Monitoring Progress
Record progress - It is very easy to overlook, and indeed forget about, the progress which your child makes. (JEFFREE D. & McCONKEY R. 1976)
Some people learn to use an AAC system fast while others are slow. Slow learners are sometimes assumed to be making no progress when compared to those who have mastered a system in a small period of time. It is therefore essential that progress is monitored. Task Analysis of the steps involved (See for example, AINSCOW M. & TWEDDLE D. (1979), KIERNAN C. (1981), KNOWLES W., MASIDLOVER M. & SMITH D. (1982), RAYMOND J. (1984)) will ease recording and help with the teaching. The use of profiling (See CRYSTAL D. (1982), HITCHCOCK G. (1986), GARFORTH D. & MACINTOSH H. (1987)) is also recommended. Be wary of making false comparisons between someone who is intellectually able and uses direct selection and someone who is cognitively impaired and physically requires the use of a single switch. Comparisons are perhaps more revealing when made by comparing the user’s present standard with the standard a month or a year ago.
The facilitator should endeavour to keep an accurate record of progress on all users. This should not involve hours of book keeping ‑ The simpler the recording system the more likely it is to be maintained. Some suggestions are given below:
C Begin with a professional assessment. A speech professional will be able to do this. The results of the assessment give guidance to teaching as well as allowing later comparisons. The effectiveness of tuition can be gauged if a later assessment shows an improvement in user language skill.
C If possible, video the user before and during training. It is difficult to gauge progress when working closely with someone. Attempt to video the user in conversation. Anyone who is being recorded in this way should have given consent beforehand.
C Find a simple way of recording mastery of vocabulary from each category studied. Mastery means just that; the user must understand the concept. A user who is able to repeat parrot fashion a word given by a facilitator, does not show mastery. The facilitator can be reasonably sure the user has mastered a particular word or concept if any two of the following criteria have been met:
i) The user has used the word correctly in a recorded spontaneous utterance.
ii) The user can recognise and name the object when it is presented blind:
C in real life (if possible);
C in model form (toy, etc);
C in a photographic form;
C abstractly, as in a line drawing, etc.
Note: if the word is an action the facilitator performs it.
iii) The user can name the object when its function is described or performed (through mime) from a choice of items laid out in front of the user. For example:
CHOICE: newspaper, comb, apple, button, book, perfume.
VERBAL DESCRIPTION:
AIt is used to keep your hair tidy”
iv) Demonstrates the use of a named object by using it appropriately; that is, the user picks up the comb and combs his or her hair.
v) The user can associate action with noun, noun with action, noun with noun, noun with position, etc. This will only be possible if the user has learnt the appropriate word, and has access to it:
Apple / eat knife / fork husband / wife
vi) The user can pick out the object from a set of photographs of similar objects.
KNIFE ‑ FORK ‑ SPOON ‑ RAZOR
AShow/give me the knife”
To avoid giving contextual cues tests should be performed blind.
An abstract concept, such as a preposition, may need a more refined assessment technique. Putting the spoon in the cup does not demonstrate a conceptual understanding of the preposition ‘in’, for example. Seek advice from a speech professional.
A mastery session may form one lesson in, for example, any five. In the session staff assess the concepts taught. It need not be formal and it should not be frightening. It should be fun.
It would be nice to be able to say, AOnce mastered never forgotten”. The user is being asked to remember the new concepts learnt as well as the symbol(s) involved in generating the word associated with the concept. It is more likely that the user has forgotten the symbol (sequence) involved and not the concept itself, in which case, further revision exercises are necessary.
Once a word or phrase has been mastered, it should be recorded. A technique is to highlight the words studied in a yellow fluorescent pen on a display. When mastery has occurred, the words are re‑highlighted in blue to give a green result. If the user subsequently uses a word correctly in a spontaneous utterance then this word may be underlined. The wall-mounted record is thus coloured coded for easy reading; yellow - learning; green - learnt; underlined - used. A visual wall-mounted record:
C is motivating for the user;
C helps maintain staff awareness of user abilities;
C helps staff to frame their language;
C charts user progress;
Mastery of words is but one aspect of a user’s development (semantic/conceptual). The facilitator encourages the user to formulate simple phrases (syntactic/grammatical) as well as working on their pragmatic use. At first, phrases may not be strictly grammatical but should be understandable. Records of a user’s expressive language ability should not just be of comprehension of what has been said but also of the quantity and quality of what is expressed. For example; ‘Man sugar pig yellow eat door’ ‑ is a 5 word expression, but has no quality, and it is not functional. The test of the effectiveness of teaching is reflected in a user’s ability to generate spontaneous multi‑word functional utterances. These should be recorded whenever possible.
The recording and monitoring of progress may be used in the evaluation of the effectiveness of the teaching strategies that have been used. It should be policy for the facilitators concerned with tuition to take the responsibility for a successful venture. In this sense:
No user can fail.
It is the facilitators that have failed the user.
Is there real progress? Can the user:
C name objects and actions?
C put words together to form simple phrases of two or more words?
C respond to a simple question?
C communicate outside the teaching environment?
and has:
C linguistic ability improved?
C the system become the primary means of communication?
C any significant other spoken positively about the user’s ability with the new system?
If the answer to the majority of these is ‘yes’, the user is making real progress. However, there is no room for complacency. Ask the question:
‘Is it possible to do better?’
It is difficult to evaluate teaching methods when qualitative and quantitative goals have not been set. It is difficult to set goals when one is dealing with unknown quantities. Judgements should be based on:
C information from significant others;
C a linguistic and cognitive developmental programme;
C the data collected;
C previous experience of the user;
C previous goals and records.
It is often better to break goals down into small steps (Task Analysis). If there is a problem, it becomes much easier to identify the cause. This can, however, become too specific. Some guidelines are given below. If, for example, the target behaviour is:
‘The user will be able to ask for a drink.’
other parameters may be specified:
C When and Where
This is not to deny the user the ability to ask for a drink in other places at other times. It merely states the time and place the user will be monitored.
C Who
Who will do the monitoring? Who will the user ask for a drink? Is this important? It may be. Some people may not interact in a manner that allows the user to communicate.
C How
Which modes of communication are allowed? Communication is communication - all modes should be allowed. Pointing to a drink is an effective means of communicating. Creative engineering of situations can negate certain methods of communication in favour of others. However, for some users, any attempt at communicating the message ‘I want a drink’ is a huge step forward and should not be overlooked.
C What
Be careful. If the user asks for a drink using the AAC system then the goal has been achieved. The words used are not the most important factor. The facilitator may be guilty of failing a user because the vocabulary used did not match those specified in the user’s goal. This is a nonsense. The facilitator may be working towards improved syntax and functionality but there are now two goals:
asking for a drink;
improved linguistic performance.
Keep goals separate. A user could be seen as failing when 50% of the goal has been met.
Do not look for excuses, never blame the user ‑ look for the cause(s) and fix the problem:
C Support
Lack of support of significant others can lead to a breakdown in the user’s desire to communicate. If any significant other is removing the system it is the facilitator’s fault. Significant others need to be shown how the AAC system operates. They need to feel they are part of a team working towards an achievable goal. They need to be given guidance in what they can do.
If any member of staff is not co-operating it may be the facilitator’s fault:
C Have staff been involved?
C Are they aware of the user’s capabilities?
C Are they aware of the system’s capabilities?
C Have they had some training?
C Are they expecting too much, too soon? If so, why?
Has a speech professional been involved? It is extremely important that professional advice is sought right from the start. It need not be daily, as long as someone can be contacted.
C Resources
It is difficult to implement an alternative language system in a half-hour lesson a week. It may take over 100 hours of tuition to begin to achieve user transparency. This is for cognitively able students. Others will require a longer period.
There must be adequate provision for a training programme. It will take time, staffing, and space dedicated to training. The facilitator is more likely to fail the user when she or he is responsible for many other students involved in separate areas of the curriculum at the same time. Stories in which a teacher is responsible for a class of twenty, in which one pupil needs to learn to use an AAC system, are sadly not uncommon. At best, the provision should be one‑to‑one but group work is to be encouraged providing it is not too big and, preferably, the members are all using the same system. Avoid the tuition of mixed systems: two users with Bliss; three using signing; another with Rebus; others using word prediction; and a few with specialised symbol systems. Communication is important and the curriculum should reflect this. One-to-one teaching may not always be possible. Teaching assistants, volunteers, and other staff may create smaller sub-groups in which training is possible.
