AAC Awareness Month

There are many options to participate in AAC Awareness Month.  The easiest is to download a sign or post and hang in a visible location.  Another is using AAC in public.  What a great motivation for some community based instruction!  Maybe even have a "AAC Sit In" and gather a large group of AAC users in a public space to communicate together (I have visions of the food court being taken over at the mall).  Even better if you do so in front of a live web cam.  The AAC Visibility and Awareness Campaign has ideas and a list of web cams all over the world if you are interested.

There is also a Read-a-Thon could be more aptly called an  "Online AAC Open Mic" where AAC users log into Skype and share their writings and thoughts about AAC.   Today my high tech AAC users tried to participate in the AAC Awareness Read-a-Thon, but we have issues with Skype and neither the blog nor the Facebook page really made up for that, thus we ended up watching some AAC Related Videos (embedded below) and posting to the Facebook page about our participation.

It was one of those great teacher moments to watch my students watching "If I had A VOCA" and "1 Voice".  One student was so enthralled that his eyes never left the monitor, with his entire torso leaning out of his wheelchair towards the screen.  The other student kept saying, "Cool!" and "Awesome!" with her AAC device.  Over the next few weeks I think we will start writing about AAC with our AAC devices.  

Would could be a more important part of AAC Awareness than AAC users being aware that there are others who communicate just like them all over the world!

Conversation vs. Quiz

When I was in my undergraduate practicum I had to wonderful opportunity to spend some time observing a teacher named Subha.  One of the things that impressed me about her classroom was that it immersed her students in communication; symbols were everywhere, they hung by subject on a pegboard that filled an entire wall, and labeled every item and every student used a communication book with direct select or partner assisted scanning.  (Dynamic Display Devices with options our students needed were just on the horizon.) On each communicate book there was a large message which read:

My name is ________________.  I am ______ years old.
I use this book to talk.  You can help me by __________.
Please DO NOT QUIZ ME by asking me where things are or to find certain messages.

In the years since I have tried to never, ever confuse conversation with twenty questions or a multiple choice quiz.  I make sure my students have a way to say something along the lines of, "I get really sick of people asking me boring questions all the time!  How about we just chat?"

That has mean some creative activities like adapted games, dramatic impressions of me developing aphasia and needing assistance thinking of a word (this is becoming less acting and more real with every passing year) and lots of meeting new people in the school and community to practice finding vocabulary.  It takes lots of practice on the part of the communication partner to stop just asking and instead converse with an AAC user.  It means saying things like, "I really love cereal in the morning.  What breakfast foods do you like?", instead of, "Where's the breakfast foods?" or "How do you feel when you see that cute boy you like?" instead of, "Find happy." 

One of the best ways to do this is for both communication partners to use the (of if possible two of the same) AAC books or devices.  We all know the fancy words for this, "Aided Language Stimulation" and "Modeling", but mostly it can be really fun.  Plus, you find out pretty quickly what is missing and how difficult a device is to use when you yourself are using the device.

Just this week I was working with a student at his home.  He is learning how to use Proloquo2Go on an iPod Touch.  I pulled out my iPhone and matched the settings on his iPod Touch.  At first we chatted, then we started racing each other to find words and finally we took turns describing the pictures the other made using an iPad.  We both had a great time and family members wanted in on the action.  I doubt he would have even sat at the table with me if I had quizzed him rote style on the vocabulary on his device.

Using this fun and functional way of working with emerging communicators using AAC means that my students usually enjoy using their AAC books or devices.  When AAC is conversation and not a quiz students think of the communication system as a voice and not work.

Wait Time

We all know we are supposed to give wait time.  It is one of those things drilled into our heads in "teacher school".  We even know how much more important it is for our kids.  Still waiting is one of those things that is hardest to do.

A few examples from our week:

• a student was being put into a stander and her helpers were preparing to give a boost up because there was a lot of slouching going on, reminded to wait and that the student IS capable of pushing further in to stand independently we waited; it took one minute and forty five seconds, but the student eventually was able to process the verbal command and touch cues and push into stand; impressive stuff
• we had recently discussed another student's need for long wait times, of up to several minutes to complete complex tasks which involve both intellectual processing and motor planning; an aide therefore cued the student early to go to the appropriate page on an AAC device and get ready to activate the right message, it took nearly four minutes, but the student was ready to answer with the rest of the class when a question was asked of the group

So much goes into what we ask our students to do.  Pushing further into stand for a student with apraxia and significant motor disabilities means understanding the prompts to stand, figuring out what is needed to complete that command and then making a body that is difficult to move purposefully on the best of days do what is being asked.  When you think about it this way just under two minutes to follow such a command is a miracle.

