyone so that they are included in our daily lives. Having integrated classes is very important so that students can gain that empathy towards others and treat them with respect.
A success Story
Beck, A., Fritz, H., Keller, A., and Dennis, M. (2000). Attitudes of School-Aged Children Toward Thier Peers Who Use Augmentative and Alternative Communication. Augmentative and ALternative Communication, Mar 2000; 16,1, 13-26.
Simpson, K., Beukelman, D., and Sharpe, T. (2000). An Elementary Student with Severe Expressive Communication Impairment in a General Education Classroom: Sequential Analysis of Interactions. Augmentative and Alternate Communication, Jun 2000; 16, 2, 107-121.
Saturday, November 26, 2011
Meet Larry and Tracy
The first time I was introduced to Tracy and Larry was in my Disabilities class this summer. We had the opportunity to watch the full movie and it was amazing. Larry and Tracy are two men with autism who travel the world with thier assistants to spread awareness for autism. They speak at conferences with the aid of their computers and assistants and bring hope to many families who have children with autism. their main objective is to let people know that they are people first adn that they have much to offer.
Both Larry and Tracy have very limited speech and can communicate some basic needs verbally but when they speak at conferences and to groups they use laptop computers. They type thier own message and their assistants read it to the public.
On thier journey in the movie we also meet others who are able to fully communicate using assistive technology. We see how they have so much to share but are just not able to speak it. If you have the opportunity to watch this movie please do, it is inspiring!!
Where Do We Start?
I think one of the biggest challenges is to decide what device is best. There has to be an intensive assessment done prior to the decision. When a school decides that a student needs to use an augmentative communication device they have an assistive technology specialist come in the school to do an assessment. After the assessment there is a team meeting to discuss the best options.
The following are some areas that have to be considered when deciding what device to use.
1) Expressive Communication
What does the student currently use to expressively request objects, continue an action, stop an action, request social interaction, express a feeling, make a
choice, initiate an interaction, terminate an interaction, or request assistance?
2) Cognitive Abilities
Does the student have object permanence? Do they understand cause and effect or means-end actions? What type of symbolic representation (object, picture, line drawing, words) do you think the student best understands?
3) Motor Skills
5) Auditory Skills
It is also important to take into consideration where the communication is going to take place most frequently. In the beginning the communication system may be used mainly in home and school. The Assessor needs to take into account the noise level and number of distractions when deciding what communication device to use.
The following are some areas that have to be considered when deciding what device to use.
1) Expressive Communication
What does the student currently use to expressively request objects, continue an action, stop an action, request social interaction, express a feeling, make a
choice, initiate an interaction, terminate an interaction, or request assistance?
2) Cognitive Abilities
Does the student have object permanence? Do they understand cause and effect or means-end actions? What type of symbolic representation (object, picture, line drawing, words) do you think the student best understands?
3) Motor Skills
Does the student have a hand preference and are they able to reach, grasp, grasp and release, isolate a finger, and/or point? In what position is the student able to move and respond? What reliable, predictable motor movements does the student have?
4) Visual Skills
What is the student's visual acuity? What is the best lighting/contrast needed? Can the student fixate on an object and at what distance? Does the student know how to scan? How many items can the student scan and how long does it take them?
At what decibel level and frequency levels does the student hear best? Can the
student localize to sound? Do they seem to like auditory feedback?It is also important to take into consideration where the communication is going to take place most frequently. In the beginning the communication system may be used mainly in home and school. The Assessor needs to take into account the noise level and number of distractions when deciding what communication device to use.
Once these things are addressed the environments where communication will occur need to be looked at. Will it be in a quiet room or a noisy classroom? The next step is to identify the types of communication the student will need in order to actively participate in the daily activities in those environments. In addition to the student's basic needs (e.g., eat, drink, toilet), the assessor may also want to consider greetings, initiations, requests of an activity, social interactions, requesting assistance, or expressing feelings.
Dymond, Stacey. (1995). Augmentative COmmunication Assessment. Retrieved November 26, 2011 from
http://www.arslpedconsultant.com/documents/Handouts%20Two%20Reviews/Augmentative%20Communication%20Assessment.pdf
Dymond, Stacey. (1995). Augmentative COmmunication Assessment. Retrieved November 26, 2011 from
http://www.arslpedconsultant.com/documents/Handouts%20Two%20Reviews/Augmentative%20Communication%20Assessment.pdf
Thursday, November 24, 2011
What is "low tech" commnication devices
Low tech communication devices are any device that does not involve electronics or electricity. Because low tech systems do not require batteries or becuase there is no electronic parts there is no option for voice output. The person using the device must rely on what is called "listener mediated" output. Basically the ‘listener’, or communication partner ‘reads’ what the augmented communicator is indicating and translates it. Low-tech communication systems require both the user and thier communication partner to be actively involved in the interaction. The responibility for acheiving effective communication is shared, with the listener taking a substantial part in working out the final message.
