Interacting With People Using AAC
... it is the province of all those who interact with the children to realise the communicative potential of what they do (KNIGHT C. 1992 page 25)
While there may be no one correct method of interacting with people using AAC systems there are certainly incorrect strategies:
The strategies that natural speakers use in their interactions with AAC users can either enhance or constrain the success of the interactions. At the very least, AAC users should be made aware of the common interaction patterns that occur in aided-natural speaker interactions. By increasing awareness and offering a variety of strategies to exert counter-control during interactions with controlling partners, clinicians can empower AAC system users with strategies for both social and strategic competence. (BUZOLICH M. & LUNGER J. 1995)
While there may be no one correct method of interacting with people using AAC systems there are certainly incorrect strategies:
The strategies that natural speakers use in their interactions with AAC users can either enhance or constrain the success of the interactions. At the very least, AAC users should be made aware of the common interaction patterns that occur in aided-natural speaker interactions. By increasing awareness and offering a variety of strategies to exert counter-control during interactions with controlling partners, clinicians can empower AAC system users with strategies for both social and strategic competence. (BUZOLICH M. & LUNGER J. 1995)
INTERACT 2 - Task & Discussion Sheet
Uncover the information section. Ask the staff to think of examples of an interaction which might stop someone communicating. Give further explanations and examples as necessary. Uncover the task. Allow time (5 - 10 minutes is reasonable) to complete it. Work through the three items for discussion. The first is to discuss what people thought their reactions might be and to relate these to users. The second deals with children developing language; suggesting things that have happened with their own children or with children they know. What is the reaction to the linguistic mistakes children make? These points can then be related to the topic. Third is the issue about purpose in providing an AAC system. If the goal is seen to be a fully conversant person, equivalent in skills to a person of similar age (without a severe communication impairment and without a disability) then there is likely to be a problem. While this may be a wonderful thing to achieve, it cannot and should not be the goal for all. For some the achievement of functional communication skills is a major step forward. This should not be denigrated because only grammatical communicative ability is valued.
INTERACT 3 - Elective Electric Mute
Our voice, our speech patterns, our use of language are very much expressions of out personalities. To change any of them, however poorly we regard them, can be to become unrecognizable to oneself. (DALTON P. 1994 page 36)
My father had told me that if I couldn’t talk right, I shouldn’t talk at all. Feeling helpless, defeated, and quite worthless, I succumbed to my own solution: I stopped talking completely (JOHNSON A. G. 1993)
A person’s voice is an integral part of a person’s personality. Being given a new voice can be a traumatic event. It is akin, in some ways, to having a new personality. It is therefore imperative that this image be a positive one for the user. If the voice is belittled or devalued in any way then this can have serious consequences - the user may elect not to use the system.
CASE STUDY- I was speaking with a deputy head teacher in a school in the presence of a young boy who had just begun to use a voice output system of AAC. The deputy turned to me and said loudly, AWhen are these things going to get a decent British accent?”
Pejorative comments on the nature of the voice of an AAC system should be kept from the user of the system. While synthesized voices will undoubtedly continue to improve we have to work with what we have here and now. The quality of today’s synthetic voices is superb but, as in all other aspects of AAC, the goalposts have moved. No longer is the cry for an ‘understandable’ voice but for a voice that can speak with a Cockney accent (for Cockney read ‘Birmingham’, ‘Boston’, .....). This too will come with time but don’t wait for it, start now. Ensure that all significant others make positive remarks about the new voice, remembering that what is positive for significant others may not necessarily be positive for the user.
It might be concluded that this section is not relevant to voiceless low tech systems but that would be mistake. All AAC systems have voices some are silent some are not. Each must be valued in its own way for what it is. While there may be ways of improving voice quality significant others should be wary of how they interact on this topic with or in front of the user. Low tech systems are also vulnerable:
AI can’t understand those squiggles”
AWhy doesn’t it just have words - if you can understand those things why can’t you understand words?”
AIt’s a silly system if it can’t say ‘my house is on fire’”
APut that thing away and let’s have a proper talk”
People may elect not to communicate for a number of reasons - the reason outlined above concerns significant others’ attitudes to the system. However, an individual may have elected not to communicate for reasons other than this. We need to consider what benefits an individual accrues through not communicating. These ‘benefits’ should be viewed empathetically, that is, from the user’s viewpoint. We may not see them as benefits but, nevertheless, to the individual they may be extremely important. The communication team could be encouraged to brain-storm the possible benefits of being incommunicado. These might include:
C Sympathy from others; Safety;
C Immunity from criticism;
C Lack of demands placed upon individual by others;
C Evasion of responsibility;
C Nepotism: continuing parental favour;
C Control of others;
C Evasion of failure.
Others may reinforce these ‘benefits’ in a number of ways:
a) by continuing to do things on behalf of the individual;
b) by being undemanding of the individual;
c) by criticising and being unsupportive of the individual when he or she tries to develop communicative skills.
We all must endeavour to alter the way we interact with people learning augmentative communication skills such that we do not unintentionally reinforce the user-perceived benefits of continuing SILENCE.
For work on elective mutes see WALLACE M. 1986; LEBRUN Y. 1990; CLINE T. & BALDWIN S. 1993; JOHNSON A. G. 1993 (pages 88-89);
My father had told me that if I couldn’t talk right, I shouldn’t talk at all. Feeling helpless, defeated, and quite worthless, I succumbed to my own solution: I stopped talking completely (JOHNSON A. G. 1993)
A person’s voice is an integral part of a person’s personality. Being given a new voice can be a traumatic event. It is akin, in some ways, to having a new personality. It is therefore imperative that this image be a positive one for the user. If the voice is belittled or devalued in any way then this can have serious consequences - the user may elect not to use the system.
CASE STUDY- I was speaking with a deputy head teacher in a school in the presence of a young boy who had just begun to use a voice output system of AAC. The deputy turned to me and said loudly, AWhen are these things going to get a decent British accent?”
Pejorative comments on the nature of the voice of an AAC system should be kept from the user of the system. While synthesized voices will undoubtedly continue to improve we have to work with what we have here and now. The quality of today’s synthetic voices is superb but, as in all other aspects of AAC, the goalposts have moved. No longer is the cry for an ‘understandable’ voice but for a voice that can speak with a Cockney accent (for Cockney read ‘Birmingham’, ‘Boston’, .....). This too will come with time but don’t wait for it, start now. Ensure that all significant others make positive remarks about the new voice, remembering that what is positive for significant others may not necessarily be positive for the user.
It might be concluded that this section is not relevant to voiceless low tech systems but that would be mistake. All AAC systems have voices some are silent some are not. Each must be valued in its own way for what it is. While there may be ways of improving voice quality significant others should be wary of how they interact on this topic with or in front of the user. Low tech systems are also vulnerable:
AI can’t understand those squiggles”
AWhy doesn’t it just have words - if you can understand those things why can’t you understand words?”
AIt’s a silly system if it can’t say ‘my house is on fire’”
APut that thing away and let’s have a proper talk”
People may elect not to communicate for a number of reasons - the reason outlined above concerns significant others’ attitudes to the system. However, an individual may have elected not to communicate for reasons other than this. We need to consider what benefits an individual accrues through not communicating. These ‘benefits’ should be viewed empathetically, that is, from the user’s viewpoint. We may not see them as benefits but, nevertheless, to the individual they may be extremely important. The communication team could be encouraged to brain-storm the possible benefits of being incommunicado. These might include:
C Sympathy from others; Safety;
C Immunity from criticism;
C Lack of demands placed upon individual by others;
C Evasion of responsibility;
C Nepotism: continuing parental favour;
C Control of others;
C Evasion of failure.
Others may reinforce these ‘benefits’ in a number of ways:
a) by continuing to do things on behalf of the individual;
b) by being undemanding of the individual;
c) by criticising and being unsupportive of the individual when he or she tries to develop communicative skills.
We all must endeavour to alter the way we interact with people learning augmentative communication skills such that we do not unintentionally reinforce the user-perceived benefits of continuing SILENCE.
For work on elective mutes see WALLACE M. 1986; LEBRUN Y. 1990; CLINE T. & BALDWIN S. 1993; JOHNSON A. G. 1993 (pages 88-89);
INTERACT 4 - The user will need a communication partner
There are two cartoons on this overhead. The first depicts Jimmy and Sam trying to communicate. Sam has not learnt Bliss and Jimmy is trying to tell him something. There are some problems:
C Sam cannot read Jimmy’s Bliss symbols;
C Sam is not literate and cannot read the words over the Bliss symbols;
C the board is upside-down to Sam;
C Sam cannot follow Jimmy’s logic in his choice of symbols and cannot translate them to a meaningful utterance (if he were a Bliss user);
C a third person is required to translate for Jimmy so that Sam can understand and respond. This third person negates any private conversation. Indeed, there may be additional reasons for an intrusive adult presence:
Sometimes it was hard for us to talk to each other because we couldn’t get around. Somebody had to push us and somebody was always there listening in - no privacy! (SMITH-LEWIS M. & FORD A. 1987)
NOTE: I wish to make clear that the points above are in no way intended to be a criticism of Bliss symbolics. Bliss symbols are a major force in the field of AAC. I am an ardent fan - the positive aspects of Bliss far outweigh any drawbacks. Further, the problems above may be rectified by putting Bliss onto a VOCA as in the BlissTalk device or the Minspeak Application ProgramJ BMW (Shirley McNaughton) for example. The problems above are equally true of a signer and a non-signer, an alpha-numeric board user and a person who is non-literate.