C Cognitive level
If the goals and the techniques are not cognitively appropriate the likely result is failure. The facilitator should consider the following:
C The language used to communicate with users:
- is it too complex?
- are the sentences used too long?
- could it be enhanced with signing or other?
C Are users’ abilities wildly different? Is the weakest being left behind?
C Are the goals set appropriate:
- is the expected standard too high?
- is the standard expected too soon?
- are others expecting too much, too soon?
- are there meetings with significant
others to discuss goals and strategies?
C Are the demands made on the user in any session too great?
C Is adequate time for the revision and reinforcement of studies (on a one‑to‑one basis if necessary)?
C Motivation and attitude
It is important there is adequate support across the curriculum for AAC. The user’s motivation will depend on the attitude of the significant others. If no one expects the user to use the AAC system then it is unlikely that it will be used, especially if, at the beginning of the lesson, it is removed because it gets in the way. All staff need to be educated. Significant others need further training.
C A team approach
It is important that training is seen as a team event and not as one individual’s responsibility. It is equally important the facilitator works to ensure the cohesion of the team and there are regular meetings to discuss goals, as well as to work on any problems that might arise.
Some people learn to use an AAC system fast while others are slow. Slow learners are sometimes assumed to be making no progress when compared to those who have mastered a system in a small period of time. It is therefore essential that progress is monitored. Task Analysis of the steps involved (See for example, AINSCOW M. & TWEDDLE D. (1979), KIERNAN C. (1981), KNOWLES W., MASIDLOVER M. & SMITH D. (1982), RAYMOND J. (1984)) will ease recording and help with the teaching. The use of profiling (See CRYSTAL D. (1982), HITCHCOCK G. (1986), GARFORTH D. & MACINTOSH H. (1987)) is also recommended. Be wary of making false comparisons between someone who is intellectually able and uses direct selection and someone who is cognitively impaired and physically requires the use of a single switch. Comparisons are perhaps more revealing when made by comparing the user’s present standard with the standard a month or a year ago.
The facilitator should endeavour to keep an accurate record of progress on all users. This should not involve hours of book keeping ‑ The simpler the recording system the more likely it is to be maintained. Some suggestions are given below:
C Begin with a professional assessment. A speech professional will be able to do this. The results of the assessment give guidance to teaching as well as allowing later comparisons. The effectiveness of tuition can be gauged if a later assessment shows an improvement in user language skill.
C If possible, video the user before and during training. It is difficult to gauge progress when working closely with someone. Attempt to video the user in conversation. Anyone who is being recorded in this way should have given consent beforehand.
C Find a simple way of recording mastery of vocabulary from each category studied. Mastery means just that; the user must understand the concept. A user who is able to repeat parrot fashion a word given by a facilitator, does not show mastery. The facilitator can be reasonably sure the user has mastered a particular word or concept if any two of the following criteria have been met:
i) The user has used the word correctly in a recorded spontaneous utterance.
ii) The user can recognise and name the object when it is presented blind:
C in real life (if possible);
C in model form (toy, etc);
C in a photographic form;
C abstractly, as in a line drawing, etc.
Note: if the word is an action the facilitator performs it.
iii) The user can name the object when its function is described or performed (through mime) from a choice of items laid out in front of the user. For example:
CHOICE: newspaper, comb, apple, button, book, perfume.
VERBAL DESCRIPTION:
AIt is used to keep your hair tidy”
iv) Demonstrates the use of a named object by using it appropriately; that is, the user picks up the comb and combs his or her hair.
v) The user can associate action with noun, noun with action, noun with noun, noun with position, etc. This will only be possible if the user has learnt the appropriate word, and has access to it:
Apple / eat knife / fork husband / wife
vi) The user can pick out the object from a set of photographs of similar objects.
KNIFE ‑ FORK ‑ SPOON ‑ RAZOR
AShow/give me the knife”
To avoid giving contextual cues tests should be performed blind.
An abstract concept, such as a preposition, may need a more refined assessment technique. Putting the spoon in the cup does not demonstrate a conceptual understanding of the preposition ‘in’, for example. Seek advice from a speech professional.
A mastery session may form one lesson in, for example, any five. In the session staff assess the concepts taught. It need not be formal and it should not be frightening. It should be fun.
It would be nice to be able to say, AOnce mastered never forgotten”. The user is being asked to remember the new concepts learnt as well as the symbol(s) involved in generating the word associated with the concept. It is more likely that the user has forgotten the symbol (sequence) involved and not the concept itself, in which case, further revision exercises are necessary.
Once a word or phrase has been mastered, it should be recorded. A technique is to highlight the words studied in a yellow fluorescent pen on a display. When mastery has occurred, the words are re‑highlighted in blue to give a green result. If the user subsequently uses a word correctly in a spontaneous utterance then this word may be underlined. The wall-mounted record is thus coloured coded for easy reading; yellow - learning; green - learnt; underlined - used. A visual wall-mounted record:
C is motivating for the user;
C helps maintain staff awareness of user abilities;
C helps staff to frame their language;
C charts user progress;
Mastery of words is but one aspect of a user’s development (semantic/conceptual). The facilitator encourages the user to formulate simple phrases (syntactic/grammatical) as well as working on their pragmatic use. At first, phrases may not be strictly grammatical but should be understandable. Records of a user’s expressive language ability should not just be of comprehension of what has been said but also of the quantity and quality of what is expressed. For example; ‘Man sugar pig yellow eat door’ ‑ is a 5 word expression, but has no quality, and it is not functional. The test of the effectiveness of teaching is reflected in a user’s ability to generate spontaneous multi‑word functional utterances. These should be recorded whenever possible.
The recording and monitoring of progress may be used in the evaluation of the effectiveness of the teaching strategies that have been used. It should be policy for the facilitators concerned with tuition to take the responsibility for a successful venture. In this sense:
No user can fail.
It is the facilitators that have failed the user.
Is there real progress? Can the user:
C name objects and actions?
C put words together to form simple phrases of two or more words?
C respond to a simple question?
C communicate outside the teaching environment?
and has:
C linguistic ability improved?
C the system become the primary means of communication?
C any significant other spoken positively about the user’s ability with the new system?
If the answer to the majority of these is ‘yes’, the user is making real progress. However, there is no room for complacency. Ask the question:
‘Is it possible to do better?’
It is difficult to evaluate teaching methods when qualitative and quantitative goals have not been set. It is difficult to set goals when one is dealing with unknown quantities. Judgements should be based on:
C information from significant others;
C a linguistic and cognitive developmental programme;
C the data collected;
C previous experience of the user;
C previous goals and records.
It is often better to break goals down into small steps (Task Analysis). If there is a problem, it becomes much easier to identify the cause. This can, however, become too specific. Some guidelines are given below. If, for example, the target behaviour is:
‘The user will be able to ask for a drink.’
other parameters may be specified:
C When and Where
This is not to deny the user the ability to ask for a drink in other places at other times. It merely states the time and place the user will be monitored.
C Who
Who will do the monitoring? Who will the user ask for a drink? Is this important? It may be. Some people may not interact in a manner that allows the user to communicate.
C How
Which modes of communication are allowed? Communication is communication - all modes should be allowed. Pointing to a drink is an effective means of communicating. Creative engineering of situations can negate certain methods of communication in favour of others. However, for some users, any attempt at communicating the message ‘I want a drink’ is a huge step forward and should not be overlooked.
C What
Be careful. If the user asks for a drink using the AAC system then the goal has been achieved. The words used are not the most important factor. The facilitator may be guilty of failing a user because the vocabulary used did not match those specified in the user’s goal. This is a nonsense. The facilitator may be working towards improved syntax and functionality but there are now two goals:
asking for a drink;
improved linguistic performance.
Keep goals separate. A user could be seen as failing when 50% of the goal has been met.
Do not look for excuses, never blame the user ‑ look for the cause(s) and fix the problem:
C Support
Lack of support of significant others can lead to a breakdown in the user’s desire to communicate. If any significant other is removing the system it is the facilitator’s fault. Significant others need to be shown how the AAC system operates. They need to feel they are part of a team working towards an achievable goal. They need to be given guidance in what they can do.