This is a time when we, as adults, caregivers, teachers, parents, therapists, need visual cues and reminders.  We need to hang signs that say wait next to the clock and around the room.  We need to cue each other to "shhh" and "wait".  We need to discuss and agree on how to move through a prompt hierarchy and how much time to leave between cues.  Because waiting is one of our key tools in our toolbox.

From Phrase Based to Core Words

Most of the AAC users I have had in my classroom over the years have used programming on their devices that is phrase based.  Entire sentences or at least independent clauses are programmed on each button.  This is usually the chosen method of programming by the SLP and TEAM because of significant cognitive and/or access issues.  The low-tech version of this is topic boards. 

Let's face it chaining a sentence or linking multiple meaning symbols together to form a thought is generally more complex intellectually and requires more activations (by they direct selection, switch or eye gaze) per sentence than phrase based programming.  Yet, it is widely understood that core vocabulary programming using the top 100 words in the language plus fringe vocabulary is best practice for AAC users.  Core vocabulary allows a wider array of messages to be displayed, reduces AAC user reliance on the person programming their device to have the correct message and has limited means of growth in communication competency for the user. 

So how do we begin to move our early or emerging communicators using phrased based AAC towards core vocabulary AAC design?

That is a complex question and the answer will be different for every AAC user.  Here are some ideas we have been trying:

• direct instruction of core vocabulary - i.e. word of the week, highlighting core words in other curriculum activities, core word bingo, etc
• static core words on every page or in every page set (top left buttons are always, "I", "want" and "don't", bottom left are always, "more" and "done", etc.)
• move away from "topic boards" towards "core vocabulary" plus fringe vocabulary even on manual boards and lower tech devices (this has the bonus of saving hours of time and programming on devices like Go Talks, Cheap Talks and TechTalks), thus a cooking overlay with core vocabulary for cooking (I, you, want, don't, come, go, more, all done, plus certain fringe words like stir, cook, pour, measure) rather than a new overlay for every recipe
• for high tech AAC users currently using phrased based communication provide a link to a core vocabulary based system which allows the user to begin to supplement phrase based communication with core vocabulary, teach the student how to go to that page set and how to use it
• teach communicator partners to respect "good tries" and look for the essence of a message, thus, "I go store" can mean, "I went to the store", "I want to go to the store", "I am going to go to the store", "I want to play store", etc.  (This is important in phrase based communication too, where, "I miss my brother" can mean, "My brother is coming home from college this weekend" or "I am thinking about my brother because he likes this recipe we are making".)
• WAIT - learning and using AAC takes time, learning to compose thoughts with AAC takes time, we need to be patient

The New Dynavox Maestro

Dynavox announced today their new device, the Maestro.

The major assests of the Maestro are the weight, durability and multi-lingual ability. 

The Maestro weighs in at 2.75 pounds with the three hour battery and 3.44 with the 9.5 hour battery  and is 2" at its thickest.  Yet it has a full size LED screen of 10.4".

The Maestro has a magnesium case with port plugs and is spill resistant.

Other than the size and durability the Maestro is a fairly standard issue AAC device.  Bluetooth, WiFi, 2 USB ports, a camera (it does have zoom and pan which most AAC devices don't have, but it is in a weird place and could not be used with any accuracy if the device is mounted), microphone, 3 or 9.5 hours battery life (depending on how much size and weight you are willing to trade off for portability), e-mail, SMS messaging, built in stand, forward facing speakers (if you use the device flat), two built in switch ports - the works, but the same works as most devices.  There is no internal CD/DVD drive, which is also now standard on new AAC devices.  Also no hot swap batteries or external volume control.  (Check the specs.)

Software wise the Maestro runs InterAACt, the same as the rest of the Dynavox version five devices.  InterAACt has some nice features especially around quick conversation, but there are some issues with symbol set mixing and inability to "turn off" visual scene displays for those who don't need/can't use them.  I assume you could get Gateway, Word Power or another vocabulary set installed on the device. 

All in all this is a device I can't wait to look at for student who need something light weight and tough.