Smith (1978) argued that reading skills are best learnt in the act of reading and I would strongly support the notion that learning to communicate may be best achieved by communicating:
The functional approach to TESL has become increasingly popular in recent years, since it has been asserted that to acquire communicative competence, the key component of the course must be to allow the student to use language for real communication. (SALTER W. & CLEMENTS N. 1988)
Learning to communicate requires that people are willing to spend time chatting with a user. Why learn to sign if there is no one to sign with? The second cartoon makes this point strongly. A VOCA is a particularly useless piece of technology on a desert island. In the (thankfully) rare cases that children have been brought up in isolation from contact with other people dreadful consequences have occurred: Language skills are absent and cognition is poor. (See - MASON M. 1942; BROWN R. 1958; ITARD J. 1962; MALSON L. 1972; RIGLER D. & RIGLER M. 1972; CURTISS S., FROMKIN V., KRASHEN S., RIGLER D., & RIGLER M. 1974; FROMKIN V., KRASHEN S., CURTISS S., RIGLER D., & RIGLER M. 1974; LANE H. 1976; CURTISS S. 1974, 1977; SHATTUCK R. 1980; INGRAM J. 1992 chapter 16; JACKENDOFF R. 1993 chapter 9; RYMER R. 1993; STEINBERG D. 1993 chapter 3; CURTISS S. 1994 for example) (See also KELLER H. 1972)
(For critical period in language acquisition see LENNEBERG E. 1967; NEWPORT E. 1990; HURFORD J. 1991; BIRDSONG D. 1992; JACKENDOFF R. 1993 chapter 9; RYMER R. 1993 chapter 29; HARLEY T. 1995 pp. 315 - 319; HORIZON 1997)
Humans are social beings. We can help a person to develop skills with an AAC system by chatting with them and providing non-threatening opportunities to chat (The latter point will be covered further later in this manual - see Techniques 13). In the hurly burly of the average educational establishment there may not appear to be time for chatting. Time must be found.
In a special educational setting individuals with severe communication impairments may be grouped together. The danger, in this instance, is that augmented communicators will not have vocal peer role models:
... the availability of partners who provided opportunities for conversational interactions were extremely limited. She was homogeneously grouped with others who had communication difficulties.
AWhen I was learning how to talk I didn’t have anybody to talk to ... most of the other kids didn’t have good speech ... I didn’t have conversations. I talked on my friend’s level. We talked about school.”
(SMITH-LEWIS M. & FORD A. 1987 - Quoting ‘Dawn’)
Dawn’s early environment did not support typical interactions with nondisabled peers. She was served in an educational program with classmates who were also nonspeaking. For the most part, her communication partners were limited to teachers, which relegated her to a respondent’s role in most communication interactions. (SMITH-LEWIS M. & FORD A. 1987)
Peer support, peer role models, as well as peer tutoring are important ingredients in the recipe that helps guarantee successful interventions. Of course, the reverse situation holds its share of problems too: a vocal child may act as a surrogate communicator, talking on behalf of a user and thus devalue the AAC system. Peers should be involved in the development of an individual’s augmented communication skills. They too need training and support. Included in the user’s peers are the user’s siblings (See BERRY J. 1987a)
Peer support helps promote AAC use through the encouragement and positive attitude of the users peer group as well as their natural affinity:
Many times the children seemed to benefit more from another child, who was verbal, not understanding the message and offering a natural child response; rather than therapeutic or educational adult input. This clearly speaks to the need for mainstreaming the children who are users with children who are verbal (LEITH V. 1990)
They will participate with kids both with and without disabilities. They will participate with and talk to their classmates in the lunchroom, in elementary school art class, in junior school home economics class, and in high school pottery class. Perhaps most importantly, they will begin to take their communication devices off the shelves of their hall closets and begin to use them, because they will have people they are interested in talking to. (MIRENDA P. 1993)
At one of these meetings one of the friends complained that it was too bad that Greg could not talk because it sure would be easier to get to know him if he could - and Paula admitted to the kids that Greg had this communication device but would not use it. She showed it to the kids, and they, of course, thought it was great - and promised that they would get Greg to use it if she would put some cool vocabulary in it. So, when they greeted Greg at the bus in the morning, they made him use his device. They had Paula program the device with knock-knock jokes and silly riddles, and Greg started using even more. They kept bugging Paula to put 5th grade boy insults in the device, and Greg used it even more. Pretty soon Greg was carrying his device everywhere and using it all the time. (MIRENDA P. 1993. page 6)
We were able to talk to the kids about the things they wanted to talk about. Most adults do not converse with children who do not speak. Instead they ask them non-stop questions and don’t wait on their responses. Student tutors know what is interesting to children and what is boring. (BAKER V. 1994)
Peer support refers to the attitudes of, and encouragement offered by, a user’s ‘unaided’ peers. It is essential that an augmented communicator’s peers, in what ever setting, are aware of:
C the system in use;
C how it will help the user;
C how they can encourage and support the user;
C the things they should try not to do ‘on behalf of the user’ in future.
The user’s peers should be helped to see that the system in use is not a toy. AAC could form the basis of a set of lessons and investigations through which the points made above could be introduced. Consider the following investigations:
C what is communication? How does it work? What can go wrong?
C do animals speak?
C how many words can we speak in one minute?
C how many words do we know?
C if you could only can say 100 things what should they be?
C what is AAC?
C what is its history? How does it fit into the bigger picture of the history of disability rights?
C how many things can you say with an AAC system?
C what is the ‘best’ way of organising them? (syntax, frequency, other ...)
C what technology is involved. How can it be improved?
The list is not intended to be exhaustive but illustrative of the potential for work in all curricular areas from English and mathematics to history, biology and craft, design, technology. User peers should also be actively involved with the user in labelling the environment. Labelling should be multi-lingual: that is more than one label for an item can be produced. One group of the user’s peers might work on labels in the indigenous language in orthographic form, while another group could produce foreign language labels. Further groups could work on an image of an ASL or BSL (or other) sign and yet others might produce labels using the user’s AAC system symbols. All these groups may change places from time to time so that all gain in experience of ‘other languages’.
The text above could be used to argue in favour of the integrated or inclusive classroom. While I would support the notion of the least restrictive environment it does not necessarily follow that for all augmented communicators this is always provided in an integrated setting. It may be that a person beginning to learn augmentative communication skills needs more support and training than the average classroom is capable of providing and thus extra provision may be necessary. However, this does not mean that exclusion is necessarily better for beginners; perhaps a combination of the best features of the two approaches will be the more successful:
For children who are competent augmentative communicators, integration allows them to take advantage of education and use their communication skills as tools for learning. For children who are still in the process of learning to communicate, the typical classroom may not provide them with sufficient models and practice for communicating via augmentative systems to develop. Their communication skills develop at a slower pace and they may not be able to effectively communicate to learn. Perhaps the best solution to this lies in a balance between the two environments. Children could spend part of their day in an intensive immersion environment and then another part of the day in an integrated setting with good follow-up. (BURKHART L. 1990, page 10)
Peer role models are important. They can help to:
C promote motivation in both staff and student alike;
C demonstrate the potential of the AAC system in use;
C instill a positive self-image in the learner.
In addition, participants have access to competent AAC role models ... who serve in the capacity of instructors, presenters, and mentors. (BRYEN B. N., SLESARANSKY G., BAKER D. B. 1995)
Sometimes staff may argue that the peer role model is cognitively more gifted than the learner and suggest that the system is too difficult claiming ‘our children could never achieve that standard’. Of course, by definition, the person that can do is more advanced than the person that cannot or is just starting out. However, if the advanced user is introduced to demonstrate the potential of a particular AAC system then this argument may be side-stepped:
AI don’t know how far Jane will get. She may never get to Susan’s level but any movement towards communicative competence and independence has got to be a positive step. You can see the potential.”