If any member of staff is not co-operating it may be the facilitator’s fault:
C Have staff been involved?
C Are they aware of the user’s capabilities?
C Are they aware of the system’s capabilities?
C Have they had some training?
C Are they expecting too much, too soon? If so, why?
Has a speech professional been involved? It is extremely important that professional advice is sought right from the start. It need not be daily, as long as someone can be contacted.
C Resources
It is difficult to implement an alternative language system in a half-hour lesson a week. It may take over 100 hours of tuition to begin to achieve user transparency. This is for cognitively able students. Others will require a longer period.
There must be adequate provision for a training programme. It will take time, staffing, and space dedicated to training. The facilitator is more likely to fail the user when she or he is responsible for many other students involved in separate areas of the curriculum at the same time. Stories in which a teacher is responsible for a class of twenty, in which one pupil needs to learn to use an AAC system, are sadly not uncommon. At best, the provision should be one‑to‑one but group work is to be encouraged providing it is not too big and, preferably, the members are all using the same system. Avoid the tuition of mixed systems: two users with Bliss; three using signing; another with Rebus; others using word prediction; and a few with specialised symbol systems. Communication is important and the curriculum should reflect this. One-to-one teaching may not always be possible. Teaching assistants, volunteers, and other staff may create smaller sub-groups in which training is possible.
C Cognitive level
If the goals and the techniques are not cognitively appropriate the likely result is failure. The facilitator should consider the following:
C The language used to communicate with users:
- is it too complex?
- are the sentences used too long?
- could it be enhanced with signing or other?
C Are users’ abilities wildly different? Is the weakest being left behind?
C Are the goals set appropriate:
- is the expected standard too high?
- is the standard expected too soon?
- are others expecting too much, too soon?
- are there meetings with significant
others to discuss goals and strategies?
C Are the demands made on the user in any session too great?
C Is adequate time for the revision and reinforcement of studies (on a one‑to‑one basis if necessary)?
C Motivation and attitude
It is important there is adequate support across the curriculum for AAC. The user’s motivation will depend on the attitude of the significant others. If no one expects the user to use the AAC system then it is unlikely that it will be used, especially if, at the beginning of the lesson, it is removed because it gets in the way. All staff need to be educated. Significant others need further training.
C A team approach
It is important that training is seen as a team event and not as one individual’s responsibility. It is equally important the facilitator works to ensure the cohesion of the team and there are regular meetings to discuss goals, as well as to work on any problems that might arise.
MONITORING 2 - Task & Discussion Sheet
Work through the task presented. About 10 - 15 minutes should be enough time. It is difficult to be certain that John has understood without undertaking a blind assessment. It is likely that John will have become very proficient at reading contextual cues and may be able to give the right answer without being aware of the concepts involved. Holding up a banana, for example, and asking AIs this a banana John?” will prove little, even if John does give a yes response.
Use the ideas generated to work through the discussion topics. Make a note of issues.
Comprehension should not be assumed ......
Use the ideas generated to work through the discussion topics. Make a note of issues.
Comprehension should not be assumed ......
MONITORING 3 - Trans-parent
It was concluded that relatives’ claims to understand minimal or unintelligible speech language were not without foundation and that there contrasting views about the patient’s abilities should not be dismissed (DAVIES P. & MEHAN H. 1988 page 141)
Parents are often regarded with suspicion about the validity of their interpretations. They often hear from other people that they overinterpret the child and that their comprehension is only an expression of wishful thinking. (BRODIN J. 1991 page 237)
Parents have a unique competence in knowing their children and understanding their children’s communication (BRODIN J. 1991 page 237)
First, there is a willingness to listen to what clients have to say and attempt to understand things from their point of view. (DALTON P. 1994 page 40)
For ‘client’ in the above quote read ‘user’ and ‘significant other’ and ‘parent’
Parents have a lifetime’s experience with their children and may have insights into hitherto untapped abilities. It is not unknown for an individual to have abilities which have been masked by a disability or for an individual to have an ability in one specific area or skill which far exceeds abilities in all other areas. Indeed, the extent of this singular ability may border on genius - now known as the savant (formerly known as idiot-savant and autistic savant). The extraordinary abilities of some special individuals has been well documented for at least a hundred years. See, for example: BARR M. 1898; WIZEL D. 1904; MITCHELL F. 1907; WITZMANN A. 1909; SANO F. 1918; BYRD H. 1920; MINOGUE B. 1923; REVESZ G. 1925; DOWNEY J. 1926; JONES H. 1926; PHILLIPS A. 1930; FAUVILLE A. 1936; OWENS W. & GRIMM W. 1941; ROTHSTEIN H. 1942; ROBERTS A. 1945; SCHEERER M., ROTHMANN E. & GOLDSTEIN K. 1945; SHIKIBA R. 1957; ANASTASI A. & LEVEE R. 1960; NURCOMBE M. & PARKER N. 1964; HORWITZ W., KESTENBAUM C., & PERSON E. 1965; LINDSLEY O. 1965; RUBIN E. & MONAGHAN S. 1965; HAMBLIN D. 1966; LUSZKI W. 1966; ALTSHULER K. & BREBBIA D. 1968; LaFONTAINE L. 1968; HORWITZ W., DEMING W., & WINTER R. 1969; VISCOTT D. 1969; CAIN A. 1970; HOFFMAN E. 1971; GOODMAN J. 1972; SPITZ H. & LaFONTAINE L. 1973; STEINKOPFF W. 1973; MORISHIMA A. 1974; HILL A. 1975; MORISHIMA A. 1975; DUCKETT J. 1976; MORISHIMA A. & BROWN L. 1976; DUCKETT J. 1977; HILL A. 1977; MORISHIMA A. & BROWN L. 1977; SELFE L. 1977; DENNIS N. 1978; RIMLAND B. 1978; HOFFMAN E. & REEVES R. 1979; BRINK T. 1980; ROSEN A. 1981; HERMELIN B. & O’CONNOR N. 1983; O’CONNOR N. & HERMELIN B. 1984; STEEL J., GORMAN R., & FLEXMAN J. 1984; SLOBODA J., HERMELIN B., & O’CONNOR N. 1985; HERMELIN B. & O’CONNOR N. 1986; McKEAGUE P. 1986; HERMELIN B., O’CONNOR N., & LEE S. 1987; MILLER L. 1987; O’CONNOR N. & HERMELIN B. 1987; CHARNESS N., CLIFTON J., & MacDONALD L. 1988; MILLER L. 1988; RIMLAND B. & FEIN D. 1988; TREFFERT D. 1988; HOWE M. 1989; O’CONNOR N. 1989; O’CONNOR N. & HERMELIN B. 1989; TREFFERT D. 1989;HERMELIN B. & O’CONNOR N. 1990; SMITH N. V. & TSIMPLI I. 1991; TSIMPLI I. & SMITH N. V. 1991; SMITH N. V. & TSIMPLI I. 1993; SMITH N. V. , TSIMPLI I. & OUHALLA J. 1993; TSIMPLI I. & SMITH N. V. 1993; TSIMPLI I. & SMITH N. V. 1994; SMITH N. V. & TSIMPLI I. 1995;)
Parental opinions should be respected although nothing must be taken for granted. If there is an obvious disparity between parental perspectives and facilitator findings then parents, as team members, should be invited to work alongside the facilitator to investigate why the difference in assessment of ability exists. It may be that parental beliefs will prove to be erroneous and care should be taken not to destroy the hopes and aspirations of parents for their child. Indeed, the goals may remain the same but the pathway to them may have to be remapped.
Sometimes, a significant other’s claims of user ability, which exceeds that of the findings of the augmentative communication team, may have arisen as a result of a user’s ‘performance’ of a task in which massive contextual cues are provided. Subconsciously we all want to succeed and success relies on the success of others: parents and their children; therapists and their clients; teachers and their pupils; lecturers and their students, etc. However, in order that we are better able to help the individual user, we must not make assumptions ........
