Why "Prove it with Low Tech First" Doesn't Work

I have student who is only able to use eye gaze for communication.  For years he used a low technology
eye gaze system from a field of two and consistently chose the item on the left.  He did somewhat better if you arranged his two choices vertically, but not much.  Fast forward five years.  He is now using a speech generating device with 25 buttons per page. He can hit the smallest targets I have ever seen on his device, buttons only centimeters in size.  Why can he communicate via eye gaze on an eye tracking device and not using low tech?

Who knows?  It could be that having a person in his space to hold up his choices distracted him.  It could be that he was bored with the two choices he was being given.  It could be that two choices being held up in space did not have a clear enough figure ground for him to visually distinguish them.  It could be because secretly he was saying, "I hate you and your two ridiculous choice cards!" I honestly don't know why he cannot respond accurately to low technology eye gaze choices yet he can communicate on a high technology system.  More over I am not sure it matters.  What matters is that his TEAM at the time, especially his parents and his augmentative and alternative communication specialist decided to try high technology eye gaze anyway.  And thank heavens they did!  AAC through high technology eye gaze changed his whole world.

Access to augmentative and alternative communication is not a hierarchy, though so many of us in the field want it to be.  We want to believe our students will work from using objects to photographs to picture symbols.  We want to believe we start with two choices and move to four and then eight and then sixteen before we try dynamic display.  We desperately want to believe less is more with emergent communicators.

The problem is what if we are wrong?  What if our stubbornness leads to us creating individuals who cannot communicate, not because of their disabilities, but because we never let them!  Because we never gave them the correct tools for them?   Living the least dangerous assumption means that we don't restrict our learners because of our own belief systems.  We assume that they can. We presume competence.  Using a hierarchical system of AAC is not living the least dangerous assumption.  It, instead, is making a very dangerous assumption.  It is assuming that the child in front of you is going to use a prescribed series of steps with mastery at each step sequentially to learn to communicate. (Which, I should note, is NOT how typical communicators develop!)  It also assumes that if the child cannot master a certain step then they cannot go beyond it - EVER. Additionally it assumes that low technology communication skills are transferable to high technology communication - which is not always the case.  Using partner assisted auditory or visual scanning is NOT the same thing as using auditory or visual scanning with a switch.  Using PECS or pointing to pictures or using a "Go Talk" is NOT the same as using a conductive touch screen with dynamic display.  Using eye gaze to look at objects or photos or picture symbols is NOT the same as using an eye tracking computer system. Just because a student can do one does not mean they can do the other and just because a student cannot do one does not mean they cannot do the other!

This hierarchy is our construction as professionals and sometimes it is right.  The worry is that sometimes it is very wrong!  We have so many more tools now that we did when I started in this field.  We have so much more research.  We have research that says that just one or three weeks of intensive aided language stimulation generally increases AAC skills (and we get to have 22 weeks with our students!  Why aren't we embracing this?).  Yet we still "drill and kill" with field of two choices for beginning communicators.

There is so much high tech can do that low tech cannot, such as:

• be explored with visual and auditory feedback independent of a communication partner
• be used to call for someone or say something when you aren't expected to (when your communication partner isn't standing at the ready)
• get immediate feedback visually and auditorially
• access highly motivating games and activities to train access skills
• be completely consistent in response no matter where you are and who you are talking to
• be precisely calibrated just for the individual and his or her best means of access
• allow different means of access depending on the day and the student's status
• be understood by unfamiliar listeners instantly
• instantly create respect in unfamiliar listeners in a way low tech cannot
• a "cool" factor that just can't be beat

There are, of course, many things low tech can do that high tech can't as well, but since I have never, ever heard anyone argue that all AAC users should "prove themselves" on high tech first I am not going to enumerate them here!

Long story short it is time for a new paradigm.  It is time to scrap the hierarchy that is so pervasive in AAC.  It is time to BELIEVE in our students.  It is time to give them a chance.  It is time to allow them a chance to try, really try, high technology AAC even if they haven't "proven themselves" with low technology first!  

Instruct, Model, Practice, Praise

Years ago one of my responsibilities was to help train new paraprofessionals to work in special needs classrooms.  One of the things I would stress was that the way we teach any skill is to instruct, model, practice, praise.  It's so simple really.  How does anyone learn anything?  There is some kind of instruction - usually a person acting as a teacher explaining to the learner. Then the teacher shows the learner how to do the new things. Next the learner tries it themselves, practices, the new skill. Finally the teacher praises what worked in practice and begins again with instructing and modeling what didn't work.

