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Demonstrating knowledge without an Augmentative Communication Device

Many children talk to communicate. However, for some children talking may not be their primary form of communication. Reasons for this vary.  Regardless of the reason, it is important to find a way for each child to communicate.

A colleague and I were recently called in for a consultation to observe and work with a young school age child. Other professionals who worked with this child were unsure of what he was capable of during the school day. We went into the school to observe this child. We noticed that the lack of certainty about this child’s abilities seemed primarily due to two things: (a) The child was demonstrating challenging behavior in the classroom that interfered and (b) that this child, at six years old, was not speaking and had no effective and assessable way to communicate in that classroom. Despite his lack of speech, it was soon very clear that this child was attempting to communicate with methods other than speech such as eye contact, pointing, vocal sounds, and unfortunately his challenging behavior. He also demonstrated difficulty with fine motor skills, which affected his ability to write or use sign language. Quickly we realized that this child was in desperate need of a way to effectively and easily communicate.

What we first did was create some simple materials to see what this child knew and what he could communicate. To begin, I made templates of 2x2 pictures that were images of items in his environment. These images were pictures of items he might request or talk about throughout the school day. I then made similar templates with pictures that represented numbers, money, letters, etc. to see if he could demonstrate his mastery of such academic skills without the use of speech or written work. After making the materials we presented them to the child. For the environmental pictures, we began handing him words and told him to “match” them. He quickly matched all words. We performed similar informal assessments using visual materials to see if this child could sequence his letters and numbers, pick out his name, and answer basic personal information questions about himself. This child quickly began demonstrating that he, in fact, can find his name, sequence his letters and numbers and answer some questions by pointing to this response.

For now, we are using the visuals to continue the assessments. Giving this child a different want to demonstrate his knowledge is allowing us to create appropriate goals for him, and therefore reduce his frustration in the classroom. We have also begun to use the environmental pictures and words as a temporary communication system of sorts. We have found success in him pointing to Yes and No cards, more/all done, and other environmental pictures such as drink. Soon, we intend to seek out an augmentative communication device that will fit his individual needs. From what we have already seen, we will recommend that this device will either allow him to type out words or to find the pictures to tell us what he is trying to say. We are hopeful that such an alternative will allow this child to ‘speak’ to us. He has already begun. When we saw him this week, we said Hello to him and waved. He quickly grabbed a few of the letter tiles we had made for him and spelled out “Hi.” Hi, indeed!

 

Figuring it All Out

Hello! My name is S. My seven-year-old son, P, has just recently been diagnosed with Asperger's Syndrome.

I was referred to this site by a therapist who is experienced with children on the autism spectrum.

This site is terrific the way one can combine one's own images, existing icons and web searches.

The trickiest part of implementing a picture schedule for P is finding a system that he will respond to.

One thing I did finally hit on after a great deal of trial and error is that he absolutely loves analog clocks. He also pays attention to them, as they are logical/visual. If I say "P, it is time to go to bed because we are both tired and it is bedtime" he really cannot make the connection between my rule and the physical/emotional demand. On the other hand, if I say "P, it is time to go to bed because it is 8:30, and, as you can see, your schedule shows that 8:30 is your bedtime" he knows that to be logical. The clock faces MATCH, and you cannot argue with that.

An example of our analog clock faces

We keep clocks in every room, too.

So this is my start. I am going to keep daily entries here to show my process/progress with the picture schedule. I hope I may be of help to others with similar situations.

Best,

S

An Interactive Approach to Calendar Time

In almost every Kindergarten classroom, the morning begins with the infamous Calendar. I have worked with many children who have difficulty picking up this abstract skill. For many kids, the calendar is simply many words to memorize: 7 days of the week, 31 numbers, 12 months, and 1 year. For one of the children I work with in particular, this had been an area we had been “teaching” for a year or so. He learned the days of the week, the months of the year, and could identify numbers up to 40. So, why was he still struggling with the calendar?

Well, for starters, he was having trouble discriminating between months, years, and days. For a child with a history of difficulty in discriminating skills, calendar was a time to sit and pick at shoe laces. Repeated practice was not helping him discriminate in these areas. With some prompting to the relevant parts of the calendar, he was a bit more successful. Still, there remained the issue of his not paying attention. Rather than switching out his shoelaces to ones that did not steal his attention, I decided to change our teaching procedures. After talking to a few other professionals, I tried two strategies to address my concerns.