Parents are often regarded with suspicion about the validity of their interpretations. They often hear from other people that they overinterpret the child and that their comprehension is only an expression of wishful thinking. (BRODIN J. 1991 page 237)
Parents have a unique competence in knowing their children and understanding their children’s communication (BRODIN J. 1991 page 237)
First, there is a willingness to listen to what clients have to say and attempt to understand things from their point of view. (DALTON P. 1994 page 40)
For ‘client’ in the above quote read ‘user’ and ‘significant other’ and ‘parent’
Parents have a lifetime’s experience with their children and may have insights into hitherto untapped abilities. It is not unknown for an individual to have abilities which have been masked by a disability or for an individual to have an ability in one specific area or skill which far exceeds abilities in all other areas. Indeed, the extent of this singular ability may border on genius - now known as the savant (formerly known as idiot-savant and autistic savant). The extraordinary abilities of some special individuals has been well documented for at least a hundred years. See, for example: BARR M. 1898; WIZEL D. 1904; MITCHELL F. 1907; WITZMANN A. 1909; SANO F. 1918; BYRD H. 1920; MINOGUE B. 1923; REVESZ G. 1925; DOWNEY J. 1926; JONES H. 1926; PHILLIPS A. 1930; FAUVILLE A. 1936; OWENS W. & GRIMM W. 1941; ROTHSTEIN H. 1942; ROBERTS A. 1945; SCHEERER M., ROTHMANN E. & GOLDSTEIN K. 1945; SHIKIBA R. 1957; ANASTASI A. & LEVEE R. 1960; NURCOMBE M. & PARKER N. 1964; HORWITZ W., KESTENBAUM C., & PERSON E. 1965; LINDSLEY O. 1965; RUBIN E. & MONAGHAN S. 1965; HAMBLIN D. 1966; LUSZKI W. 1966; ALTSHULER K. & BREBBIA D. 1968; LaFONTAINE L. 1968; HORWITZ W., DEMING W., & WINTER R. 1969; VISCOTT D. 1969; CAIN A. 1970; HOFFMAN E. 1971; GOODMAN J. 1972; SPITZ H. & LaFONTAINE L. 1973; STEINKOPFF W. 1973; MORISHIMA A. 1974; HILL A. 1975; MORISHIMA A. 1975; DUCKETT J. 1976; MORISHIMA A. & BROWN L. 1976; DUCKETT J. 1977; HILL A. 1977; MORISHIMA A. & BROWN L. 1977; SELFE L. 1977; DENNIS N. 1978; RIMLAND B. 1978; HOFFMAN E. & REEVES R. 1979; BRINK T. 1980; ROSEN A. 1981; HERMELIN B. & O’CONNOR N. 1983; O’CONNOR N. & HERMELIN B. 1984; STEEL J., GORMAN R., & FLEXMAN J. 1984; SLOBODA J., HERMELIN B., & O’CONNOR N. 1985; HERMELIN B. & O’CONNOR N. 1986; McKEAGUE P. 1986; HERMELIN B., O’CONNOR N., & LEE S. 1987; MILLER L. 1987; O’CONNOR N. & HERMELIN B. 1987; CHARNESS N., CLIFTON J., & MacDONALD L. 1988; MILLER L. 1988; RIMLAND B. & FEIN D. 1988; TREFFERT D. 1988; HOWE M. 1989; O’CONNOR N. 1989; O’CONNOR N. & HERMELIN B. 1989; TREFFERT D. 1989;HERMELIN B. & O’CONNOR N. 1990; SMITH N. V. & TSIMPLI I. 1991; TSIMPLI I. & SMITH N. V. 1991; SMITH N. V. & TSIMPLI I. 1993; SMITH N. V. , TSIMPLI I. & OUHALLA J. 1993; TSIMPLI I. & SMITH N. V. 1993; TSIMPLI I. & SMITH N. V. 1994; SMITH N. V. & TSIMPLI I. 1995;)
Parental opinions should be respected although nothing must be taken for granted. If there is an obvious disparity between parental perspectives and facilitator findings then parents, as team members, should be invited to work alongside the facilitator to investigate why the difference in assessment of ability exists. It may be that parental beliefs will prove to be erroneous and care should be taken not to destroy the hopes and aspirations of parents for their child. Indeed, the goals may remain the same but the pathway to them may have to be remapped.
Sometimes, a significant other’s claims of user ability, which exceeds that of the findings of the augmentative communication team, may have arisen as a result of a user’s ‘performance’ of a task in which massive contextual cues are provided. Subconsciously we all want to succeed and success relies on the success of others: parents and their children; therapists and their clients; teachers and their pupils; lecturers and their students, etc. However, in order that we are better able to help the individual user, we must not make assumptions ........
MONITORING 4 - Do not assume...
The importance of context in the teaching vocabulary cannot be over emphasised. It is through contextual cues that many learners of AAC make sense of the world. Some are so highly skilled in interpreting and making use of contextual cues it is easy to be fooled into thinking they have a more developed understanding of spoken language than is, in fact, the case. The word fooled applies only to the assessor, as the user makes use of these cues to make sense of the world and intends no deception. People:
....often claim that ‘he understands everything I say’, not realising they are using massive non‑verbal situational cues in their communication, so that difficulties in receptive language often go unnoticed. By the time a delay becomes evident there may already have been more serious difficulties concerned with the understanding of symbols and in verbal comprehension, both of which can interfere with intellectual development (COOPER J., MOODLEY M., & REYNELL J. 1978)
Children use many clues to help them try to make sense of what they hear. They use knowledge of the world, familiarity, the situation and many other clues. Therefore we must be careful when drawing conclusions about children’s abilities, because what may look like complete comprehension at first sight may not be full understanding due to mastery of language. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
It is frequently impossible for a student with physical handicaps to independently complete worksheeets and workbook pages. However, the student who is unable to hold a pencil can be expected to indicate mastery of the same skill. One possible means for doing this is to indicate answers to the worksheet and test problems either through verbal or nonverbal means. The indicated answers are generally transcribed by a classroom assistant or helper. However, people who have been the Ascribe” in this situation have described how difficult it is to avoid cueing, and how tempting it is to Abeg” a reluctant student into productivity, thus inadvertently helping the student avoid the consequences other students in the classroom face for similar inattention to a task. This phenomenon is confirmed by a nontraditional communicator who well remembers the days when people assumed that he has mastered skills because he was so good at reading the subtle cues of his teachers and manipulating them into doing some of the work for him (ZABALA J. 1990)
There are many examples where children and adults have been credited with a considerable understanding of speech, but careful observation has revealed that it was not the words that they understood, but rather the gestures accompanying the speech, or special conditions in the situation. (VON TETZCHNER S. & MARTINSEN H. 1992)
The facilitator must ensure the user understands the vocabulary and is able to transfer or generalise skills learnt in one setting to others encountered throughout the day.
The cartoon makes the point that anything popped into a pan in a kitchen is likely to be food. The contextual cues give the game away. Everyone makes use of body language, prosody and context to understand the meaning of what is being said. We should not assume, however, a response means comprehension.
Von Tetzchner and Martinsen (1992) quote the instance of an ambulant three-year-old who is fond of orange juice. When his mother shouts, ACome and have some orange juice” he comes running. His mother was told to sit still and then shout out her message in the normal way. When she did this she was surprised when the boy did not react and carried on playing. However, when she stood up and walked to the kitchen table on which the bottle of orange juice was standing and once again said the same words the boy came immediately.