Peer tutoring, takes two forms; peer tutors who are not AAC users themselves and peer tutors who also use the same system of AAC as the learner. We may distinguish the latter from the former with the acronym APT or Aided Peer Tutors. Peer tutoring and peer involvement (as opposed to APT) has been successfully demonstrated (see MARCH J. 1989; MARCH J. 1990; BAKER V. 1994, ROMSKI M., SEVCIK R. & WILKINSON K. 1994; VAN TATENHOVE G. & LAYMAN R. 1994; CAVIN K. & CORNWALLIS P. 1995; RUMBLE G. 1995; MVDP 1996) and has many benefits:
It is now time to explore alternative methods of providing support services within the schools while maintaining the integrity of the program. I feel that using peer students to facilitate .... training is a means of increasing training time in the public schools as well as maximising the direct service time of the professional staff. (MARCH J. 1990 page 94)
I have been facilitating the training of Word Strategy with my son since February ‘89. Using this structured training program, I was amazed how quickly he learned the sequence and his mastery of the system as far as it has been presented. During a period of 60 days with 40 hours of training, at 45 minutes per day, 5 days a week, Bryan achieved a mastery level of 160 words in all their forms.... (MARCH J. 1990, page 98)
The group members were more confident about talking to Katie and had a better understanding of appropriate ways to do this. (CAVIN K. & CORNWALLIS P. 1995 page 42)
The group members were more aware of Katie’s abilities and were seen to include her in shared activities (CAVIN K. & CORNWALLIS P. 1995 page 42)
Aided Peer Tutoring involves users with advanced AAC skills in a particular area tutoring users with lesser skills in the same area (see VAN TATENHOVE G. 1991). In many instances, this is a natural occurrence with one user helping another user in a specific situation. However, it can also be formalised, preferably under the supervision of a speech and language professional. Little has been written on the idea of Aided Peer Tutoring in AAC:
The use of nonspeaking, aided communicators as paid peer trainers to other nonspeaking , aided communicators has received little to any documentation in contemporary literature. A survey of the Augmentative and Alternative Communication Journal from its inception in 1985 to the present indicate no articles dedicated to the topic of AAC training via peers teaching peers. While there are an abundance of articles related to facilitator training and interaction, any form of true peer training is an untapped area of study. (VAN TATENHOVE G. 1991 page 135)
In a recent article in the College of Speech and Language Therapists’ Bulletin (May 1995) peer tutoring was successfully demonstrated and positively endorsed. Peer tutors can:
C act as role models;
C increase positive self-image in tutor and learner;
C increase motivation (See BAKER V. 1994);
C are an efficient, cost-effective way of providing support and tuition;
C help promote positive staff and student-peer attitudes to aided communication and aided communicators (See VAN TATENHOVE G. 1991);
C help promote the idea of the work ethic and dispel the myths that surround disabled people (See - MILLAR A. 1994)
C help provide a consistency of approach (See VAN TATENHOVE G. 1991)
While the use of APT is in its infancy, the deaf community has a long history of developing signing skills through peer interaction (WOOD D. 1986; BERRY J. 1987a; SACKS O. 1991; INGRAM J. 1994; PINKER S. 1994). Indeed, where direct peer interaction is not present from an early age it has been shown (WOOD D., GRIFFITHS A., & HOWARTH I. 1986) that deaf children do not develop cognitively or linguistically to the same level as their hearing peers and may only develop literacy skills to a twelve-year-old level (CONRAD R. 1977; TOWNER P. 1988).
Few nonspeaking adults have the luxury of interacting with competent aided communicators. Taken a step further, few technological competent aided communicators are given the opportunity to serve as teachers of less able peers. The marriage of these two realities offers the possibility of a very powerful therapy model. It may not be a model which is easy to orchestrate or which has immediate visible results. However, the long term effects in the areas of attitude and influence toward use of AAC technology may be significant. (VAN TATENHOVE G. 1991 page 144)
C Sam cannot read Jimmy’s Bliss symbols;
C Sam is not literate and cannot read the words over the Bliss symbols;
C the board is upside-down to Sam;
C Sam cannot follow Jimmy’s logic in his choice of symbols and cannot translate them to a meaningful utterance (if he were a Bliss user);
C a third person is required to translate for Jimmy so that Sam can understand and respond. This third person negates any private conversation. Indeed, there may be additional reasons for an intrusive adult presence:
Sometimes it was hard for us to talk to each other because we couldn’t get around. Somebody had to push us and somebody was always there listening in - no privacy! (SMITH-LEWIS M. & FORD A. 1987)
NOTE: I wish to make clear that the points above are in no way intended to be a criticism of Bliss symbolics. Bliss symbols are a major force in the field of AAC. I am an ardent fan - the positive aspects of Bliss far outweigh any drawbacks. Further, the problems above may be rectified by putting Bliss onto a VOCA as in the BlissTalk device or the Minspeak Application ProgramJ BMW (Shirley McNaughton) for example. The problems above are equally true of a signer and a non-signer, an alpha-numeric board user and a person who is non-literate.
Smith (1978) argued that reading skills are best learnt in the act of reading and I would strongly support the notion that learning to communicate may be best achieved by communicating:
The functional approach to TESL has become increasingly popular in recent years, since it has been asserted that to acquire communicative competence, the key component of the course must be to allow the student to use language for real communication. (SALTER W. & CLEMENTS N. 1988)
Learning to communicate requires that people are willing to spend time chatting with a user. Why learn to sign if there is no one to sign with? The second cartoon makes this point strongly. A VOCA is a particularly useless piece of technology on a desert island. In the (thankfully) rare cases that children have been brought up in isolation from contact with other people dreadful consequences have occurred: Language skills are absent and cognition is poor. (See - MASON M. 1942; BROWN R. 1958; ITARD J. 1962; MALSON L. 1972; RIGLER D. & RIGLER M. 1972; CURTISS S., FROMKIN V., KRASHEN S., RIGLER D., & RIGLER M. 1974; FROMKIN V., KRASHEN S., CURTISS S., RIGLER D., & RIGLER M. 1974; LANE H. 1976; CURTISS S. 1974, 1977; SHATTUCK R. 1980; INGRAM J. 1992 chapter 16; JACKENDOFF R. 1993 chapter 9; RYMER R. 1993; STEINBERG D. 1993 chapter 3; CURTISS S. 1994 for example) (See also KELLER H. 1972)
(For critical period in language acquisition see LENNEBERG E. 1967; NEWPORT E. 1990; HURFORD J. 1991; BIRDSONG D. 1992; JACKENDOFF R. 1993 chapter 9; RYMER R. 1993 chapter 29; HARLEY T. 1995 pp. 315 - 319; HORIZON 1997)
Humans are social beings. We can help a person to develop skills with an AAC system by chatting with them and providing non-threatening opportunities to chat (The latter point will be covered further later in this manual - see Techniques 13). In the hurly burly of the average educational establishment there may not appear to be time for chatting. Time must be found.
In a special educational setting individuals with severe communication impairments may be grouped together. The danger, in this instance, is that augmented communicators will not have vocal peer role models:
... the availability of partners who provided opportunities for conversational interactions were extremely limited. She was homogeneously grouped with others who had communication difficulties.
AWhen I was learning how to talk I didn’t have anybody to talk to ... most of the other kids didn’t have good speech ... I didn’t have conversations. I talked on my friend’s level. We talked about school.”
(SMITH-LEWIS M. & FORD A. 1987 - Quoting ‘Dawn’)
Dawn’s early environment did not support typical interactions with nondisabled peers. She was served in an educational program with classmates who were also nonspeaking. For the most part, her communication partners were limited to teachers, which relegated her to a respondent’s role in most communication interactions. (SMITH-LEWIS M. & FORD A. 1987)
Peer support, peer role models, as well as peer tutoring are important ingredients in the recipe that helps guarantee successful interventions. Of course, the reverse situation holds its share of problems too: a vocal child may act as a surrogate communicator, talking on behalf of a user and thus devalue the AAC system. Peers should be involved in the development of an individual’s augmented communication skills. They too need training and support. Included in the user’s peers are the user’s siblings (See BERRY J. 1987a)
Peer support helps promote AAC use through the encouragement and positive attitude of the users peer group as well as their natural affinity:
Many times the children seemed to benefit more from another child, who was verbal, not understanding the message and offering a natural child response; rather than therapeutic or educational adult input. This clearly speaks to the need for mainstreaming the children who are users with children who are verbal (LEITH V. 1990)
They will participate with kids both with and without disabilities. They will participate with and talk to their classmates in the lunchroom, in elementary school art class, in junior school home economics class, and in high school pottery class. Perhaps most importantly, they will begin to take their communication devices off the shelves of their hall closets and begin to use them, because they will have people they are interested in talking to. (MIRENDA P. 1993)
At one of these meetings one of the friends complained that it was too bad that Greg could not talk because it sure would be easier to get to know him if he could - and Paula admitted to the kids that Greg had this communication device but would not use it. She showed it to the kids, and they, of course, thought it was great - and promised that they would get Greg to use it if she would put some cool vocabulary in it. So, when they greeted Greg at the bus in the morning, they made him use his device. They had Paula program the device with knock-knock jokes and silly riddles, and Greg started using even more. They kept bugging Paula to put 5th grade boy insults in the device, and Greg used it even more. Pretty soon Greg was carrying his device everywhere and using it all the time. (MIRENDA P. 1993. page 6)
We were able to talk to the kids about the things they wanted to talk about. Most adults do not converse with children who do not speak. Instead they ask them non-stop questions and don’t wait on their responses. Student tutors know what is interesting to children and what is boring. (BAKER V. 1994)
Peer support refers to the attitudes of, and encouragement offered by, a user’s ‘unaided’ peers. It is essential that an augmented communicator’s peers, in what ever setting, are aware of:
C the system in use;
C how it will help the user;
C how they can encourage and support the user;
C the things they should try not to do ‘on behalf of the user’ in future.