Scott, Janet (1998). Low Tech Methods of Augmentative Communication. Augmentative Communication in Practice: An Introduction. Retrieved November 24, 2011 from http://www.acipscotland.org.uk/Scott.pdf
The student using the communication system would have to indicate to thier partner which symbol, letter or word is being selected. This can be achieved by simply pointing or for a student with physical limitations they may have to point with their eyes. Other augmentative communication users may use light pointers (perhaps worn on a sweat band around their head) to access a communication display, while some may use head or mouth sticks or hand-held pointers.
Here is a student using his feet to select letters. Some students may use thier head by tilting it side to side to select,or thier feet or simply eye gaze. It is necessary that thier partner pays close attention to what is selected so the student can communicate thier needs. These communication systems would be difficult to have back and forth conversations as it would take a long time for the student to say a full sentnece. It is more used for getting wants and needs addressed. For students with poor motor control it could be very frustrating for them. A student at my last school used her eyes to communicate. It was mainly for yes/no questions. If her answer was no she would look to the right and if it was yes she would look to her left.
The following are some types of low tech communication systems that students may have:
Communication Boards
Symbols on communication boards are displayed on a 2-dimensional matrix. The actual size of the communication board depends on the physical ability of the user and thier needs. Boards can be made for different activities so that the student could have numerous boards for communicating. These boards are easy to make. Boardmaker is a very user freindly progam that allows teachers to make grids from one to two pictures up to twenty or more pictures.
Scott, Janet (1998). Low Tech Methods of Augmentative Communication. Augmentative Communication in Practice: An Introduction. Retrieved November 24, 2011 from http://www.acipscotland.org.uk/Scott.pdf
The student using the communication system would have to indicate to thier partner which symbol, letter or word is being selected. This can be achieved by simply pointing or for a student with physical limitations they may have to point with their eyes. Other augmentative communication users may use light pointers (perhaps worn on a sweat band around their head) to access a communication display, while some may use head or mouth sticks or hand-held pointers.
The following are some types of low tech communication systems that students may have:
Communication Boards
Symbols on communication boards are displayed on a 2-dimensional matrix. The actual size of the communication board depends on the physical ability of the user and thier needs. Boards can be made for different activities so that the student could have numerous boards for communicating. These boards are easy to make. Boardmaker is a very user freindly progam that allows teachers to make grids from one to two pictures up to twenty or more pictures.
Communication or Conversation Books
In a communication book symbols are displayed on pages of a binder or photo album. The communication books can allow a number of items to be stored in a relatively small space and easily transported with the student. For young students these books can be on a strap that the student wears across thier shoulder. These books can be used as an introductory before the student moves on to the "high tech" communication systems.
Topic Boards
Topic boards are restricted vocabulary of symbols that are displayed on a 2-dimensional matrix. The vocabulary set is topic specific, for instance the board on the left is specific to Valentine's Day and can be used to help plan activities.
Topic Boards
These low tech choices are just a few that are available for students. As I look at these and some high tech devices it is easy to see the benefits of both. Both systems could be costly, For the communication boards there would be the need to be constantly making new symbols and boards as the curriculum changed. To have them last longer they would need to be printed on cardstock and laminated to ensure they would last. The high tech devices would be costly and only one student can use it at one time.
Pyramid Educational Consultants. Retrieved on November 24, 2011 from
http://www.pecs.org.uk/shop/asp/prodtype.asp?prodtype=7
Pyramid Educational Consultants. Retrieved on November 24, 2011 from
http://www.pecs.org.uk/shop/asp/prodtype.asp?prodtype=7
More technology....
There are many high tech systems used for augmentative communication but there are also many low tech devices that are used by some children. There are many advantages and disadvantages to using these high tech devices. The systems may not be as portable as a small iPod or iPad and would be heavy for children to carry around. This would not be an option for some. It would be difficult for some children to use these devices independently as many children would have poor fine motor control. Below are some devices that can be used for communication.
Intellikeys
Intellikeys means physical, visual, and cognitive access for people with a wide range of disabilities. IntelliKeys is an alternative keyboard that plugs into any Macintosh or Windows computer. It’s an ideal solution for students who have difficulty using a standard keyboard.