The contextual, unconscious, gesturing aspect of cueing which permits people to give a correct response without really knowing the answer is known as the Clever Hans phenomenon (PFUNGST O. 1911. See also SEBEOK T. & ROSENTHAL R. 1981). Hans was a horse whose owner, Herr Von Osten, claimed could perform feats of mental arithmetic. Hans would tap out the answer to a question with his hoof. Pfungst’s book ‘Clever Hans’ detailed his explanation for the event. Von Osten completely believed that the horse was able to perform these feats. However, he or the person asking the question was unconsciously giving contextual, gestural, and body language cues:
By means of tapping his hoof Hans could add, subtract, multiply and divide. He could spell, read, solve problems of musical harmony, and answer personal questions. His owner, Mr. von Osten, a German mathematics teacher, unlike the owners of the other clever animals of the time, did not profit financially from his horse’s talents, and it seemed unlikely that he had any fraudulent intent. He was quite willing to let others question Hans even in his absence so that cues from the owner could be ruled out as the reason for the horse’s abilities. In a brilliant series of experiments Pfungst discovered that Hans could answer questions only if the questioner himself knew the answer and was visible to the horse during the foot-tapping of the answer. Finally, it was discovered that whenever people asked Hans a question, they leaned forward very slightly the better to see Hans’ hoof. That, it turned out, was the unintentional signal for Hans to begin tapping. Then, as Hans approached the number of hoof taps representing the correct answer, the questioners would typically show a tiny head movement. That almost imperceptible cue was the signal for Hans to stop tapping, and Hans was right again. The questioner, by expecting Hans to stop at the right answer was actually Atelling” Hans the right answer and thereby fulfilling his own prophecy. (ROSENTHAL R. & JACOBSON L. 1992 page 36)
It is human nature to want people to succeed. Indeed, value as a professional depends upon it. We may be unwittingly guilty of providing contextual, gestural and body language cues to the answer to students or pupils.
The ‘Thomas Harris’ (HARRIS T. 1981, HARRIS T. 1989) quote at the foot of the overlay, makes the point again. Don’t ass-u-me because it makes an ASS out of U and ME!
Not only is there a probability of assuming too much, but there is also a danger of giving the game away .....
....often claim that ‘he understands everything I say’, not realising they are using massive non‑verbal situational cues in their communication, so that difficulties in receptive language often go unnoticed. By the time a delay becomes evident there may already have been more serious difficulties concerned with the understanding of symbols and in verbal comprehension, both of which can interfere with intellectual development (COOPER J., MOODLEY M., & REYNELL J. 1978)
Children use many clues to help them try to make sense of what they hear. They use knowledge of the world, familiarity, the situation and many other clues. Therefore we must be careful when drawing conclusions about children’s abilities, because what may look like complete comprehension at first sight may not be full understanding due to mastery of language. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
It is frequently impossible for a student with physical handicaps to independently complete worksheeets and workbook pages. However, the student who is unable to hold a pencil can be expected to indicate mastery of the same skill. One possible means for doing this is to indicate answers to the worksheet and test problems either through verbal or nonverbal means. The indicated answers are generally transcribed by a classroom assistant or helper. However, people who have been the Ascribe” in this situation have described how difficult it is to avoid cueing, and how tempting it is to Abeg” a reluctant student into productivity, thus inadvertently helping the student avoid the consequences other students in the classroom face for similar inattention to a task. This phenomenon is confirmed by a nontraditional communicator who well remembers the days when people assumed that he has mastered skills because he was so good at reading the subtle cues of his teachers and manipulating them into doing some of the work for him (ZABALA J. 1990)
There are many examples where children and adults have been credited with a considerable understanding of speech, but careful observation has revealed that it was not the words that they understood, but rather the gestures accompanying the speech, or special conditions in the situation. (VON TETZCHNER S. & MARTINSEN H. 1992)
The facilitator must ensure the user understands the vocabulary and is able to transfer or generalise skills learnt in one setting to others encountered throughout the day.
The cartoon makes the point that anything popped into a pan in a kitchen is likely to be food. The contextual cues give the game away. Everyone makes use of body language, prosody and context to understand the meaning of what is being said. We should not assume, however, a response means comprehension.
Von Tetzchner and Martinsen (1992) quote the instance of an ambulant three-year-old who is fond of orange juice. When his mother shouts, ACome and have some orange juice” he comes running. His mother was told to sit still and then shout out her message in the normal way. When she did this she was surprised when the boy did not react and carried on playing. However, when she stood up and walked to the kitchen table on which the bottle of orange juice was standing and once again said the same words the boy came immediately.
The contextual, unconscious, gesturing aspect of cueing which permits people to give a correct response without really knowing the answer is known as the Clever Hans phenomenon (PFUNGST O. 1911. See also SEBEOK T. & ROSENTHAL R. 1981). Hans was a horse whose owner, Herr Von Osten, claimed could perform feats of mental arithmetic. Hans would tap out the answer to a question with his hoof. Pfungst’s book ‘Clever Hans’ detailed his explanation for the event. Von Osten completely believed that the horse was able to perform these feats. However, he or the person asking the question was unconsciously giving contextual, gestural, and body language cues:
By means of tapping his hoof Hans could add, subtract, multiply and divide. He could spell, read, solve problems of musical harmony, and answer personal questions. His owner, Mr. von Osten, a German mathematics teacher, unlike the owners of the other clever animals of the time, did not profit financially from his horse’s talents, and it seemed unlikely that he had any fraudulent intent. He was quite willing to let others question Hans even in his absence so that cues from the owner could be ruled out as the reason for the horse’s abilities. In a brilliant series of experiments Pfungst discovered that Hans could answer questions only if the questioner himself knew the answer and was visible to the horse during the foot-tapping of the answer. Finally, it was discovered that whenever people asked Hans a question, they leaned forward very slightly the better to see Hans’ hoof. That, it turned out, was the unintentional signal for Hans to begin tapping. Then, as Hans approached the number of hoof taps representing the correct answer, the questioners would typically show a tiny head movement. That almost imperceptible cue was the signal for Hans to stop tapping, and Hans was right again. The questioner, by expecting Hans to stop at the right answer was actually Atelling” Hans the right answer and thereby fulfilling his own prophecy. (ROSENTHAL R. & JACOBSON L. 1992 page 36)
It is human nature to want people to succeed. Indeed, value as a professional depends upon it. We may be unwittingly guilty of providing contextual, gestural and body language cues to the answer to students or pupils.
The ‘Thomas Harris’ (HARRIS T. 1981, HARRIS T. 1989) quote at the foot of the overlay, makes the point again. Don’t ass-u-me because it makes an ASS out of U and ME!
Not only is there a probability of assuming too much, but there is also a danger of giving the game away .....
MONITORING 5 - Do not give the game away...
It is natural to want the person learning an AAC system to succeed. Indeed, the desire for success may lead to people unconsciously give the game away. In the cartoon, Mr Lissenbad is giving verbal and visual clues to Shani. Rather than let her tell him the name of the item of clothing on her word prediction system, he enters the communication continuum with a multi-choice verbal prompt. He takes on the active role:
AIt’s a shirt, a sock, or a tie. Which is it. Is it a shirt? Is it a sock?”
at this point he stops, hesitates, and repeats. He did not repeat after he had said shirt. Even then, Shani gives no response. The verbal cues go on:
AIt’s a bit smelly! Is it a sock? Looks a bit like a sock doesn’t it?”
Then the body language cues enter:
(Teacher smiles) AIs it a sock?”
Shani never actually says, AYes, that thing you are holding is a sock”. She merely smiles a little in response to Mr. Lissenbad’s smile:
(Shani smiles a little) AYES! That’s it! You are right! Good girl.”
The cartoon may be a little over the top. However, it is based on true life examples. During assessment, it is essential that the game is not given away, that the user is tested for comprehension and not for ability to read contextual cues. Be wary, contextual cues can be extremely subtle.
Another problem area is the situation in which any response is deemed to be correct........
AIt’s a shirt, a sock, or a tie. Which is it. Is it a shirt? Is it a sock?”
at this point he stops, hesitates, and repeats. He did not repeat after he had said shirt. Even then, Shani gives no response. The verbal cues go on:
AIt’s a bit smelly! Is it a sock? Looks a bit like a sock doesn’t it?”
Then the body language cues enter:
(Teacher smiles) AIs it a sock?”
Shani never actually says, AYes, that thing you are holding is a sock”. She merely smiles a little in response to Mr. Lissenbad’s smile:
(Shani smiles a little) AYES! That’s it! You are right! Good girl.”
The cartoon may be a little over the top. However, it is based on true life examples. During assessment, it is essential that the game is not given away, that the user is tested for comprehension and not for ability to read contextual cues. Be wary, contextual cues can be extremely subtle.
Another problem area is the situation in which any response is deemed to be correct........
