Social-emotional reciprocity: the back-and-forth communication that develops within the first year
Emergent literacy: knowledge of reading and writing skills, and involves interaction with and learning from print
Receptive language: how one understands the words that are heard
Expressive language: how a child puts their thoughts into words & sentences
*can sometimes be delayed in children from bilingual households
Pragmatic language: social use of language (e.g., taking turns speaking, staying on topic)
2 months: begins to coo
4 months: babbling begins, has different cries based on different needs
6 months: "jabbering" with various consonants, but not yet functional communication
9 months: better at gesturing - can point and better understand the gesturing and facial expressions of others
12 months: should have words such as "dada", "mama", or "no" or "uh-oh"
By two years old, a child should:
use 2–4-word sentences ("I want apple juice")
point to pictures when asked ("Where is the flower?")
marked improved gestural communication & identification
2-3 years: carry on simple conversations and respond to questions more functionally; knows and can communicate name, sometimes age
By four years old, a child should:
be able to converse with others, especially about things they like
sing simple rhymes or songs
able to copy language for functional tasks, such as the Pledge of Allegiance
By five years old, a child should:
better able to express and follow rules for social play
tell a simple story using several sentences
marks more complex sequencing and recall
sing, dance & act
use of choices to promote interest and motivation
asking "do you want to put on your shoes" gives the child an opportunity to say "no"
instead, you can ask "do you want to walk or hop to go put on your shoes" to still give them a choice while giving independence to do tasks
modeling of strategies (either adult or peer)
frequent collaboration with other team members to increase skill acquisition and generalization
family/caregivers
SLP
teacher or daycare provider
use interest-based materials, activities, routines
follow along with what the child likes to do
imitate the child so they become interested in what is being taught
provide caregivers with support and assistance to develop and facilitate daily routines
create and use natural opportunities for social communication
offer choices in activities & materials
consider accessibility of materials (e.g., are they out of reach or in a container with a lid?)
consider whether multiple or additional items are needed; do not offer all items at once
use pauses and wait time to create opportunities, give time to process & generate responses
acknowledge attempts to communicate
observe how and why the child socially communicates
use breakdowns and challenges as a teaching and learning opportunity
model communication and social participation
provide the verbal or visual cue so the child can imitate
use a variety of types of words (e.g., nouns, verbs, descriptive words, location words)
model social play interactions
use different ways to enter and maintain an interaction
use different ways to communicate (e.g., gesture, sign, verbal word, picture)
build or scaffold by modeling more complex or varied communication or play skills
use supports to enhance participation
use visual supports to hep childunderstand and as a way to communicate
use props during shared book reading
use peers and caregivers to model
use augmentative or alternative communication to offer easily accessible ways to communicate
a set of tools and strategies that an individual uses to solve every day communicative challenges
effective communication occurs when the intent and meaning of one individual is understood by another person - the form is less important than the successful understanding of the message
Aided AAC: any device, either electronic or non-electronic, that is used to transmit or receive messages, ranging from communication books or boards to speech-generating devices
Pictures
Communication boards/books
Speech generating devices
Single message devices
AAC software on a device
Unaided AAC: does not require special outside tools or any supplemental materials, because it is based on natural communication such as facial expressions, gestures, body language, informal vocalization, and even implies sign languages
Facial expressions
Pointing
Vocalizations/Verbalizations
Body language
Gestures
Remember:
The form is less important than the successful understanding of the message - sometimes we get stuck doing things one specific way that other communication is missed out
Ask yourself:
Does this form of AAC facilitate this client's occupations?
If yes, reflect on what is going well.
If no, how can we change/modify/adapt?
Consider contexts!!
expectations of contexts differ (home v. school/work v. clinic v. community)
thinking about who we need to communicate with and why helps to reframe what we are looking for in AAC.
Goals:
providing a means for individual to say what they want to say and how they want to say it, when they want, and to whom they want - autonomy of an individual's communication should be central
collaboration with SLPs
physical access
mounting of devices
on tables
wheelchairs
kickstands
shoulder straps
positioning
choosing the best access method for that person
changing and adapting access methods with positioning
wheelchair vs. in bed vs. in the shower
fine motor
strength
endurance
voluntary movement
adaptation
consider:
if they need to hold/carry their device; how will they do that for long periods of time?
do they have strength to do that?
what other supports do they need?
choosing best access point - each type of AAC can be accessed through multiple means
direct selection
eye gaze
pointing
pointers
head tracking
indirect selection
partner assisted scanning
eye pointing
auditory scanning
strengthening/maintaining strength needed
vision considerations
sensory considerations
tactile
vibration
keyguard
3D printed symbols
textured buttons
auditory
auditory scanning
loudness of device
speaking voice
visual
contrasted text
bold text
large print
scanning abilities
number of choices per page
eye gaze needs
adapting all of the above as the person grows, disease progresses, and abilities change
working with other members of the team to ensure the person has access and ability across contexts
advocate for a variety of communication strategies
demonstrate the value of unaided AAC
utilize AAC to facilitate meaningful occupations
make AAC available regardless of context
Optical Head Pointer (1)
Optical Head Pointer (2)
Eye Gaze Control System (1)
Eye Gaze Control System (2)
Keyguard Device