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Transcript of Current, Best Strategies for Speech- Language Pathologists to Help Students with Augmentative...
![Page 1: Current, Best Strategies for Speech- Language Pathologists to Help Students with Augmentative Alternative Communication Needs MariBeth Plankers, M.S.,](https://reader030.fdocuments.us/reader030/viewer/2022032600/56649db25503460f94aa19bb/html5/thumbnails/1.jpg)
Current, Best Strategies for
Speech-Language
Pathologists to Help
Students with Augmentative
Alternative Communication Needs MariBeth Plankers, M.S., CCC-SLPRegional Area Technology CenterMinnesota State University MoorheadMoorhead, Minnesota
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AgendaAM
8:30 Introduction
8:45 AAC General Info
8:55 Levels of Technology
9:30 Assessment
10:00 Break
10:15 Goals and Objectives
10:30 Vocabulary Selection
11:15 Collaboration
11:15 Planning Process
PM
11:45 Lunch
1:00 Literacy and AAC
1:30 Accommodations/Modifications/VI, OT, PT
2:10 Alternate Access
2:30 Autism Spectrum/Visual Strategies
3:05 Wrap up/Questions
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Handbook Tour Addressing Questions and Introduction of Program Manager
TABLE OF CONTENTS
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A Gift!
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Qualities of the Gift
Immediate
Accessible
Dynamic
In Control
Emotions
Reflective
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It defines who we are as a person. The gift is…
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The Ability to Communicate
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“I wonder…..” The rest of the story to be told…..
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AAC General Information
What does AAC mean to you as an SLP?
Page 1
AAC RESOURCES Sticker reminder! Page 2
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CommunicationsUnaided
Gestures
Body Language
Facial Expressions
Sign Language
Aided
Low-Tech
Mid-Tech
High-Tech
Electronic Communication Systems
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Levels of Technology
Page 5
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Initial ConsiderationsThe Model
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Model to AAC Guidelines
Student related AAC Options
Environmental Barriers
AAC Task Requirements
Goals
Multiple Modes
Team Decision
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AAC Options Student related
Accessibility
Cognition
Purpose
Function
Compatibility for setting/situation
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Eliminate the Inappropriate
OptionsTech Level
Size
Vocabulary
Mounting
Dated
Student changes
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AAC Task Requirements
Communication Functions
Academic
Social/Emotional
Gaining Attention
On-going Communication
Multi-media
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Goal DrivenWhat is the overall goal?
Benchmarks to determine
Setting/Situation
People: Friends, family, school, community, vocational
Personal
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Multiple Mode Considerations
Gestures
Signing
Eye Gaze
Facial
Pictures/Graphics/Text
Speech Generating Devices
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Team Decision Process
Student
Parent/Guardian
Agency
School Staff: General/Special Ed.
Community
Vocational
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Levels of AAC Technology
Page 6
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No-Tech Considerations
Page 6
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Gestures, Facial, Signing
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Scavenger Hunt
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Low/Mid-Tech Considerations
Page 7
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High-Tech Considerations
Page 8
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Aided Language Stimulation
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Aided Communication Strategies: 101Handbook
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The AAC Expert Learner, we must
show: How to use their system
How to communicate
How to use other modes of communication in conjunction
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Key Aided Language Strategies
Allow for a model of communication to occur
Find strong areas of interest
Give feedback through various models: verbal, visual, tactile
Create numerous opportunities
Utilize stucture and routine throughout day
Consider wait time
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Create multiple means of engagement.
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Create multiple means for representation.
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Create multiple means for action and expression.
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Assessment Process
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AAC Assessment
On-going process
Team supported
Leads to intervention planning
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Include in the AAC Assessment
Student information
Environmental barriers and strengths
Modes/methods of communication
Current and considered interactions
Tasks to achieve
Tools for consideration
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Interview the IEP team
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Participation Model
SETT (Student, Environment
Task and Tools)
Every Move Counts Clicks and Chats
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Benefits of Participation ModelThere is a need for continuation
of intervention planning and implementation due to change in
on going communication.
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Assessment Segments Note the current communication abilities and needs, in addition to the expectations in the environment.
Identify a communication systems that will support the student in new communication settings/situations.
Continue to support the system with changes as needed based on abilities and changes with the student.
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Participation Model Process
Participation Patterns
Communication Opportunities
Participation Comparison
Barriers: Opportunity and Access
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Participation Model Benchmarks
1. Identify a target activity (Twirl painting)
2. List the steps of the activity
3. Observe typical peers’ ability and performance and then rate the potential AAC individual’s level of independence.
4. Indicate if a difference is noted between the typical peer and the observed AAC individual’s performance.
5. Document which barriers inhibit participation.
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Participation DocumentationLevels of Participation
Note the range from independent to no participation.