MONITORING 6 - Don't make it a 'Heads you win, tails I lose' situation
In the cartoon, Tiggles has accidentally walked over Sally’s Bliss board. The cat inadvertently rested her paw for a while on the word ‘mother’. Sally’s mother assumed that Tiggles was trying to speak to her and created for the cat a ‘Kitty Bliss board’. There is a problem with Kitty Bliss. No matter where the cat’s paw comes to rest Sally’s mother can interpret this as a meaningful message. Thus the board itself is the proof of the cat’s ability to speak. AAC systems in which all the available choices are positive and appropriate to the task in hand do not necessarily demonstrate an ability to make a reasoned choice:
Often a learner’s initial communicative repertoire may consist almost exclusively of symbols representing preferred items. Consequently, touching any symbol will result in good things happening. In many instances, learners may not attend to the symbols they select since any symbol touched results in the receipt of a desirable object or activity. (REICHLE J. 1991 p. 135)
How can we be sure that Tiggles does comprehend the items on the Kitty Bliss board:
i) Sally’s mother is asked to leave the room.
ii) Tiggles is told one of the items from the board.
iii) Sally’s mother is asked to return.
ii) Tiggles is asked to tell her the item chosen.
Of course, if Tiggles were to fail to perform or Sally’s mother were to say the wrong thing, it does not follow that the cat did not comprehend, nor is unable to use Kitty Bliss. The cat may be refusing to cooperate, mother may have misread Tiggles paw points or Tiggles may have misunderstood the instructions. However, repeated success in a blind situation strongly suggests that mother is correct ..... Tiggles does love her!
Kitty symbolics is a term I now use to talk about this concept. It refers to a situation in which an augmented communicator cannot fail to communicate providing she or he makes some effort at pointing at the board. Kitty symbolics has the advantage that the user is always successful and may be used as a means to an end. Cause and effect may be linked in this way. It is not a system that should be used to test user awareness without stringent safeguards.
CASE STUDY: Student X was sitting waiting for breakfast. A member of staff listed the choices to him - Corn Flakes, Weetabix, Porridge, Sugar Puffs...... He didn’t choose the same cereal every day but his smile was seen as evidence of a choice and of the understanding of the concept. After all he had chosen his own breakfast, hadn’t he? He may well have understood the choices offered, then again, he may have not. The scenario does not prove or disprove the claim of cognisance. Wherever X smiled, his smile was understood as an acceptable choice. If however, the choice had been - Corn Flakes, razor blades, pig food, Weetabix, porridge, light bulb, ..... and he was able to smile appropriately every day, there are grounds for accepting X’s cognisance of the food on offer. We might now find that his smile would be in response to the thought of being offered a light bulb for breakfast!
In the case study above, the introduction of non-preferred items of breakfast food (any food X is known to dislike) into the menu allows the facilitator to reach a more reliable decision of X’s ability to make a reasoned choice. There is still a danger that, as has been discussed in ‘Monitoring 4’, the facilitator ‘gives the game away’ through unintentional prosodic or gestural cues. This can be avoided by adopting a ‘blind’ approach to the listing of menus. A suggestion is to create a set of small cards, each depicting an item from the breakfast menu (perhaps the logo off a small packet of cereal). Don’t forget to include non-preferred items. The cards can be shuffled to randomise the order and presented one at a time. In this instance, X’s smile is taken as a selection. This is also an opportunity to teach the use of a category marker. Before the presentation of the cards the user is prompted to touch a card representing the food category. If such physical skills are absent, users can be helped to touch and to note the category card.
After this routine has been established the user can be helped to make requests from environmentally specific symbol boards or wall charts. For example, in the user’s bedroom a wall chart may be displayed with category makers along the top row and choices from the categories in the columns below or visa-versa (row/column or column/row):
CLOTHES
COLOURS
ACTIONS
JEWELLERY
Vest
White
Go Bathroom
Watch
Underpants
Black
Go Toilet
Ring
Sweat shirt
Red
Brush hair
Bracelet
Jeans
Blue
Make-up
Necklace
Note: items on chart will normally be symbols
If the user eye points or gestures towards the chart then the facilitator can scan the category row (or column) saying the name of the category out loud:
AClothes, colours, actions”
User vocalises
AAn Action?”
User gives a yes response
AGo Bathroom, Go toilet, Brush hair”
User vocalises
AOh silly me I’ve forgotten to brush your hair this morning, haven’t I?”
The category labels on the wall chart or symbol board should match the category labels displayed in the augmented communicator’s room (See Environment).
Often a learner’s initial communicative repertoire may consist almost exclusively of symbols representing preferred items. Consequently, touching any symbol will result in good things happening. In many instances, learners may not attend to the symbols they select since any symbol touched results in the receipt of a desirable object or activity. (REICHLE J. 1991 p. 135)
How can we be sure that Tiggles does comprehend the items on the Kitty Bliss board:
i) Sally’s mother is asked to leave the room.
ii) Tiggles is told one of the items from the board.
iii) Sally’s mother is asked to return.
ii) Tiggles is asked to tell her the item chosen.
Of course, if Tiggles were to fail to perform or Sally’s mother were to say the wrong thing, it does not follow that the cat did not comprehend, nor is unable to use Kitty Bliss. The cat may be refusing to cooperate, mother may have misread Tiggles paw points or Tiggles may have misunderstood the instructions. However, repeated success in a blind situation strongly suggests that mother is correct ..... Tiggles does love her!
Kitty symbolics is a term I now use to talk about this concept. It refers to a situation in which an augmented communicator cannot fail to communicate providing she or he makes some effort at pointing at the board. Kitty symbolics has the advantage that the user is always successful and may be used as a means to an end. Cause and effect may be linked in this way. It is not a system that should be used to test user awareness without stringent safeguards.
CASE STUDY: Student X was sitting waiting for breakfast. A member of staff listed the choices to him - Corn Flakes, Weetabix, Porridge, Sugar Puffs...... He didn’t choose the same cereal every day but his smile was seen as evidence of a choice and of the understanding of the concept. After all he had chosen his own breakfast, hadn’t he? He may well have understood the choices offered, then again, he may have not. The scenario does not prove or disprove the claim of cognisance. Wherever X smiled, his smile was understood as an acceptable choice. If however, the choice had been - Corn Flakes, razor blades, pig food, Weetabix, porridge, light bulb, ..... and he was able to smile appropriately every day, there are grounds for accepting X’s cognisance of the food on offer. We might now find that his smile would be in response to the thought of being offered a light bulb for breakfast!
In the case study above, the introduction of non-preferred items of breakfast food (any food X is known to dislike) into the menu allows the facilitator to reach a more reliable decision of X’s ability to make a reasoned choice. There is still a danger that, as has been discussed in ‘Monitoring 4’, the facilitator ‘gives the game away’ through unintentional prosodic or gestural cues. This can be avoided by adopting a ‘blind’ approach to the listing of menus. A suggestion is to create a set of small cards, each depicting an item from the breakfast menu (perhaps the logo off a small packet of cereal). Don’t forget to include non-preferred items. The cards can be shuffled to randomise the order and presented one at a time. In this instance, X’s smile is taken as a selection. This is also an opportunity to teach the use of a category marker. Before the presentation of the cards the user is prompted to touch a card representing the food category. If such physical skills are absent, users can be helped to touch and to note the category card.
After this routine has been established the user can be helped to make requests from environmentally specific symbol boards or wall charts. For example, in the user’s bedroom a wall chart may be displayed with category makers along the top row and choices from the categories in the columns below or visa-versa (row/column or column/row):
CLOTHES
COLOURS
ACTIONS
JEWELLERY
Vest
White
Go Bathroom
Watch
Underpants
Black
Go Toilet
Ring
Sweat shirt
Red
Brush hair
Bracelet
Jeans
Blue
Make-up
Necklace
Note: items on chart will normally be symbols
If the user eye points or gestures towards the chart then the facilitator can scan the category row (or column) saying the name of the category out loud:
AClothes, colours, actions”
User vocalises
AAn Action?”
User gives a yes response
AGo Bathroom, Go toilet, Brush hair”
User vocalises
AOh silly me I’ve forgotten to brush your hair this morning, haven’t I?”
The category labels on the wall chart or symbol board should match the category labels displayed in the augmented communicator’s room (See Environment).