Instruct.
Model.
Practice.
Praise.

Repeat as needed.

We've all learned this way.  Think of learning to tie your shoes or ride a bike or do a task analysis or create an alternative assessment portfolio! Someone told you, "Pick up the laces and cross them..." or "Choose the standard you want to assess...."  They showed you.  Maybe you practiced with hand-over-hand support, maybe you saw samples of the process, maybe you tried it on your own.  When you got it right there was acknowledgement and praise.  (Though in the case of alt-assessment I wouldn't count on it.)

It is such a natural process we don't think about about it.  I wonder, however, why when we are teaching learners with significant special needs we forget that this is how to teach a new skill? Especially when it comes to augmentative and alternative communication!  We often don't instruct much at all and we rarely model.  We skip straight to the practice and sometimes we even turn the practice into testing. Testing has no part in learning.  Testing, if it happens at all, is for after we teach a new skill; after we have instructed, modeled, practiced and praised.

Yet we have all seen this and some of us have done it - the endless testing by drilling the student or asking them to do a task before we explained or showed them how to do it.  I am not sure why we do this.  Maybe it is the never ending drive to collect data at any cost? Maybe it is the crunch for time that happens with feeding and ADLs and everything else that needs to happen?  Maybe we have simply lost touch with the way that teaching looks?

Worse yet some teachers blame the student for failing to learn when they never actually instructed or modeled.  They say the student is "too low".  They say the student "isn't ready".  They say the student "hasn't met mastery".  How can this be if the teacher hasn't taught?

What would it be like in our classrooms if we looked at each task our students are asked to learn and then used this natural way of teaching a skill?  What if we tossed aside our "ask, ask, ask" mentality (which is really testing) and turned to teaching?  What can you do to return to teaching by using the steps of instruct, model, practice and praise?

AAC is a Seed!

Communication RRRepair (You're Going to Hear Me RRRoar!!)

Many of us have encoutered individuals who are able to speak but whose poor intelligibility, often times

I should RRRoar!

combined with an unfamiliar or distracted communication partner, cause frequent communication breakdowns.  Even infrequent communication breakdowns can cause major frustration!  One situation that comes to mind for me happened when working with an adult who has cerebral palsy.  We had discussed many topics over the course of the day including his spinal surgeries and, of course, his computer.  He said to me what I heard as, "I am going to undergo an operation on my neck."  I repeated it back to check my understanding.  He told me no and repeated himself.  I still did not understand.  We went maybe five more rounds of this before he was able to use eye gaze and moving his wheelchair slightly to point my vision towards his computer.  With that context cue he repeated himself again and I heard, "I am going to upgrade the operating system on my Mac!"  When I retold this story to a friend who is a speech therapist and an AAC specialist she said, "And that's something that's pretty unlikely to be on a communication system!"  True, very true.

We have all probably met children (and adults) whose speech is afffected enough that some professional would recommend AAC, which is, of course a very valid strategy.  We have also probably all met the child (or adult) who will NOT use AAC. What can we do?

Most of the research on communication repair focused on a couple of strategies: using a topic cue to create context (as was done with visual pointing in the story above) and using letter cueing by stating or pointing to the first letters of the words.  Using both strategies at once has also been studied.  All three of these can increase understanding but do not eliminate all frustration. 

In working with children with low intelligibility who do not use AAC or use it only as back up, I like to focus on teaching them the three R's - Repeat, Rephrase, Repair.  I teach children that when someone doesn't understand them then they can start by repeating themselves.  If they can repeat themselves more clearly and slow down or speak up that might help.

 If they are still not understood they can try rephrasing or saying it a different way.  We spend a lot of time working on this skill because it isn't as easy as it sounds!  We play a lot of games where one person says a sentence and the other tries to say it in a different way.  

If they are still not understood then they can repair using a strategy.  The strategies I teach depend on the talents and challenges of the student.  They include by aren't limited to, "It starts with ___" alphabet cues, spelling whole words, creating a context (which I sometimes call giving hints), calling in a more familiar listener, and using "cold, warm, hot" to aid the listener in asking questions and/or using AAC boards or devices.  When working on learning how to give hints we work on using gestures, topic boards or lists, spelling boards, finger spelling and other skills.  

I should note that I make teaching spelling, especially identifying and indicating the inital phoneme of common and uncommon words a priority in my teaching.  Having students learn word prediction is a great way to teach initial phoneme identification and writing at the same time!