The user’s peers should be helped to see that the system in use is not a toy. AAC could form the basis of a set of lessons and investigations through which the points made above could be introduced. Consider the following investigations:
C what is communication? How does it work? What can go wrong?
C do animals speak?
C how many words can we speak in one minute?
C how many words do we know?
C if you could only can say 100 things what should they be?
C what is AAC?
C what is its history? How does it fit into the bigger picture of the history of disability rights?
C how many things can you say with an AAC system?
C what is the ‘best’ way of organising them? (syntax, frequency, other ...)
C what technology is involved. How can it be improved?
The list is not intended to be exhaustive but illustrative of the potential for work in all curricular areas from English and mathematics to history, biology and craft, design, technology. User peers should also be actively involved with the user in labelling the environment. Labelling should be multi-lingual: that is more than one label for an item can be produced. One group of the user’s peers might work on labels in the indigenous language in orthographic form, while another group could produce foreign language labels. Further groups could work on an image of an ASL or BSL (or other) sign and yet others might produce labels using the user’s AAC system symbols. All these groups may change places from time to time so that all gain in experience of ‘other languages’.
The text above could be used to argue in favour of the integrated or inclusive classroom. While I would support the notion of the least restrictive environment it does not necessarily follow that for all augmented communicators this is always provided in an integrated setting. It may be that a person beginning to learn augmentative communication skills needs more support and training than the average classroom is capable of providing and thus extra provision may be necessary. However, this does not mean that exclusion is necessarily better for beginners; perhaps a combination of the best features of the two approaches will be the more successful:
For children who are competent augmentative communicators, integration allows them to take advantage of education and use their communication skills as tools for learning. For children who are still in the process of learning to communicate, the typical classroom may not provide them with sufficient models and practice for communicating via augmentative systems to develop. Their communication skills develop at a slower pace and they may not be able to effectively communicate to learn. Perhaps the best solution to this lies in a balance between the two environments. Children could spend part of their day in an intensive immersion environment and then another part of the day in an integrated setting with good follow-up. (BURKHART L. 1990, page 10)
Peer role models are important. They can help to:
C promote motivation in both staff and student alike;
C demonstrate the potential of the AAC system in use;
C instill a positive self-image in the learner.
In addition, participants have access to competent AAC role models ... who serve in the capacity of instructors, presenters, and mentors. (BRYEN B. N., SLESARANSKY G., BAKER D. B. 1995)
Sometimes staff may argue that the peer role model is cognitively more gifted than the learner and suggest that the system is too difficult claiming ‘our children could never achieve that standard’. Of course, by definition, the person that can do is more advanced than the person that cannot or is just starting out. However, if the advanced user is introduced to demonstrate the potential of a particular AAC system then this argument may be side-stepped:
AI don’t know how far Jane will get. She may never get to Susan’s level but any movement towards communicative competence and independence has got to be a positive step. You can see the potential.”
Peer tutoring, takes two forms; peer tutors who are not AAC users themselves and peer tutors who also use the same system of AAC as the learner. We may distinguish the latter from the former with the acronym APT or Aided Peer Tutors. Peer tutoring and peer involvement (as opposed to APT) has been successfully demonstrated (see MARCH J. 1989; MARCH J. 1990; BAKER V. 1994, ROMSKI M., SEVCIK R. & WILKINSON K. 1994; VAN TATENHOVE G. & LAYMAN R. 1994; CAVIN K. & CORNWALLIS P. 1995; RUMBLE G. 1995; MVDP 1996) and has many benefits:
It is now time to explore alternative methods of providing support services within the schools while maintaining the integrity of the program. I feel that using peer students to facilitate .... training is a means of increasing training time in the public schools as well as maximising the direct service time of the professional staff. (MARCH J. 1990 page 94)
I have been facilitating the training of Word Strategy with my son since February ‘89. Using this structured training program, I was amazed how quickly he learned the sequence and his mastery of the system as far as it has been presented. During a period of 60 days with 40 hours of training, at 45 minutes per day, 5 days a week, Bryan achieved a mastery level of 160 words in all their forms.... (MARCH J. 1990, page 98)
The group members were more confident about talking to Katie and had a better understanding of appropriate ways to do this. (CAVIN K. & CORNWALLIS P. 1995 page 42)
The group members were more aware of Katie’s abilities and were seen to include her in shared activities (CAVIN K. & CORNWALLIS P. 1995 page 42)
Aided Peer Tutoring involves users with advanced AAC skills in a particular area tutoring users with lesser skills in the same area (see VAN TATENHOVE G. 1991). In many instances, this is a natural occurrence with one user helping another user in a specific situation. However, it can also be formalised, preferably under the supervision of a speech and language professional. Little has been written on the idea of Aided Peer Tutoring in AAC:
The use of nonspeaking, aided communicators as paid peer trainers to other nonspeaking , aided communicators has received little to any documentation in contemporary literature. A survey of the Augmentative and Alternative Communication Journal from its inception in 1985 to the present indicate no articles dedicated to the topic of AAC training via peers teaching peers. While there are an abundance of articles related to facilitator training and interaction, any form of true peer training is an untapped area of study. (VAN TATENHOVE G. 1991 page 135)
In a recent article in the College of Speech and Language Therapists’ Bulletin (May 1995) peer tutoring was successfully demonstrated and positively endorsed. Peer tutors can:
C act as role models;
C increase positive self-image in tutor and learner;
C increase motivation (See BAKER V. 1994);
C are an efficient, cost-effective way of providing support and tuition;
C help promote positive staff and student-peer attitudes to aided communication and aided communicators (See VAN TATENHOVE G. 1991);
C help promote the idea of the work ethic and dispel the myths that surround disabled people (See - MILLAR A. 1994)
C help provide a consistency of approach (See VAN TATENHOVE G. 1991)
While the use of APT is in its infancy, the deaf community has a long history of developing signing skills through peer interaction (WOOD D. 1986; BERRY J. 1987a; SACKS O. 1991; INGRAM J. 1994; PINKER S. 1994). Indeed, where direct peer interaction is not present from an early age it has been shown (WOOD D., GRIFFITHS A., & HOWARTH I. 1986) that deaf children do not develop cognitively or linguistically to the same level as their hearing peers and may only develop literacy skills to a twelve-year-old level (CONRAD R. 1977; TOWNER P. 1988).
Few nonspeaking adults have the luxury of interacting with competent aided communicators. Taken a step further, few technological competent aided communicators are given the opportunity to serve as teachers of less able peers. The marriage of these two realities offers the possibility of a very powerful therapy model. It may not be a model which is easy to orchestrate or which has immediate visible results. However, the long term effects in the areas of attitude and influence toward use of AAC technology may be significant. (VAN TATENHOVE G. 1991 page 144)
INTERACT 5 - Be careful what you say...
Dear Mrs. <Mother’s Name’,
D. wouldn’t do much math today. For twenty minutes he was struggling to tell us something using the Liberator. We asked him if it was something important for us to know. He replied Ayes” so we let him work at telling us. Finally he said AHappy Thanksgiving”. We tried to explain to D. how much math time was wasted on this. I don’t know if he understands.
Sincerely,
Mrs. <Teacher’s Name’
Letter to B.K. from her son’s school (November 8th 1995) which was included in a personal correspondence to the author from Mrs. K. (initials used to protect confidentiality). D. operates his VOCA using a single switch.
What, if anything, is wrong with the above note to home from school?
Professionals and significant others must carefully scrutinize their comments directed toward and in the presence of children. (SWEENEY L. 1993)
and, I would add, in the presence of parents! It is very easy for an unthinking remark or aside to have a negative effect on a person’s use of an AAC system:
AListen at Jenny showing off!”
AWhen are you going to learn to talk properly?”
AStop using that silly machine.”
AWhat am I supposed to do with these silly squiggles?”
APut that board away. It’s a waste of time here.”
AWhy don’t you use your natural voice?”
ADid you use your machine or did you talk to them?”.
Sometimes remarks are made which are supposedly helpful in nature but may achieve just the opposite result:
Pupil: AGreenhouse go - go now.”
Teacher: AWhen you can say it properly - when you can say ‘I want to go to the greenhouse’ then I’ll let you go.”
In the above real-life example, the teacher was trying to model (and encourage the pupil to use) the correct syntactical form. However, it turned out to have the opposite effect - the pupil stopped using her system.
If we are constantly criticised for behaving in a certain manner it is likely that we will stop behaving that way. It is often a difficult task to get a person to initiate for the first time. If initiation is nullified by careless or unthinking remarks many weeks of hard work may be destroyed. In the world outside the classroom the functional utterance (See below - INTERACT 5) should be accepted.
CASE STUDY: In a special school a user of a VOCA had just got off the phone to his mother. A short time afterwards one of the speech therapists employed at the school was heard to say, ADid you talk to her or did you use your machine?”. The implication was that talking is using your voice and using your machine is not talking. The augmentative system was thus devalued.
D. wouldn’t do much math today. For twenty minutes he was struggling to tell us something using the Liberator. We asked him if it was something important for us to know. He replied Ayes” so we let him work at telling us. Finally he said AHappy Thanksgiving”. We tried to explain to D. how much math time was wasted on this. I don’t know if he understands.