MONITORING 7 - ...Check
While the ability to utter speech sounds, such as ‘dog’, in appropriate situations (when a dog is present or is barking, for example), is a good indicator that the child knows the word, simply being able to utter the sound form is of no significance. This is like someone being able to repeat the Japanese word inu. Anyone can do this but unless that person knows the meaning of that word, which is ‘dog’, we would not say the person knows that word. A parrot can learn to utter many words and sentences but we do not regard the parrot as having knowledge of language in any significant sense. What is critical is that the child know the meaning of what is uttered. Even if a child learns to imitate some words, we would not say that the child knows those words unless the child demonstrates in some way that he or she knows the meaning of the words. We can judge this is the child uses the word correctly, or if the child responds appropriately in some behavioural way, such as by looking, pointing or following some command. (STEINBERG D. 1993 page 17)
While, in the main, agreeing with the philosophy of Steinberg above I would want to add a note of caution to the last sentence in the quote concerning an appropriate response. Sometimes an appropriate response does not demonstrate understanding of the meaning of the words spoken. Put a fly in an upside down jam jar with a hole in the lid. Tell the fly that you are about to turn the jar over and it is to find its way out through the hole. Turn the jar over. The fly escapes. The fly understands the English language! Of course not but, be careful, this phenomenon can also happen with people.
There are only a few ways of being certain a non-vocal person has comprehended a concept. One of these is Blind Assessment. It involves not knowing the question or stimulus when testing user comprehension. This can be achieved in a number of ways:
C Play your cards right: The concept is displayed as a drawing, picture, or photograph. From the rear, the image can not be seen. The card is mixed in among other cards displaying similar as well as dissimilar items. For example, suppose we wanted to ascertain whether a person understood the concept shirt. We might begin by finding (or creating) a picture of a shirt on a piece of card. This can be mixed in among other images. The pack is shuffled and presented to the user one item at a time. It is important the person presenting cannot see the face value of the cards. In this way, no contextual cue can be given and no delay can be unconsciously added in the presentation of one card to give a cue to the right answer. The user is tasked to indicate when the shirt picture is reached. If the selection is correct, there is a reasonable certainty that the user understands that this is a shirt. If the response is incorrect the user should be given a second chance. The cards are remixed and the exercise repeated. If there is still a failure, the assumption must be that the user does not recognise the picture as a shirt or does not have the concept. There are other reasons for failure. The user may not wish to cooperate in this exercise. This is untypical. It could also be argued a photograph or picture of a shirt is not the same thing as a real shirt. However, as the user is going to have to select a symbol to represent shirt from an AAC system, the user should be able to comprehend the photograph is an image of the shirt. If unable to comprehend this, it is unlikely that the user will be able to cope with a system which relies on symbol selection.
This technique has the advantage that it may be undertaken by a single member of staff. The techniques below require the co-operation of two people to perform blind assessment of capability and comprehension.
C I can’t see it: The object is placed out of view of the questioner - in a box, behind a screen, etc. such that only the user can see the item. The user names the object using the AAC system. The facilitator may repeat the user’s choice, AIt’s a watch. Is that right?” to give the user the opportunity to check before the facilitator removes the screen. This can be played as a game. The technique requires two people.
C Guess what: In this situation, member of staff B is sent out of the room while a set of objects is arranged in front of a user. Another person A selects an object and without looking at it or touching it in any way tells the user its name. A then leaves the room. B re-enters and points to each item until the user says yes. The user is not requested to name the selected item. In this instance the user could be repeating the name given by A without understanding to which of the items the name refers. The technique could be modified however so that A points to an item without stating its name.
C Messenger: This situation is similar to Guess what. A person is sent outside the room. The facilitator holds up an object but does not name it. The object is put out of sight. The person outside is invited into the room and the user is asked to name the object seen.
C Shop Keeper: An object is shown to the user, named, and the symbol selection pointed out. The user is then sent to the opposite side of the room to purchase an item from the role-play shop. The shop keeper may prompt and help the user to achieve the desired goal.
In an assessment the prompts are all withdrawn. The item is shown to the user but not named. The shop keeper inquires what the user wishes to buy and the items are not on display. The shop keeper should have no idea which item has been selected to purchase.
There is no need to go to the lengths that Mr. Jolly engineered in the cartoon. However, to ensure user comprehension and to assess the effectiveness of tuition, blind assessment is important.
There are other ways to assess a person’s understanding of a concept: if a user suddenly said AI ink spill shirt” spontaneously and had done just that, then it is reasonable to accept the user has a sound grasp of the concepts involved (Ink, to spill, shirt ).
Remember the earlier cautionary note - Be wary: actions do not always speak louder than words. Performing an action with an object (for example drinking from a cup) does not guarantee that the user knows the name of the object and can link it to its symbol choice on the AAC system in question.
A further note of caution:
AAbsence of evidence is not the same as evidence of absence”
While a person may not perform to command at times of assessment we cannot go on to state that this person is incapable of performing the task. This is equally as incorrect as assuming all responses equate to evidence of comprehension. All we can say is that we have not seen any evidence that s/he is able to perform the task.
While, in the main, agreeing with the philosophy of Steinberg above I would want to add a note of caution to the last sentence in the quote concerning an appropriate response. Sometimes an appropriate response does not demonstrate understanding of the meaning of the words spoken. Put a fly in an upside down jam jar with a hole in the lid. Tell the fly that you are about to turn the jar over and it is to find its way out through the hole. Turn the jar over. The fly escapes. The fly understands the English language! Of course not but, be careful, this phenomenon can also happen with people.
There are only a few ways of being certain a non-vocal person has comprehended a concept. One of these is Blind Assessment. It involves not knowing the question or stimulus when testing user comprehension. This can be achieved in a number of ways:
C Play your cards right: The concept is displayed as a drawing, picture, or photograph. From the rear, the image can not be seen. The card is mixed in among other cards displaying similar as well as dissimilar items. For example, suppose we wanted to ascertain whether a person understood the concept shirt. We might begin by finding (or creating) a picture of a shirt on a piece of card. This can be mixed in among other images. The pack is shuffled and presented to the user one item at a time. It is important the person presenting cannot see the face value of the cards. In this way, no contextual cue can be given and no delay can be unconsciously added in the presentation of one card to give a cue to the right answer. The user is tasked to indicate when the shirt picture is reached. If the selection is correct, there is a reasonable certainty that the user understands that this is a shirt. If the response is incorrect the user should be given a second chance. The cards are remixed and the exercise repeated. If there is still a failure, the assumption must be that the user does not recognise the picture as a shirt or does not have the concept. There are other reasons for failure. The user may not wish to cooperate in this exercise. This is untypical. It could also be argued a photograph or picture of a shirt is not the same thing as a real shirt. However, as the user is going to have to select a symbol to represent shirt from an AAC system, the user should be able to comprehend the photograph is an image of the shirt. If unable to comprehend this, it is unlikely that the user will be able to cope with a system which relies on symbol selection.
This technique has the advantage that it may be undertaken by a single member of staff. The techniques below require the co-operation of two people to perform blind assessment of capability and comprehension.
C I can’t see it: The object is placed out of view of the questioner - in a box, behind a screen, etc. such that only the user can see the item. The user names the object using the AAC system. The facilitator may repeat the user’s choice, AIt’s a watch. Is that right?” to give the user the opportunity to check before the facilitator removes the screen. This can be played as a game. The technique requires two people.
C Guess what: In this situation, member of staff B is sent out of the room while a set of objects is arranged in front of a user. Another person A selects an object and without looking at it or touching it in any way tells the user its name. A then leaves the room. B re-enters and points to each item until the user says yes. The user is not requested to name the selected item. In this instance the user could be repeating the name given by A without understanding to which of the items the name refers. The technique could be modified however so that A points to an item without stating its name.
C Messenger: This situation is similar to Guess what. A person is sent outside the room. The facilitator holds up an object but does not name it. The object is put out of sight. The person outside is invited into the room and the user is asked to name the object seen.
C Shop Keeper: An object is shown to the user, named, and the symbol selection pointed out. The user is then sent to the opposite side of the room to purchase an item from the role-play shop. The shop keeper may prompt and help the user to achieve the desired goal.
In an assessment the prompts are all withdrawn. The item is shown to the user but not named. The shop keeper inquires what the user wishes to buy and the items are not on display. The shop keeper should have no idea which item has been selected to purchase.