The new hit song "Roar" has given me another great tool -  I have been reminding my students that I want to hear them RRRoar when things get hard!  Repeat, rephrase and repair using a stategy!  

The PrAACtical AAC blog posted about speech supplementation strategies a few months ago and shared some spelling boards and text-based topic boards that can be downloaded.  You can also find my Communication RRRepair book over on Teachers-Pay-Teachers.  You can find a nice slideshow about this topic by Hustad and Buelkelman here.

Switch Activities for Christmas!

Christmas switch activities abound this season.  

• Special Bites has shared  four new, fun switch activities for Chrsitmas!  These are added to their other Yuletide favorites and  Christmas Cause and Effect music/video slideshows here and here. Watch out for some of the farting reindeers, I've seen them make paraprofessionals and adminstrators who suffer from low sense of humor a little upset!  

• Shiny Learning has Shiny Singing Sheep and a demo of Press to Reveal Christmas

• If you happen to be a member of HelpKidzLearn you have access to an Advent Calendar, Card Maker, Christmas Presents, Make a Snowman, The Snow Family, and Little Lost Penguin.

• LowIncidenceAT has "revamped" switch videos (editted for more switch hitting form Priory Woods website including Singing Santa, Have a Quacky Christmas, Up on a Housetop and a three choice Christmas activity.

• Papunet has a switch accessible card making activity with Christmas options

• The illustrious Ian Bean gives us (scroll almost all the way down) Mistletoe and Wine, Oh Christmas Tree, Let It Snow and Happy Christmas.

• Don't miss all the two switch accessible books about Christmas on Tar Heel Reader

• Or the Christmas stories at Northpole which are accessible if you choose, "Hear a Story" and then put the switch over "turn the page"

• Priory Kids has Tootin' Reindeer, Singing Santa,  Christmas Alphabet, and Up on the Housetop

Make YouTube Switch Accessible for Special Needs Kids - using Specialbites!

Morning Meeting with Older Students

Write a Morning Meeting Mission

Morning Meeting shouldn't be something we do in our classrooms because it is what everyone does or its what we have always done.  It should be, like everything else we do in school, purpose driven and related to classroom and individual educational goals.  Writing morning meeting mission is something you can do on your own, with your classroom staff or with your TEAM.  The idea is to reflect in writing the purpose of holding a daily morning meeting and really reflect on what parts of your morning meeting meet educational goals and which parts are done because everyone does them.

Here are some things you can consider putting in your Morning Meeting Mission:

• Morning Meeting sets the tone for the day
• Morning Meeting is a time to re-establish trust and connection
• Morning Meeting allows use to ensure students needs are met beyond the physical and academic
• Morning Meeting is a time that allows students to learn goal-setting and self-reflection
• Morning Meeting is a means for the class to govern itself
• Morning Meeting generates a space for students to create and explore
• Morning Meeting is a when students are able to learn about what will happen in the day 

The Morning Meeting Area
Much attention is given on Pinterest and teacher blogs to cool looking morning meeting areas with a LOT of attention to how the calendar and its related activities look.  There are many inspiring ideas online, but in older classrooms we want to steer away from "pre-school" looking morning meeting areas.  We don't want peer visitors to enter the room and think, "Oh look, we had that calendar in my Kindergarten!"

• Your morning meeing area should reflect your morning meeting mission.
• Your morning meeting area should be age appropriate which means no blue or yellow pocket chart calendar after elementary school and no cutesy numbers either.  Would you see those straws for counting the number of days passed in any other classroom at your students age level? If not time to get rid of them.  
• Older students would likely be interested in having some input into what the morning meeting area looks like or even if you have one at all.  Consider doing survey and having votes over how things should look.  

Sharing News From Home
This activity, which seems to be based somewhat on "show and tell" from pre-school, is a staple of special
education morning meetings.  It makes sense to some degree as it allows non-speaking students to tell about their evening or weekend.  However, having 5 to 10 students each play back a series of messages can be time consuming.  Many of our students also learn, with out us meaning to teach them, that dragging out this process allows them time where they have the full attention of adults and classmates and power over everyone as we beg them to play their message!  Is this really what we are aiming for?  Not to mention that a formal retelling of your evening or weekend stops happening after about Kindergarten in general education, so it isn't really age appropriate.  This isn't to say students should not share news, they should!  This is to say that we need to rethink how students share news from home.