Sincerely,
Mrs. <Teacher’s Name’
Letter to B.K. from her son’s school (November 8th 1995) which was included in a personal correspondence to the author from Mrs. K. (initials used to protect confidentiality). D. operates his VOCA using a single switch.
What, if anything, is wrong with the above note to home from school?
Professionals and significant others must carefully scrutinize their comments directed toward and in the presence of children. (SWEENEY L. 1993)
and, I would add, in the presence of parents! It is very easy for an unthinking remark or aside to have a negative effect on a person’s use of an AAC system:
AListen at Jenny showing off!”
AWhen are you going to learn to talk properly?”
AStop using that silly machine.”
AWhat am I supposed to do with these silly squiggles?”
APut that board away. It’s a waste of time here.”
AWhy don’t you use your natural voice?”
ADid you use your machine or did you talk to them?”.
Sometimes remarks are made which are supposedly helpful in nature but may achieve just the opposite result:
Pupil: AGreenhouse go - go now.”
Teacher: AWhen you can say it properly - when you can say ‘I want to go to the greenhouse’ then I’ll let you go.”
In the above real-life example, the teacher was trying to model (and encourage the pupil to use) the correct syntactical form. However, it turned out to have the opposite effect - the pupil stopped using her system.
If we are constantly criticised for behaving in a certain manner it is likely that we will stop behaving that way. It is often a difficult task to get a person to initiate for the first time. If initiation is nullified by careless or unthinking remarks many weeks of hard work may be destroyed. In the world outside the classroom the functional utterance (See below - INTERACT 5) should be accepted.
CASE STUDY: In a special school a user of a VOCA had just got off the phone to his mother. A short time afterwards one of the speech therapists employed at the school was heard to say, ADid you talk to her or did you use your machine?”. The implication was that talking is using your voice and using your machine is not talking. The augmentative system was thus devalued.
INTERACT 6 - Speech not Teach
I don’t want to talk grammar. I want to talk like a lady.
(GEORGE BERNARD SHAW. Liza Doolittle, Pygmalion, act 2.)
A functional utterance is not necessarily grammatical. It does not have to contain every part of speech that a fully grammatical equivalent utterance would contain. It does not have to be presented in the correct syntactical order. It needs only to be understood. If it is understood (Greenhouse go now) then it is functional. If a person is able to correct a non-grammatical phrase then it follows it has been understood. Correcting a functional utterance is not a recommended strategy:
Approximation ‑ Experimentation and acceptance are as necessary for the non‑speaking child as they are for the child beginning to talk. The teacher serves as a COACH NOT A CRITIC. The focus is on development of language strategies and learning to apply these strategies in the natural or whole language context (THUMA‑REW S. 1988)
The manner in which a user uses language however should be not be ignored. It may be mentally noted that ‘Jimmy does not use the copula form of the verb correctly’ and ‘Sally has no idea of a central determiner’. These can be raised at the next case conference. It may be that Jimmy does not use a particular form because:
C he is cognitively not ready for it;
C he has not been taught it;
C he chooses not to use it;
C he has forgotten where it is located or stored.
If it is appropriate, an intervention strategy can be put into action in the communication classroom. Here it is non-threatening and not perceived as criticism of ability. Outside of the safety of this environment, the functional utterance should be accepted. Indeed, the listener should encourage the speaker to say more:
Jimmy: ADad car come.”
Facilitator: AOh Dad is coming in the car, is he? When’s hecoming Jimmy?”
Jimmy: AFriday come Mum”
Facilitator: AMum’s coming as well on Friday. Why are they coming?”
Jimmy: AGo home Mum Friday”
Jimmy is encouraged to say more. The facilitator attempts to model the correct form of the sentence for Jimmy to hear. There is no harm in this and it allows Jimmy the opportunity to check the facilitator’s understanding of his message.
....Grammar errors are accepted and rewarded over time without worry and with confidence that the child will learn. Adults accept the error but continue to use proper and full language (THUMA‑REW S. 1988)
It should not be presumed that modelling will result in the development of correct syntactical forms. Users may have heard many ‘correct syntactical forms’ all their lives and still be unable to produce them:
It is important to emphasise that language development takes place under guidance in compulsory situations. Sheer ‘exposure’ to language is insufficient. It may appear to work with many children, because the home has in fact provided that guidance and compulsion. (WILKINSON A. 1971)
However, there is good reason to model(in a non-threatening manner) the standard form of any utterance. This point will be developed further below.
If the goal is to enable people to communicate then the functional utterance should be respected and encouraged. Development of grammatical skills should take place as a result of a carefully considered intervention strategy.
A user should be encouraged to communicate and not discouraged through criticism and unthinking remarks. A user must be encouraged to communicate even if the words and syntax produced are at a developmental level which is not commensurate with the person’s age.
Providing meaningful opportunities to use the system is more valuable than hours of drill activities (BRUNO J. 1986)
It is important that the facilitator instills the virtues of reinforcement of communication into all staff who are likely to interact with any user. Augmented communicators are not going to attempt communication if their efforts are belittled or they are immediately given a diatribe on the complexities of syntactic structure. Equally, unless there are times and situations throughout the day when communication is encouraged, the development of skills will be stinted. A passive environment will create passive people. The environment is of prime concern for all facilitators.
(GEORGE BERNARD SHAW. Liza Doolittle, Pygmalion, act 2.)
A functional utterance is not necessarily grammatical. It does not have to contain every part of speech that a fully grammatical equivalent utterance would contain. It does not have to be presented in the correct syntactical order. It needs only to be understood. If it is understood (Greenhouse go now) then it is functional. If a person is able to correct a non-grammatical phrase then it follows it has been understood. Correcting a functional utterance is not a recommended strategy:
Approximation ‑ Experimentation and acceptance are as necessary for the non‑speaking child as they are for the child beginning to talk. The teacher serves as a COACH NOT A CRITIC. The focus is on development of language strategies and learning to apply these strategies in the natural or whole language context (THUMA‑REW S. 1988)
The manner in which a user uses language however should be not be ignored. It may be mentally noted that ‘Jimmy does not use the copula form of the verb correctly’ and ‘Sally has no idea of a central determiner’. These can be raised at the next case conference. It may be that Jimmy does not use a particular form because:
C he is cognitively not ready for it;
C he has not been taught it;
C he chooses not to use it;
C he has forgotten where it is located or stored.
If it is appropriate, an intervention strategy can be put into action in the communication classroom. Here it is non-threatening and not perceived as criticism of ability. Outside of the safety of this environment, the functional utterance should be accepted. Indeed, the listener should encourage the speaker to say more:
Jimmy: ADad car come.”
Facilitator: AOh Dad is coming in the car, is he? When’s hecoming Jimmy?”
Jimmy: AFriday come Mum”
Facilitator: AMum’s coming as well on Friday. Why are they coming?”
Jimmy: AGo home Mum Friday”
Jimmy is encouraged to say more. The facilitator attempts to model the correct form of the sentence for Jimmy to hear. There is no harm in this and it allows Jimmy the opportunity to check the facilitator’s understanding of his message.
....Grammar errors are accepted and rewarded over time without worry and with confidence that the child will learn. Adults accept the error but continue to use proper and full language (THUMA‑REW S. 1988)
It should not be presumed that modelling will result in the development of correct syntactical forms. Users may have heard many ‘correct syntactical forms’ all their lives and still be unable to produce them:
It is important to emphasise that language development takes place under guidance in compulsory situations. Sheer ‘exposure’ to language is insufficient. It may appear to work with many children, because the home has in fact provided that guidance and compulsion. (WILKINSON A. 1971)
However, there is good reason to model(in a non-threatening manner) the standard form of any utterance. This point will be developed further below.
If the goal is to enable people to communicate then the functional utterance should be respected and encouraged. Development of grammatical skills should take place as a result of a carefully considered intervention strategy.
A user should be encouraged to communicate and not discouraged through criticism and unthinking remarks. A user must be encouraged to communicate even if the words and syntax produced are at a developmental level which is not commensurate with the person’s age.
Providing meaningful opportunities to use the system is more valuable than hours of drill activities (BRUNO J. 1986)
It is important that the facilitator instills the virtues of reinforcement of communication into all staff who are likely to interact with any user. Augmented communicators are not going to attempt communication if their efforts are belittled or they are immediately given a diatribe on the complexities of syntactic structure. Equally, unless there are times and situations throughout the day when communication is encouraged, the development of skills will be stinted. A passive environment will create passive people. The environment is of prime concern for all facilitators.
INTERACT 7 - I can C the Pea
Imitation L Comprehension L Production
Thus far we have discussed the error of equating the absence of a verbal product with the absence of a cognitive process. It is also possible to make an error in the opposite direction, to equate the presence of a verbal product with the presence of a cognitive process. A retarded child may sit politely, nod his head in apparent understanding as we explain or teach something, and then repeat for us what we have just said. His faultless recital might lead us to conclude that he understands what we have said, but he may not even understand what he is reciting. If we automatically assume a correspondence between cognitive process and verbal product, we may erroneously conclude, in the first set of instances discussed, that a retardate knows less than he really does, and, in the instance to which I now refer, that he knows more. (MILGRAM N. 1973 page 171)
In general, children imitate before they comprehend and comprehend before they are able to produce (FRASER C., BELLUGI U., & BROWN R. 1963) (See also WILKINSON A. 1971, JEFFREE D. & McCONKEY R. 1976, BLOOM P. 1993, and INGRAM D. 1989 chapter 9). It should not be presumed that imitation of a modelled sentence indicates comprehension. Nor should it be presumed that the ability to understand and carry out a given command means an ability to produce a sentence form of equal syntactic structure.