There are 6 basic layouts that can be fitted into the device. The overlays feature large, well-spaced keys in high contrast colors to make it easy for students to locate letters and numbers. Each represents a different keyboard configuration to facilitate physical and cognitive access.
A special set-up overlay allows you to customize settings such as the response or repeat rate to ease access for students who tend to press more than one key at a time or keep their finger on a key too long.
IntelliKeys becomes an even more powerful communication tool when you design your own curriculum activities and custom overlays using Overlay Maker, Intellitalk, Intellipics, and ClickIt! .
Intellikeys is fairly easy to use, software is downloaded onto the computer and the computer can read what overlay you have selected. If there is a fine motor issue than the large keyboard will help those students and it acts like the regular keyboard. If the student only requires the arrow kieys there is an overlay for that and those keys are the only ones they can select. This device can be used to help students communicate but also access the computer to do assignments or play games.
Assistive Technology Online Project. (2000-2005). Intellikeys. Retrieved November 24, 2011 from http://atto.buffalo.edu/registered/Tutorials/intellikeys/index.php
Intellikeys
Intellikeys means physical, visual, and cognitive access for people with a wide range of disabilities. IntelliKeys is an alternative keyboard that plugs into any Macintosh or Windows computer. It’s an ideal solution for students who have difficulty using a standard keyboard.
There are 6 basic layouts that can be fitted into the device. The overlays feature large, well-spaced keys in high contrast colors to make it easy for students to locate letters and numbers. Each represents a different keyboard configuration to facilitate physical and cognitive access.
A special set-up overlay allows you to customize settings such as the response or repeat rate to ease access for students who tend to press more than one key at a time or keep their finger on a key too long.
IntelliKeys becomes an even more powerful communication tool when you design your own curriculum activities and custom overlays using Overlay Maker, Intellitalk, Intellipics, and ClickIt! .
Intellikeys is fairly easy to use, software is downloaded onto the computer and the computer can read what overlay you have selected. If there is a fine motor issue than the large keyboard will help those students and it acts like the regular keyboard. If the student only requires the arrow kieys there is an overlay for that and those keys are the only ones they can select. This device can be used to help students communicate but also access the computer to do assignments or play games.
Assistive Technology Online Project. (2000-2005). Intellikeys. Retrieved November 24, 2011 from http://atto.buffalo.edu/registered/Tutorials/intellikeys/index.php
Thursday, November 17, 2011
Communicating using the iPod Touch
One of the newer forms of communication for students is using the iPad or iPod Touch. We are only recently seeing them in schools. Throughout our course we have had the oppotunity to learn more about the iPod and what it is capable of doing. One positive aspect of the iPod Touch is that it is very portable and the student can carry it anywhere's. Some studentscan wear it on a strap around thier neck so that it is easy to access but not in the way. The iPod can be used for learning, communicatng between home and school and a schedule for the students.
Two summers ago I took an assistive technology course and we were introduced to the program proloquo2go. It is a costly app but allows the student to communicate independently. This program allows you to have many layers so each subject can have it's own seperate board and also one for home, wants/needs and greetings to name a few. It is very hard to show exactly how amazing this program is. For the beginner it can be very basic and as the student progresses more layouts can be added so the student can communicate in many more settings.
In my school we have a student in grade six who has Downe Syndrome and is non verbal. He has just recieved an iPad with this program. I am looking forward to watching his progress and that of his teachers as he learns to communicate with his peers. It is very exciting to watch a child get his voice, it opens up a whole new world.
This device will work with many students but if there are fine motor issues the iPod Touch may not be the appropriate choice. It requires the student to be able to point to small areas and to also have to swipe from board to board. Many students with cerebral palsy do not have that fine motor control. FOr these students an alternate form of augmentative communication would be necessary. In my next blog I will look at communication devises that are better suited for students with fine motor issues.
How things have changed?
If I sit back for a moment and think how Assistive Technology has changed I wouldn't know where to start. There are some items that really haven't changed much and other forms of communication that have taken on a very high tech approach.
My initial experience with augmentative communication really did not allow for conversations that allowed turn taking but was a way for the child to communicate his/her wants and needs. For example they would push a switch and a pre-recorded voice would say "I need to go to the bathroom" or "can I have a drink please". The child may have a 3 switch apparatus where there may be a greeting and response but there would be no way to continue the conversation. For this project I am going to look at how far communication has come and ways to help students be able to commnicate more freely with thier peers independently. I plan to also look at the social aspect for students who are non verbal and rely on augmentative communication for their voice. Are they socially accepted by thier typically developing peers? I hope to discuss some of the newer technology that is out available and any controversies that may exist.
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