Some questions to ask yourself:

• can students share their news during breakfast, snack or lunch?  Could you have "water cooler" talk in your pre-vocational classroom?  Coffee Talk in your high school room? This would be a much more logical time for that kind of conversation in older classrooms
• does it need to be in a large group?  could students "pair and share" instead?  
• can you use a different time of the day to help students comment on what is on their switches or devices thus moving the focus from playing someone else's words to generative language?
• could students use their message from home to write in a daily journal? 

Calendar Activities

Calendar Activities are a staple of morning meeting through elementary school.  Telling the date and weather,
counting the calendar, making patterns with the number cards on the calendar and graphing the weather are all common.  There is nothing wrong with these activities per se in older classrooms.  The question is does calendar fit in with your morning meeting mission or are you doing it because you think you should? Are your students actually learning anything from the daily recitation of "Yesterday was... Today is... Tomorrow will be..."?  Have you thought about what it would be like to do that activity everyday from pre-school to graduation and possibly then in adult services?  Are the materials you are using for calendar age appropriate or would they be more likely to be seen in the second grade classroom down the street?  

Calendar Considerations:

• look back at your morning meeting mission - do calendar tasks fit?
• ask yourself if calendar activities are meaningful, educational and age appropriate
• If not then 
• consider moving calendar tasks to another part of the day:
• journal writing
• students filling in an individual calendar
• students setting up their daily schedule or agenda book with the date on top
• consider eliminating calendar tasks altogether 

The Pledge

Most schools have the pledge on the loudspeaker daily, yet we in special education often then repeat it in our morning meeting.  We sometimes add to the event of saying the pledge by handing out flags to everyone or having a large flag and a student to hold it despite the flag on the wall every other classroom uses.  Would it be possible to particpate in the pledge with everyone else and use the flag on the wall?  What do you gain and what do you lose by doing this.  The pledge is an important part of the being a school child in America and I am not advocating eliminating it, but as teachers we need to give thought to how much time we spend on saying the pledge and if there are other things we are losing out on doing during that time.

Morning Greeting

Morning Greeting is a part of many general education morning circles.  Typically the teacher picks (although sometimes a child picks) a greeting such as "smile and wave", "shake hands" or "high five" and then one child starts by turning to the child next to him or her and giving the greeting and it passes around the circle.  This activity is great in those elementary classrooms for working on eye contact, learning each others names and some of the pragmatics of language.  Many times our students need to work on this too.  We can also use this time to work using our AAC devices for greetings, cool!  However, our students have often been in the same group of children for years before they get to middle school or high school.  How many times can we ask Raheeb to greet Jovanny in a year?  In three years?  In ten years?  As teachers we can give careful thought to how and when morning greeting occurs.

Morning Message
In lower grades morning message is a time when the students read a note written to them as a class by the teacher on the board or a flip chart.  With a little modification this can be a great activity in older special needs classrooms - because lets face it, getting a note from someone is age appropriate for every one. Some ways to adapt for our learners include embedding key picture symbols into the text (keep a supply of key symbols ready), using morning message to teach core vocabulary for AAC, recording the morning message on a switch for a students to "read" to the group or using a video of a mystery morning message reader on your interactive whiteboard.  How can you make morning message fit with your morning meeting mission?

Announcements
This is a good time to review visual schedules and calendar box for the day as well as go over any changes
that might be happening.

Other Ideas
What can you do that is age appropriate, engaging and functional for your students at morning meeting?

• Have students present work that they are proud of and have other students comment on it
• Create a video (on the computer or iPad) about an activity and share it during morning meeting
• Watch a video or listen to music and have students comment about it, vote on how much they liked or disliked it or create a video response later
• Run morning meeting as a news show or morning talk show with current events, weather forecast, fashion review, entertainment news and celebrity gossip (your students can be the celebrities)
• Go for a morning walk instead as a class and use the time to chat and exercise
• Make it an AAC group focusing on greetings, social exchanges, learning about the core vocabulary word of the week and re-connecting 
• Create a rotating schedule of fun activities - Monday Morning Music and Movement (dance party!), Talk to Me Tuesday (students invite a guest and interview him or her), Word of the Week Wednesday (where students make a word map about the core vocabulary word of the week), Thinking Thursday (where students solve a real world problem that is relevant to them - like how to get mom let them stay up late), Fabulous Friday (where student do a This Was Our Week review of photos they took with the iPad or communication devices during the week) 
• Cut it down to a morning check in where students say hello and how they are and review their schedules and announcements and then use the time for other things 

Resources

• Responsive Classroom has done a lot of work around morning meeting in elementary and middle school (they call it CPR: Cicle of Power and Respect in middle school)