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Types of BarriersOpportunity
Policy
Practice
Attitude
Skill
Access
Message Selection
Vocabulary
Symbols
Other notations
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Intervention Planning
1. Opportunities are given to the student (time)
2. Demonstrate clarification of student’s ability
3. Accessibility is ready and always available
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Intervention continued
4. AAC systems are readily accessible for quick and easy communication
5. Intervention may also include changes in the environment
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SETT
Student
Environment
Task
Tools
Pgae 16
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Benefits of Using the SETT
It is sequential
Driven by student needs
Supported by the environment and tasks
Tools are considered last
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Example of Student questions
What does the student need to do, but is currently unable to do?
What are the student’s strengths, abilities, accomplishments, motivators and unique needs?
What strategies and accommodations have been successful?
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Examples of Environmental
questionsWhat environments are typical for the student to complete IEP tasks along with materials available?
What is the physical and instructional arrangements?
What current supports and resources are available to the student and Team?
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Examples of Task questions
What are the natural occurring activities that take place in the environment that are critical to the student?
What are other ways of completing the task?
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Tools
What might be included and considered for the student’s AAC system of tools?
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SETT Framework Reminders
Begin with the student in mind.
Determine the role and expectations of the environment and how the student works within a variety of settings/situations.
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SETT Process Continued
Determine the tasks within the environment that the student is expected to accomplish.
Begin the process of determining tools that will best address the student’s AAC needs based on the environment and tasks demands.
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Every Move Counts Clicks and Chats
Sensory based approach to communication and assistive technology for individuals with significant sensory motor differences, developmental difference and autism.
Page 17Jane Korsten, Terry Foss, Lisa Berry 2007, 2011 EMC Communication,
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Every Move Counts
Everyone communicates in some way.
The goal is to identify a symbol system appropriate to the individual’s cognitive abilities.
Communication must be recognized and consistently reinforced with those with severe differences. http://www.everymovecounts.net/theprogram.html
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Technology is a tool that should be used to
achieve goals and objectives. Once a tool has been decided, we
then must begin to determine what we
want the tool to accomplish.
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Goals and ObjectivesWhat is your goal for today?
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What is it that you want the student to
accomplish? Determine the AAC student’s
final outcome.
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Three Components of a Goal:
1. Students know what they are suppose to do
2. How to do it
3. Why it is important
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Goal example:The student will increase their ability to communicate effectively and independently using multiple modalities (facial expressions, gestures, verbal speech) with various communication partners in a variety of settings.
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Lesson Plan objective examplesAllow for indication of preference or choice
Provide opportunities for requests and comments (through multiple modes of communication)
Provide opportunities for engagement with literacy (reading of a story)
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Vocabulary SelectionWhat can we say??
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Nouns
Verbs
Descriptors Labels
Modifiers
Actions
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AAC VocabularyCore
Few in number
High use
Many settings
Variety
80% of sample words
FringeLarge number
Limited use
Select settings
Mainly names/nouns
20% of sample words
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Conversation Role Play Find a communication partner. Ask them
what they are doing tonight.Count the core and fringe vocabulary they
use in their response.
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Data Outcome:Core words: 80-95%Fringe words: 5-20%
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What is the priority in selecting
vocabulary? Type of AAC User
Interests/MotivatorsParticipationSuccess
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Priority Selection Continued
Specific TechniquesEnvironmentOpportunitiesTasks Demands
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Breakdown of Communicators
Emergent Communicator
Context Dependent
Independent
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Emergent Communicator
Symbolic Communication needs to be indentified.
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Context-Dependent
CommunicatorSpecialized strategies required.
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Independent Communicator
Increase desire to gain across all settings.
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Additional Vocabulary
Options
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Pixon ProjectStart with core vocabulary
Carryover to an AAC system that uses these words
Continue with simple manual board
Transition to possible speech generating device with manual boards
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Pixon examples and resources https://store.prentrom.com/product_info.php/cPath/30/products_id/163
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Starter set
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PODD Communication
BooksProvide multiple opportunities to communicate
Give a variety of messages
Offer many topics
Consider multiple environments
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Vocabulary Organization
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Collaborative Team
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The TeamWho’s on the team?
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Team Discussions Plan for those discussions.
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AgendaTeamMember
Team member 1
Team member 2
Team member 3
Team member 4
Team member 5
Topics
CurriculaAssess/EvalClassroomBehavior
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Agenda TeamMember
Team member 1
Team member 2
Team member 3
Team member 4
Team member 5
Topics Programdevice
Program boards
Curricula
Social Science
Assess/Eval
Perform-ance testing
Informalvocabulary
Large groupintro
Classroom
Large group intro
Behavior
Small group
Small group
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Roles and Responsibilities
Your Role(As You See It)
General Education(As You See It)
Paraprofessional’s Role(As You See It)
Your Role(As Seen by Others)
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Develop a Plan
Determine Roles and Responsibilities
Plan Agenda
Think Cross Categorical
Communicate with one another
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Monitor Procedures
Access ideas/strategies
Behavior management
Adaptive procedures
Universal design for learning
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Collaboration OptionsThe ideas through technology are endless!