First, I made a calendar board for him to use during calendar time in the classroom. Rather than sitting and waiting to be called on (which he never was), he was given his own “calendar” board. This board allowed him a chance to participate with each question (i.e “What month is it?”). Since we are also working on reading, each month and day was written out, cut, and laminated. I color coded the text of these months to be green, and days to be blue. Then I had each number (purple) and the years (orange) typed out as well. I then took a long piece of cardstock and filled his board with 4 horizontal Velcro strips. Each strip held the days, months, numbers, or years. At the top was one long strip with 4 pieces of Velcro: one for each day, month, number, and year. This allowed him to scan the possible responses, choose the correct response, and place it up on the top “date” strip.

I also took pictures of all of his therapists, his camps, his afterschool activities and made 2x2 squares of each using a Mrs. Riley template. After school, on his own large calendar in his room, we taped (or velcroed) what he was doing each day or who he was seeing that afternoon. These visuals were placed on the calendar at the start of the day. The visuals were meant to give some concrete element to the abstract notion of “Tuesday” or “July.”

Within days, he was finally beginning to discriminate between the different skills. He would now scan his calendar and look at what he did today, go up to the top and tell me “It’s Tuesday!” And then we’d talk about his vacation coming up in “July.” This made sense to him. He also began participating much more during calendar time. Without direct teaching, he has also learned to recognize and spell all the days and months of the year! As a result, the visuals and calendar board had helped this child who had struggled with these skills for over a year, learn them fluently within weeks.

Retelling a story using visual strategies

The ability to retell a storybook is a skill that many children struggle to learn. For example, I work with a particular child who struggled with retelling a story. She could answer a few questions about the story, but struggled to create a few comments that described what she understood about the story. Repeatedly, when I finished the story she could only make a comment or two. Occasionally, these comments were not even related or true! And she always told me that everyone “lived happily ever after.” Whether that was a result of her love for princesses or a certain animation company’s relentless search for bliss, it still remained that I need to find a way to help this little girl find a way to retell me a story. I knew she had the ability to comprehend the words, sequence events, and recall information. I also knew that she is a visual learner. I decided to use visual cue cards to begin teaching her how to sequence plot events and recall important parts of a story.

To begin making the visual cue cards, I first found a handful of Kindergarten books that had clear plot lines. A few great ones I found were: “The Knight and the Dragon,” “A Porcupine named Fluffy” and “The Tiny Seed”, as well as most Fairy tale books (3 Billy goats gruff, Goldilocks and the three bears, 3 little pigs). Then, I took each book and picked out 4-6 relevant parts of each story. Each of these parts of the story was then made into a visual cue card. I made the cards in one of two ways; either with directly scanned images from the book itself or with symbols found in Mrs. Riley.

Scanned image method: I scanned in the relevant pictures, one by one, of the story’s plotline onto my computer and saved each image.  Once it was saved, I created a new 3”x3” template in Mrs. Riley. I then uploaded the scanned plot images by going to the “new card” feature. After selecting the saved image, I would drag the image to one of the squares on the template. When the template was filled with my images, I printed out the page. The images were then cut out.

Symbols method: First, I created a 3”x3” template in Mrs. Riley. Then with a list of relevant events in the story, I searched for symbols within Mrs. Riley’s database that would represent the key points in the story. Once I filled the template with symbols or pictures that represented the story events, I printed out the page and cut into cards.

Each method can be used as visual supports, yet one may work more effectively for an individual child. I found that the scanned images directly from the story book worked better for the child I was working with. I recommend trying out both methods; each with a different book. Then you can see which method seems to be more effective for a particular child.

Now with my trusty visual cue cards in hand, I attempted to teach this child to retell a story again. We read a particular story for a few days in a row. Following the story, I would ask her to tell me what happened or to tell me about the story. Following these instructions, I would immediately lay out the pile of images and teach her to sequence the images in order. Once she finished doing this, we both went through the images and ‘retold’ the story with a comment or two about each image. Once she sequenced and told me the story independently with the visuals, I took away the visuals. I then began asking her to remember the story without the visual prompts. At this point, she was successful and even began adding details that were not in the visual pictures! It seemed that the pictures were acting as cues for her to remember other parts of the story as well.

So, we did these procedures for a few stories. After the 4 or 5th story, she was able to begin to sequence the events of a story in her head and retell me a story without ever needing visuals for that particular story! We now read novel books and she is able to tell me the story in her story telling voices.  Occasionally, I still get a “and they lived happily ever after” at the very end of her retelling, but some of the time she is right. Some stories do end in happily ever after…

Article on How to Use Visual Supports and Schedules

 Just found this great how-to article written by the folks at the Center for Autism and Related Disabilities (CARD) at the University of Florida/Gainsville:

http://card.ufl.edu/resources/visual-supports/

Although the use of visual media has been shown to be effective for communicating with persons who have disabilities for some time, their use with persons who have autism has become very popular recently. This web site will help you to become more familiar with the uses and benefits of visual supports