Understanding comes before the spoken word. Children understand more than they can express, as a rule. When teaching language we have, above all, to help this understanding (JEFFREE D. & McCONKEY R. 1976)
One way of expressing this is to say that they often understand and can recognize as correct what they cannot yet themselves produce. (WOOD D. 1988)
While facilitators should be encouraged to model the correct phrasal form (in a non-threatening manner) this is all that should occur in the functional environment. A requirement to imitate may be used as a tool in the teaching environment (See INTERACT 5) where it is less likely to be perceived as threatening.
Modelling through expansion may help with the imitation skills which precede comprehension. In an experiment (See INGRAM J. 1992 pp. 192 - 193) in which some young three-and-a-half-year-old children heard expanded sentences and others heard explanatory sentences, however, the latter were linguistically more advanced after three months.
EXPANSIVE Child: ADog bark”
Parent: AYes, the dog is barking, isn’t it?”
EXPLANATORY Child: ADog bark”
Parent: AYes, he’s trying to frighten the cat.”
Thus, it would appear that an improved strategy is to model the correct syntactic form but progress further and cover new territory through explanation and additional questions:
User: ADad Friday come”
Response: AOh! Dad’s coming on Friday. I guess he’s coming to take you home for the weekend. What will you be doing?”
Staff should be aware that:
C the functional utterance is to be accepted without criticism;
C modelling the correct form in a non-threatening manner is desirable;
C imitation precedes comprehension. A user who is able to repeat a given phrase does not necessarily understand it. A user who can repeat an item’s name does not necessarily know what that item is.
ASay parasemanticity”
AParasemanticity”
AGood. Now tell me what it means”
C comprehension precedes production. Vocalised grammatical precision should not be expected when there is cognition of a given syntactic structure;
C asking further questions to encourage communication is a good tactic.
Until recently, I believed that ICP was the correct developmental process for all AAC users. However, after talking with Peggy Locke (LOCKE P. 1996), I have changed my opinion! Peggy pointed out that, for some voice output communication aid users at least, production can precede comprehension. Suppose an individual is provided with a simple VOCA which is programmed to operate from a single switch such that, when the individual hits the switch, the same single message is generated. Although the individual may not yet understand this message, if there is a consistent response from significant others, then the individual may begin to understand that the message has a connection to the event. Indeed, this can be used as a method for teaching the meaning of an utterance.
People who use voice output communication aids are able to make an utterance without understanding it. In this instance, the order of my mnemonic has now to change and I have to make a:
Public Correction (Production before Comprehension)
This may only hold true for simple single messaging systems where significant others provide a consistency of response. However, children often produce words whose meaning is over-generalised. The word ‘Rover’ (the child’s dog’s name) may be used for all animals, then for all dogs, and finally for just the specific dog. In this instance, the child’s production (‘Rover’) precedes full comprehension (that Rover is the name of a specific dog and not the name for all animals). The child’s production is gradually refined until the child’s comprehension is commensurate with the norm. Production, could be seen, as a way of refining the meaning of a particular utterance. However, it is unlikely that the child is doing this. The child initially believes s/he has comprehended the word and, in the light of evidence to the contrary makes alterations to the meaning, resulting in the refinement process. It could reasonably be argued, therefore, that comprehension continues to precede production.
Thus far we have discussed the error of equating the absence of a verbal product with the absence of a cognitive process. It is also possible to make an error in the opposite direction, to equate the presence of a verbal product with the presence of a cognitive process. A retarded child may sit politely, nod his head in apparent understanding as we explain or teach something, and then repeat for us what we have just said. His faultless recital might lead us to conclude that he understands what we have said, but he may not even understand what he is reciting. If we automatically assume a correspondence between cognitive process and verbal product, we may erroneously conclude, in the first set of instances discussed, that a retardate knows less than he really does, and, in the instance to which I now refer, that he knows more. (MILGRAM N. 1973 page 171)
In general, children imitate before they comprehend and comprehend before they are able to produce (FRASER C., BELLUGI U., & BROWN R. 1963) (See also WILKINSON A. 1971, JEFFREE D. & McCONKEY R. 1976, BLOOM P. 1993, and INGRAM D. 1989 chapter 9). It should not be presumed that imitation of a modelled sentence indicates comprehension. Nor should it be presumed that the ability to understand and carry out a given command means an ability to produce a sentence form of equal syntactic structure.
Understanding comes before the spoken word. Children understand more than they can express, as a rule. When teaching language we have, above all, to help this understanding (JEFFREE D. & McCONKEY R. 1976)
One way of expressing this is to say that they often understand and can recognize as correct what they cannot yet themselves produce. (WOOD D. 1988)
While facilitators should be encouraged to model the correct phrasal form (in a non-threatening manner) this is all that should occur in the functional environment. A requirement to imitate may be used as a tool in the teaching environment (See INTERACT 5) where it is less likely to be perceived as threatening.
Modelling through expansion may help with the imitation skills which precede comprehension. In an experiment (See INGRAM J. 1992 pp. 192 - 193) in which some young three-and-a-half-year-old children heard expanded sentences and others heard explanatory sentences, however, the latter were linguistically more advanced after three months.
EXPANSIVE Child: ADog bark”
Parent: AYes, the dog is barking, isn’t it?”
EXPLANATORY Child: ADog bark”
Parent: AYes, he’s trying to frighten the cat.”
Thus, it would appear that an improved strategy is to model the correct syntactic form but progress further and cover new territory through explanation and additional questions:
User: ADad Friday come”
Response: AOh! Dad’s coming on Friday. I guess he’s coming to take you home for the weekend. What will you be doing?”
Staff should be aware that:
C the functional utterance is to be accepted without criticism;
C modelling the correct form in a non-threatening manner is desirable;
C imitation precedes comprehension. A user who is able to repeat a given phrase does not necessarily understand it. A user who can repeat an item’s name does not necessarily know what that item is.
ASay parasemanticity”
AParasemanticity”
AGood. Now tell me what it means”
C comprehension precedes production. Vocalised grammatical precision should not be expected when there is cognition of a given syntactic structure;
C asking further questions to encourage communication is a good tactic.
Until recently, I believed that ICP was the correct developmental process for all AAC users. However, after talking with Peggy Locke (LOCKE P. 1996), I have changed my opinion! Peggy pointed out that, for some voice output communication aid users at least, production can precede comprehension. Suppose an individual is provided with a simple VOCA which is programmed to operate from a single switch such that, when the individual hits the switch, the same single message is generated. Although the individual may not yet understand this message, if there is a consistent response from significant others, then the individual may begin to understand that the message has a connection to the event. Indeed, this can be used as a method for teaching the meaning of an utterance.
People who use voice output communication aids are able to make an utterance without understanding it. In this instance, the order of my mnemonic has now to change and I have to make a:
Public Correction (Production before Comprehension)
This may only hold true for simple single messaging systems where significant others provide a consistency of response. However, children often produce words whose meaning is over-generalised. The word ‘Rover’ (the child’s dog’s name) may be used for all animals, then for all dogs, and finally for just the specific dog. In this instance, the child’s production (‘Rover’) precedes full comprehension (that Rover is the name of a specific dog and not the name for all animals). The child’s production is gradually refined until the child’s comprehension is commensurate with the norm. Production, could be seen, as a way of refining the meaning of a particular utterance. However, it is unlikely that the child is doing this. The child initially believes s/he has comprehended the word and, in the light of evidence to the contrary makes alterations to the meaning, resulting in the refinement process. It could reasonably be argued, therefore, that comprehension continues to precede production.
INTERACT 8 - The pain of the strain...
Under pressure everybody is capable of making mistakes. Put a person who has athetoid cerebral palsy under pressure and see if it helps. If a person learning a system of AAC is put under immense pressure then the result is likely to be more errors, which further increases the pressure, which increases the errors, and so on.
The cartoon depicts Sam being put under immense pressure. Teacher is waiting and the class is waiting. Sam is trying to create a phrase in response on the spot. Apart from holding everything and everyone up, it puts Sam under too much pressure and can have harmful effects. There are alternatives:
C take the strain. Ask the question in such a manner that it can be answered simply (in one or two words) but avoid the yes or no question;
C ensure the question is understood. Use a multi-modal approach. Sign, use body language, models, pictures, etc;
C give the person time to answer but do not hold up everything in deathly silence while the answer is being prepared. A technique is to give everyone a question to be thinking about. Give Sam his question first but visit him for the answer:
i) when he makes it plain he has generated it by indicating (through a VOCA or by gesture, etc);
ii) last in the group (giving maximum time).