Skype Facetime
Wiki Blogs
Listserve websites
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Team ReflectionTeaching personality and style
New sense of enthusiasm and healthier, work environment
Aware of current ideas in education
Extension of interpersonal skills
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Planning ProcessWhat is the goal you want to accomplish?Share one goal you wish to
accomplish!
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Key Instructional Strategies
1. Structure the environment
2. Present choices and opportunities
3. Implement AAC into the classroom
4. Documentation
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ChoicesOpportunities
Morning Start time
Reading small group
Math group
Gym
Lunch
Tasks
Greeting and Request
Turn taking
Request action
Turn taking/Action
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Classroom and AACDetermined by needs of the student
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Document, Document, Document
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Documentation Consideration
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Prompting
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Questions to Review
What did the environment look like?
What task was the student to achieve?
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Multiple ModalitiesTargeting AAC
Low Tech
No Tech
Mid-Tech
High Tech
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Movement Creates Engagement
Engagement Creates Thinking
And
Thinking Creates Results
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Targeting AAC AAC User Template
Time of day
Activity Goal/objective
Mode of Comm.
Data Collection
8:30 amStart Room
Art painting
ParticipateChoicesRequestTeam with peer
Comm. BoardSGDStep by step
++++-+++CCCCCSS
SSSSSS I
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Feature Matching AAC User AAC System
Sensory-Motor Physical Sensory Combination of Physical/Sensory
Sensory-Motor Component Auditory Visual Tactile Motor Access
Cognitive Components Cognitive Skills Language Skills Academic Skills
Cognitive Components Cognition for Operation Language Organization Flexibility and Growth
Environment Components User’s Environment Need for AAC Motivation/Behaviors
Environment Components Operation/Programming Durability/Repair Portability/Compatibility
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Collaborative Planning 101
On-going process
Re-evaluation
Reflection
Rejuvenation
Template Access for Process Planning
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Literacy and AAC UsersShare your favorite literacy selection!
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Research reveals five skilled areas:
Phonemic Awareness
Phonics
Fluency
Vocabulary
Comprehension
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10% or less of AAC users read beyond 2nd grade
Karen Erickson (2003)
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Traditional reading instruction
Decoding
Sounds make up words
Letter sound relationship spoken aloud
Individual reading aloud
Choral reading aloud
Sight words only
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Assessment of Literacy and AAC Users
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Literacy Strategies for AAC UsersExchange 1 literacy strategy with the person next to you! Aacliteracy.pbworks.com
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Physical Strategies
Adapting books
Text to speech options
Create stories
Software options
Websites
Switch access
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Communication Strategies
Vocabulary options
Associations (comparisons)
Graphic organizers
Sequencing of events/story
Visual supports
Opportunites to respond/comment/question
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Comprehension Strategies
Text to speech
Speech to text
Pre-teach vocabulary
Pre-program and on the spot programming of SGD
Allow wait time for exploration and comprehension
Ask and answer questions
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Writing Strategies
Audio: Music, rhyme, singing with signing
Visual: Lists, sequence, planning, problem solving
Tactile: Journaling, personal self, reflection
Movement: Story telling, video modeling, performance
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General Literacy Strategy: KWL
Already know
What to know
Have Learned
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General Strategy: Reading
ComprehensionMonitor comprehension
Meta=-Cognition
Graphic and semantic organizers
Answer questions
Generate question
Recognition of story struction
SummarizingPage 43
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Inclusive Planning for Literacy
Include all children
Assist with strategies
Use technology
Use AAC no-tech supports
Involve everyone… as we learn from one another
Model, model, model: Partner Assisted Scanning
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Role of Technology with Literacy
Accommodations
Modifications
Supports and adapts
Carryover to other settings and situations
Must be part of the routine/expectations
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AAC Literacy Apps
iBooks
Enhanced books
Grasshoppers apps
Book Creator (rainbow colored app)
Language Builder apps
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Accommodating and Modifying Curriculum
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Accommodations are what we put in place to allow a student with a disability to participate as fully as possible in the general education curriculum.
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Accommodations may be provided for:
Assessment and assignments
Learning environment
Time demands and scheduling
Special communication systems
Instructional methods and materials (AIM)
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Video Modeling
Pgae 49
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Why is video modeling effective?
Capture nature of social skills
Offers real life experiences
Identifies with the students’ interests
Gives access to watch it over and over
Eliminates surrounding distractions and helps for focus on a specific action
Provides a beginning, middle and end routine Page 49
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Research supports Video Modeling
Individualized interventions produced higher generalization than group interventions
Interventions should be designed to address the individual, rather than forcing to “fit” into a selected group
Meta-Analysis of Student-Based Social Skills Interventions for Children with ASD. Scott Bellini et al., Remedial & Special Education, May/June 2007.
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What is Video Modeling?
Video ModelingWatching a peer on videoWatching an adult on videoWatching others on Video
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What is Video Modeling?
Video Self-ModelingWatching yourself on video
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Skills to be taught using video modeling
Social Skills: play skills, perspective taking, conversational skills
Functional Skills: Self care, community participation
Positive Behaviors
Language Learning
Prepare for a new event
Prepare for an event that creates anxiety and/or fear
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Cortical Vision ImpairmentOccupational and Physical Therapy
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Cortical Vision impairment is
a visual loss which causes
difficulty in processing and interpreting incoming visual
information.
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Cortical Vision Impairment (CVI)
CausesLack of oxygen to the brain
Brain malformation or head injury
CNS infections
Poison or drug exposure
Premature birth/trauma
Cerebral Palsy/Seizures/Epilepsy
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Methods for InterventionUse movement to assist with
locating and maintaining visual tracking.
Use high contrast such as black and white stripes.
Use boundaries and borders improve attention and eye gaze behaviors.
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Continued Methods for Intervention
Simplify the visual environment. Present one item at a time and gradually increase object presentation.
Allow adequate time for responding and processing.
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More Interventions
Provide adequate lighting.
Use selective colors, such as red and yellow.
Use technology to adjust size, color, contrast and brightness.
Use simultaneous touch and vision to establish tactile perception.
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CVI RemindersTeam approach for intervention is very important.
The ability to use vision fluctuates across time and situations.
The unusual attending and eye gaze behaviors is used as an attempt to self-compensate for visual difficulties.
Appropriate and timely intervention is of utmost importance.
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Occupational/Physical Therapy
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Focus of OT and PT with AAC
Seating and positioning/mobility
Computer access
Augmentative communication
Activities of Daily Living
Environmental Controls
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Typical Roles in an AAC Evaluation
Functional range of motion
Strength/Sensory
Cognitive/Functional skill level
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Roles Continued
Coordination/Reach
Hand strength and finger isolation or other isolated access control
Posture and change in position and environment
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Alternative Access
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Direct Selection Methods
Range of motion
Position of changes
Move object around and assess right/left, top/bottom, midline/cross midline
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Head/Mouth Access
Head Mouse
Low tech options: mouthstick
QuadJoy: mouse/sip and puff access
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Sip/Puff
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Eye Gaze and Head Control Access
Eye Gaze Tracker infrared input (Tobii ati)
Add the Head Mouse Tracker
Use with dedicated computers and AAC devices
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Head Pointer
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Head Tracker
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Eye Tracker
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Switch AccessDetermine ability for single switch access
Identify activation site
Access one or more switches
Determine switch type
Activate and release switch on command
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Hierarchy of Access Sites (multiple sites
if able)Hands,
Head/voice
Arms/elbows
Legs/knees
Feet
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Indirect Selection Method
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Scanning
Automatic: runs automatically number of times programmed to
Step: press to select and advance movement of cursor
Directed or Inverse: hold down switch until movement stops
SeeBboardmaker examples
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Autism Spectrum DisorderShare a social moment!
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ASD Qualifying Areas
Communication
Social Interaction
Sensory Integration
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Augmentative Alternative Communications: Autism Spectrum
Disorder
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AAC Supports for ASD
Visuals
Choices/Options/Personal Perferences
Routine and Predictability
Social Opportunities
Multiple Modes for Access
Motivation
Speech Generating Supports
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How do we determine the plan of action?
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A thorough assessment of includes:
Observations
Non-biased opportunities
Formal and informal assessment tools
Team interviews on social cognition and social behaviors
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Key Components
Create opportunities for engagement for
participation
Determine skills to acquire
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Sensory Motor Movement
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Movement creates engagement and engagement creates opportunities to communicate.
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AAC Camp Minnesota State University
Moorhead Speech Language and Hearing Clinic
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Sensory Foundation for Camp
Tactile: perception of touch
Vestibular: perception and movement
Auditory: hearing input
Proprioceptive: body awareness
Visual: visual acuity and visual perception
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Tactile Activities
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Visual Supports and Strategies
Share your favorite visual!
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Visual Supports
Increase in understanding
Clarification
Routine
Positive outcomes
Planning
Make or break of success
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Designing Visuals
What does it mean?
Carryover?
Size, font, style, limit language
Graphics, photos, line drawings, objects
MovementPage 69
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Visual Supports for Communicationshttp://www.autism-mi.org/about_autism/interventions_support/visual.html/title/creating-visual-literacy-supports-for-special-needs-students
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Informal Assessment Checklists
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AAC Technology Checklist Considerations
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The rest of the story….
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