C make use of TRV (Temporarily Restricted Vocabularies) (this topic is covered in greater depth in the vocabulary issues section). When using TRV the range of responses to a set of questions is narrowed for the entire class. Questions generally range about a specific topic and, therefore, it is an easily implemented tactic to make explicit four or five possible answers to the questions about to asked. For example, suppose the class is looking at symmetry. A simple TRV may be the words ‘symmetrical’ and ‘asymmetrical’. A further example is:
‘Equilateral triangle’ ‘Square’ ‘Rectangle’ ‘Pentagon’
(Holding up a picture to the class) AName this shape Sam”
AWhich shape has three axes of symmetry?”
AName one shape that has four axes of symmetry”
ACan you name another?”
AName the shape with three equal sides”
AWhich shape has opposite sides parallel but not all equal in length?”
The person using row-column scanning is usually slower than one using a system of direct selection. Take the strain:
AChristina. Hi! You’ve got something to say. Tell you what, go ahead and build it up. When you are ready just speak I’ll come straight back to you. In the mean time I’ll be working with John over here.”
Of course, it may not always be appropriate to do this. Life isn’t that simple! Any technique that reduces the strain on an individual will inevitably speed up the communicative process. Letting people know you have time for them is important. Ensuring that people are not made to feel self-conscious is also important.
The cartoon depicts Sam being put under immense pressure. Teacher is waiting and the class is waiting. Sam is trying to create a phrase in response on the spot. Apart from holding everything and everyone up, it puts Sam under too much pressure and can have harmful effects. There are alternatives:
C take the strain. Ask the question in such a manner that it can be answered simply (in one or two words) but avoid the yes or no question;
C ensure the question is understood. Use a multi-modal approach. Sign, use body language, models, pictures, etc;
C give the person time to answer but do not hold up everything in deathly silence while the answer is being prepared. A technique is to give everyone a question to be thinking about. Give Sam his question first but visit him for the answer:
i) when he makes it plain he has generated it by indicating (through a VOCA or by gesture, etc);
ii) last in the group (giving maximum time).
C make use of TRV (Temporarily Restricted Vocabularies) (this topic is covered in greater depth in the vocabulary issues section). When using TRV the range of responses to a set of questions is narrowed for the entire class. Questions generally range about a specific topic and, therefore, it is an easily implemented tactic to make explicit four or five possible answers to the questions about to asked. For example, suppose the class is looking at symmetry. A simple TRV may be the words ‘symmetrical’ and ‘asymmetrical’. A further example is:
‘Equilateral triangle’ ‘Square’ ‘Rectangle’ ‘Pentagon’
(Holding up a picture to the class) AName this shape Sam”
AWhich shape has three axes of symmetry?”
AName one shape that has four axes of symmetry”
ACan you name another?”
AName the shape with three equal sides”
AWhich shape has opposite sides parallel but not all equal in length?”
The person using row-column scanning is usually slower than one using a system of direct selection. Take the strain:
AChristina. Hi! You’ve got something to say. Tell you what, go ahead and build it up. When you are ready just speak I’ll come straight back to you. In the mean time I’ll be working with John over here.”
Of course, it may not always be appropriate to do this. Life isn’t that simple! Any technique that reduces the strain on an individual will inevitably speed up the communicative process. Letting people know you have time for them is important. Ensuring that people are not made to feel self-conscious is also important.
INTERACT 9 - What's your position on this?
Positioning yourself appropriately can make all the difference when interacting with a person using an AAC system. Some pointers for this are:
C eye contact is crucial. It shows that you are attending to the person and that the person is attending to you. Of course, the user must break eye contact to select from the system (until automaticity is acquired). Further, if it is the person’s turn to speak, focussed eye contact can help to show that you are waiting for a response.
C position yourself in front of the person you are speaking to; face to face. Reading a communication board from behind may be practical but is not good communication. It should be noted, however, that positioning yourself directly in front of another can be confrontational and threatening for some individuals. If you image a red danger line emanating directly from a person’s nose then it is best to avoid standing ( or sitting) directly on this line, rather position yourself just to one side of it (See the work of Dave Hewett);
C if a person is using a VOCA do not read the display. People who read displays tend to stand behind the user. Don’t read. Listen to what is being said. If you don’t understand say so. Reading the display should be used as a last resort and only with permission;
NOTE: the Toby Churchill LightwriterJ has an additional forward facing display to facilitate face-to-face interactions
C speak at the user’s height. For a person in a wheelchair, looking up is a real pain in the neck. It is also not a natural conversational mode. The person higher up may be seen as dominating the conversation. If possible, sit down and establish good eye contact.
C eye contact is crucial. It shows that you are attending to the person and that the person is attending to you. Of course, the user must break eye contact to select from the system (until automaticity is acquired). Further, if it is the person’s turn to speak, focussed eye contact can help to show that you are waiting for a response.
C position yourself in front of the person you are speaking to; face to face. Reading a communication board from behind may be practical but is not good communication. It should be noted, however, that positioning yourself directly in front of another can be confrontational and threatening for some individuals. If you image a red danger line emanating directly from a person’s nose then it is best to avoid standing ( or sitting) directly on this line, rather position yourself just to one side of it (See the work of Dave Hewett);
C if a person is using a VOCA do not read the display. People who read displays tend to stand behind the user. Don’t read. Listen to what is being said. If you don’t understand say so. Reading the display should be used as a last resort and only with permission;
NOTE: the Toby Churchill LightwriterJ has an additional forward facing display to facilitate face-to-face interactions
C speak at the user’s height. For a person in a wheelchair, looking up is a real pain in the neck. It is also not a natural conversational mode. The person higher up may be seen as dominating the conversation. If possible, sit down and establish good eye contact.
INTERACT 10 - 'Time (and tide) waits for no man'
16th Century Proverb
The opposite of talking isn’t listening. The opposite of talking is waiting. (LEBOWITZ F. 1981)
Sometimes people will ask a question and while a user is attempting to respond they will move onto another question. A period of silence is unnerving for some people. Significant others often answer on behalf of an augmented communicator with only the briefest of pauses between the end of the initiating question and their decision to respond (LIGHT J. 1985). If they are encouraged to wait there is likely to be an increase in the communicative initiatives of the user (See, for example GLENNEN S. & CALCULATOR S. 1985; HAMILTON B. & SNELL M. 1993). Significant others will often begin guessing a user’s message before the user has had time to make it explicit. Significant others will also guess what a user wants from the context:
User pulls the dress of a teacher.
AWhat’s the matter Sam. Do you want something? Oh you’ve knocked your drink over. I’ll get you another one.”
The opportunity for Sam to communicate using the AAC system is lost.
Wait before:
C guessing what a user wants;
C answering on behalf of a user;
C asking another to answer on behalf of a user;
C asking another (clarifying) question.
Sometimes people unfamiliar with AAC will interrupt an augmented communicator while a response is being built. A technique for VOCA users is to leave the voice output on while answering so that the listener hears the communication being built and is more likely to wait. Symbol board users may be encouraged to point to a prepared message for inexperienced listeners who do not wait:
APlease be patient. I am not very fast. I will point to some symbols.”
Sometimes a clear message is displayed on a users AAC system for all ‘listeners’ to see:
AMy name is Sammy. I use this board to talk. I point to the pictures. Please be patient as I have to think about what I want to say.”
When teachers ask pupils questions, they tend to leave about a second of silence, on average, before they resume talking (if the children have not responded). In a study of the effects of different teacher ‘wait times’ on children’s responses (ROWE M. 1974; SWIFT J. & GOODING C. 1983), teachers were provided with a buzzer (which only they could hear) and were asked, having posed a question, to wait until this was sounded before going on. The buzzer was controlled by an observer, who waited for three seconds after each question before activating it (again, if no response was forthcoming from the class). The increased ‘wait time’ allowed to children resulted in more frequent, relevant, thoughtful, and ‘high level’ responses to the teachers’ questions. (WOOD D. 1988)
Whatever techniques are used, it is important that significant others give users more opportunity to communicate by waiting:
In order to give users of aided communication an opportunity to control the course of conversation better, and contribute to the conversation on a more equal footing, it is first and foremost important that they be given the time they need to say what they want to say. This implies that the conversational partners must wait long enough before they begin to interpret or guess at what the individuals are saying, or take the communicative initiative, be it a continuation of the conversation or a change of topic (VON TETZCHNER S. & MARTINSEN H. 1992)
Positive results from the use of the ‘time-delay’ technique has been well documented in the literature (See HALLE J., MARSHALL A. & SPRADLIN J. 1979; HALLE J., BAER D., & SPRADLIN J. 1981; HALLE J. 1982; CHARLOP M., SCHREIBMAN L., & THIBODEAU M. 1985; CHARLOP M. & WALSH M. 1986; HANDEN B. & ZANE T. 1987; GOBBI L., CIPANI E., HUDSON C., & LAPENTA-NEUDECK R. 1986; McCOOK B., CIPANI E., MADIGAN K., LaCAMPAGNE J. 1988). Again this involves waiting for a set amount of time. If after the time has elapsed the person has still not performed the required action then a prompt is given:
Time delay can be used to provide opportunities for learners to communicate in the natural environment. In a time-delay procedure controlling cues are withheld briefly to give the learner time to respond. (REICHLE J. & SIGAFOOS J. 1991 p. 167)
WAIT!
The opposite of talking isn’t listening. The opposite of talking is waiting. (LEBOWITZ F. 1981)
Sometimes people will ask a question and while a user is attempting to respond they will move onto another question. A period of silence is unnerving for some people. Significant others often answer on behalf of an augmented communicator with only the briefest of pauses between the end of the initiating question and their decision to respond (LIGHT J. 1985). If they are encouraged to wait there is likely to be an increase in the communicative initiatives of the user (See, for example GLENNEN S. & CALCULATOR S. 1985; HAMILTON B. & SNELL M. 1993). Significant others will often begin guessing a user’s message before the user has had time to make it explicit. Significant others will also guess what a user wants from the context:
User pulls the dress of a teacher.
AWhat’s the matter Sam. Do you want something? Oh you’ve knocked your drink over. I’ll get you another one.”
The opportunity for Sam to communicate using the AAC system is lost.
Wait before:
C guessing what a user wants;
C answering on behalf of a user;
C asking another to answer on behalf of a user;
C asking another (clarifying) question.
Sometimes people unfamiliar with AAC will interrupt an augmented communicator while a response is being built. A technique for VOCA users is to leave the voice output on while answering so that the listener hears the communication being built and is more likely to wait. Symbol board users may be encouraged to point to a prepared message for inexperienced listeners who do not wait:
APlease be patient. I am not very fast. I will point to some symbols.”
Sometimes a clear message is displayed on a users AAC system for all ‘listeners’ to see:
AMy name is Sammy. I use this board to talk. I point to the pictures. Please be patient as I have to think about what I want to say.”
When teachers ask pupils questions, they tend to leave about a second of silence, on average, before they resume talking (if the children have not responded). In a study of the effects of different teacher ‘wait times’ on children’s responses (ROWE M. 1974; SWIFT J. & GOODING C. 1983), teachers were provided with a buzzer (which only they could hear) and were asked, having posed a question, to wait until this was sounded before going on. The buzzer was controlled by an observer, who waited for three seconds after each question before activating it (again, if no response was forthcoming from the class). The increased ‘wait time’ allowed to children resulted in more frequent, relevant, thoughtful, and ‘high level’ responses to the teachers’ questions. (WOOD D. 1988)
Whatever techniques are used, it is important that significant others give users more opportunity to communicate by waiting:
In order to give users of aided communication an opportunity to control the course of conversation better, and contribute to the conversation on a more equal footing, it is first and foremost important that they be given the time they need to say what they want to say. This implies that the conversational partners must wait long enough before they begin to interpret or guess at what the individuals are saying, or take the communicative initiative, be it a continuation of the conversation or a change of topic (VON TETZCHNER S. & MARTINSEN H. 1992)
Positive results from the use of the ‘time-delay’ technique has been well documented in the literature (See HALLE J., MARSHALL A. & SPRADLIN J. 1979; HALLE J., BAER D., & SPRADLIN J. 1981; HALLE J. 1982; CHARLOP M., SCHREIBMAN L., & THIBODEAU M. 1985; CHARLOP M. & WALSH M. 1986; HANDEN B. & ZANE T. 1987; GOBBI L., CIPANI E., HUDSON C., & LAPENTA-NEUDECK R. 1986; McCOOK B., CIPANI E., MADIGAN K., LaCAMPAGNE J. 1988). Again this involves waiting for a set amount of time. If after the time has elapsed the person has still not performed the required action then a prompt is given:
Time delay can be used to provide opportunities for learners to communicate in the natural environment. In a time-delay procedure controlling cues are withheld briefly to give the learner time to respond. (REICHLE J. & SIGAFOOS J. 1991 p. 167)
WAIT!
INTERACT 11 - The Mind Reader
This is a common problem as the cartoon illustrates:
ADid you enjoy the party? I bet you did! I did. It was fun wasn’t it? Yes it was!”
Often people will ask a question then answer it for themselves. This has to be avoided. Do not be tempted to list the possible answers to a question without any time for the user to respond:
"What did you do over the weekend?” Brief Pause
ADid you go shopping?”
ADid you go out with your parents?”
ADid you go to see your friend?”
This is a common occurrence and has the effect of terminating the conversation as the augmented communicator slips into a more passive, other controlled, yes or no conversational mode. The rule is wait and see. It may take several (if not tens of) seconds for a user to respond. The person may have cognitive difficulties, must make sense of the question, formulate an answer, decide which mode of response is appropriate (try to vocalise, sign, use a symbol board, use a VOCA, etc), break the answer down into vocabulary that may be accessed (if the words of the answer are not in the system the user has to think of other ways of saying the same thing), recall where the vocabulary is positioned, and finally, access the vocabulary. This may take time. Wait !
ADid you enjoy the party? I bet you did! I did. It was fun wasn’t it? Yes it was!”
Often people will ask a question then answer it for themselves. This has to be avoided. Do not be tempted to list the possible answers to a question without any time for the user to respond:
"What did you do over the weekend?” Brief Pause
ADid you go shopping?”
ADid you go out with your parents?”
ADid you go to see your friend?”
This is a common occurrence and has the effect of terminating the conversation as the augmented communicator slips into a more passive, other controlled, yes or no conversational mode. The rule is wait and see. It may take several (if not tens of) seconds for a user to respond. The person may have cognitive difficulties, must make sense of the question, formulate an answer, decide which mode of response is appropriate (try to vocalise, sign, use a symbol board, use a VOCA, etc), break the answer down into vocabulary that may be accessed (if the words of the answer are not in the system the user has to think of other ways of saying the same thing), recall where the vocabulary is positioned, and finally, access the vocabulary. This may take time. Wait !
INTERACT 12 - A Speechless Affair!
A similar reluctance to accept help can be found where one partner in a marriage suffers a stroke. When impaired communication is involved the spouse may not only take over the physical management of the disabled person but also speak for them, interpret thoughts and feelings to others, thus forming a barrier between the disabled spouse and the rest of the world. (DALTON P. 1994 page 56)
This differs from the previous section which deals with answering your own questions. Here a significant other makes the decision to respond on behalf of the user to an initiation by some third party. In the cartoon Shani is asking Saul a question but Jimmy’s Mum answers on his behalf, much to Saul’s disgust! We have no right to answer for others. We should hold our tongues to encourage active communication from the user.
This topic has been tackled in PASSIVE 6 - ‘Don’t become a shackle’. One should not attempt to answer on behalf of an augmented communicator unless you have permission.
This differs from the previous section which deals with answering your own questions. Here a significant other makes the decision to respond on behalf of the user to an initiation by some third party. In the cartoon Shani is asking Saul a question but Jimmy’s Mum answers on his behalf, much to Saul’s disgust! We have no right to answer for others. We should hold our tongues to encourage active communication from the user.
This topic has been tackled in PASSIVE 6 - ‘Don’t become a shackle’. One should not attempt to answer on behalf of an augmented communicator unless you have permission.
INTERACT 13 - What's my line?
Do not attempt to guess an answer before a person has finished speaking. This can be particularly annoying. It can speed up an otherwise slow conversation but tends to make the listener active and the speaker inactive. Guessing the end of an augmented communicator’s sentence is fine when the decision has been made by the speaker . However, it is not good when the decision has been made by the listener. The AAC system eventually becomes redundant as the listener begins to do more and more. This is not desirable:
It is tempting (and sometimes efficient) to complete words and sentences for a person spelling on a communication board, however to do so without the applicant’s approval is an inappropriate imposition. If this will expedite communicate greatly, ask the applicant for permission to try this strategy. Do not take control of the applicant’s side of the interaction. (STUMP R. 1993)
In some instances guessing may lead to dependency and hinder development of good conversational strategies. (VON TETZCHNER S. & MARTINSEN H.1992)
There can be problems with a user giving permission for another to complete sentences on his or her behalf. A person who is passive will probably willingly agree to allow a listener to increase the efficiency of the interaction by guessing or part-guessing the words and phrases being generated. The danger is that this may serve to reinforce the speaker’s passivity and not lead to the development of effective use of the communication system. Thus, by attempting to improve the communication we may be guilty of reinforcing negative traits and limiting use and knowledge of the system. Be careful!
It is tempting (and sometimes efficient) to complete words and sentences for a person spelling on a communication board, however to do so without the applicant’s approval is an inappropriate imposition. If this will expedite communicate greatly, ask the applicant for permission to try this strategy. Do not take control of the applicant’s side of the interaction. (STUMP R. 1993)
In some instances guessing may lead to dependency and hinder development of good conversational strategies. (VON TETZCHNER S. & MARTINSEN H.1992)
There can be problems with a user giving permission for another to complete sentences on his or her behalf. A person who is passive will probably willingly agree to allow a listener to increase the efficiency of the interaction by guessing or part-guessing the words and phrases being generated. The danger is that this may serve to reinforce the speaker’s passivity and not lead to the development of effective use of the communication system. Thus, by attempting to improve the communication we may be guilty of reinforcing negative traits and limiting use and knowledge of the system. Be careful!