There is no need to go to the lengths that Mr. Jolly engineered in the cartoon. However, to ensure user comprehension and to assess the effectiveness of tuition, blind assessment is important.
There are other ways to assess a person’s understanding of a concept: if a user suddenly said AI ink spill shirt” spontaneously and had done just that, then it is reasonable to accept the user has a sound grasp of the concepts involved (Ink, to spill, shirt ).
Remember the earlier cautionary note - Be wary: actions do not always speak louder than words. Performing an action with an object (for example drinking from a cup) does not guarantee that the user knows the name of the object and can link it to its symbol choice on the AAC system in question.
A further note of caution:
AAbsence of evidence is not the same as evidence of absence”
While a person may not perform to command at times of assessment we cannot go on to state that this person is incapable of performing the task. This is equally as incorrect as assuming all responses equate to evidence of comprehension. All we can say is that we have not seen any evidence that s/he is able to perform the task.
MONITORING 8 - Blind assessment
This overhead reaffirms and reminds us that:
If
you are asking the question
ensure
you do not know the answer
and .......
People with learning difficulties
often have a Ph.D.
in reading the contextual clue.
Thus, if one wants to provide a natural context in which the child can learn how to answer questions, the person asking the questions should not know the answer. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
The method of recording and testing that seemed to have been most interesting to Washoe was the series of double-blind procedures used in her formal vocabulary testing. During the first of these tests, she would find herself seated in front of a box that front time to time would be opened by a human companion who would ask Washoe what was there. Washoe, although perhaps bewildered as to why the human observer could not look into the box and see for himself, would accommodatingly reply, and the observer would write down the first sign she made. The point of this procedure was to prevent the recorder from giving Washoe any cues as to the nature of the object, which would be placed in the box by another experimenter who neither Washoe nor the observer could see. Washoe did not seem to mind so much identifying the obvious to her slow-witted companions as she did the long waits while the exemplars were changed. Furthermore, if the exemplar was a Coke, she would, on occasion, abruptly terminate the game by grabbing it and running up a tree. (LINDEN E. 1975 talking about the testing of the chimpanzee Washoe who was taught to sign by R. & B. Gardner. Page 26)
If
you are asking the question
ensure
you do not know the answer
and .......
People with learning difficulties
often have a Ph.D.
in reading the contextual clue.
Thus, if one wants to provide a natural context in which the child can learn how to answer questions, the person asking the questions should not know the answer. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
The method of recording and testing that seemed to have been most interesting to Washoe was the series of double-blind procedures used in her formal vocabulary testing. During the first of these tests, she would find herself seated in front of a box that front time to time would be opened by a human companion who would ask Washoe what was there. Washoe, although perhaps bewildered as to why the human observer could not look into the box and see for himself, would accommodatingly reply, and the observer would write down the first sign she made. The point of this procedure was to prevent the recorder from giving Washoe any cues as to the nature of the object, which would be placed in the box by another experimenter who neither Washoe nor the observer could see. Washoe did not seem to mind so much identifying the obvious to her slow-witted companions as she did the long waits while the exemplars were changed. Furthermore, if the exemplar was a Coke, she would, on occasion, abruptly terminate the game by grabbing it and running up a tree. (LINDEN E. 1975 talking about the testing of the chimpanzee Washoe who was taught to sign by R. & B. Gardner. Page 26)
MONITORING 9 - Keep a record of all spontaneous communication
In the cartoon, Mr. Lukforjob is negating the communicative process while trying to record what the students are saying. His technique is appalling. He is recording directly onto the blackboard where the information may be wiped away and is not private. He is telling the students to be quiet and he also has his back to Jimmy so he cannot tell what Jimmy might be saying. Spontaneous communication charts should become a feature of all educational environments. They should be simple and obey Caroline Musselwhite’s two minute rule (MUSSELWHITE C. 1992).
An example record sheet for spontaneous utterances is given in the next overhead. Recorded spontaneous utterances build into a picture of a person’s expressive ability.
A spontaneous utterance:
C Is not a parrot fashion response to a spoken or visual stimulus:
AThis is a glass Jimmy. What is it?”
C Does not involve echoing:
AIt’s a nice day today isn’t it Jimmy?”
AYes, it nice day today”
The other is putting words into the user’s mouth. This is not a spontaneous utterance. However, if the response had been:
AYes, the sky’s blue, but I bet it will rain later.”
then, this would be classed as spontaneous although it was given in direct response to a spoken stimulus. The facilitator should add a note in the context column which might say something like, AIn response to ‑ ‘It’s a nice day today isn’t it?’”
C Occupies the far left position in the continuum
Spontaneous ‑ Managed ‑ Elicited - Parroted
C Does not involve describing an environment which has been purposely structured and tutored. If , after a lesson on cutlery, a knife and fork is place in front of a user and the facilitator asks, AWhat can you see?” The response, AI see knife fork” is not a spontaneous utterance. However, if the user enters the room and without prompting, asks, AAre we going to eat?”, or AWhy knife fork table?” then this is recorded as spontaneous.
C Is initiated by a user, or given as a functional response to a direct question which does not prompt the use of words. All functional communication that is initiated by the user (the user begins the conversation) is classed as spontaneous and should be recorded. However, a functional response to a direct question may also be regarded as spontaneous. Consider the following:
AIt’s bacon and egg or, cheese on toast, for breakfast. Which would you like?”
ABacon egg” NOT SPONTANEOUS
AWhat would you like for breakfast?”
AIce cream” ELICITED (NON-FUNCTIONAL)
is an elicited non-functional response (unless ice cream is a standard breakfast dish in the household or it is what the user really wants for breakfast)
............................
AWhat would you like for breakfast?”
ABacon egg please” ELICITED
is an example of an elicited response, but may still be recorded (with notes in the context column) unless it is a stereotyped response (something the user always says in response to this question having earlier been prompted to do so).
...........................
However:
ABacon please eggs breakfast” SPONTANEOUS
when initiated by a user is spontaneous.
Only the last two examples should be considered as spontaneous; the first with the phrase ‘in response to what would you like for breakfast’ recorded in the context column. If the user had said the latter phrase at tea time, it would not be functional, although it may be recorded with an appropriate comment in the context column.
C Is functional but not necessarily grammatical. A functional response does not have to be grammatical and should be recorded. In the example ‘bacon please egg’, a grammatical response may have been:
AMay I have bacon and eggs please?”
The response given was appropriate. The verbatim phrase is recorded on a spontaneous communication sheet and the words transferred to the mastery sheet. The phrase:
AWheelchair garage Friday”
would also be recorded if it made sense to the facilitator. In this case
it might mean ‑ ‘The garage is coming to mend my electric wheelchair on Friday’. It is wise to go and check that the garage is coming to mend the wheelchair on Friday.
AYellow dog man fruit go Saturday” is a non-functional expression. Do not be tempted to read functional messages where none exist, that is, to make sense of non‑sense:
AOh! He means our dog. He’s brown but you could say he was a sort of yellow, he’s male too, is going to eat some fruit on Saturday. We go shopping on Saturday sometimes and I occasionally buy fruit, and Danny loves to feed the dog.......”
The rule is:
If you are not positive then do not record.
The facilitator can not be everywhere at once. Nor will it be possible to follow the user round all day long recording everything that may be said. The facilitator must involve all significant others in this. However:
AHe said what?”
AThe mosquito is the prime cause of malaria in the tropics.”
AAre you positive you didn’t prompt him?”
AYes, he just came out and said it.”
ABut he doesn’t have mosquito or malaria on his board.”
AHe spelt them.”
ABut he can’t spell!”
AWell, he spelt them well enough for me to know what he was saying.”
ABut ........”
It is essential that significant others understand what constitutes a spontaneous utterance and how to fill in the form. Several copies of the form may be placed in different locations for each user: user’s room; user’s home; main corridor; physio room; communication classroom; etc. A master sheet can then be collated from time to time.
Words that are spelled out should also be recorded on the sheet provided. They should be underlined or highlighted to distinguish them from spoken (symbol selection) words using the system.
AI want go cinemaA
A word that has been spelt may, nevertheless, be contained in the symbol set of the system. A word may be spelled because:
C the symbol (sequence) has not been taught;
C the user has forgotten that it is there;
C the user has forgotten where it is;
C in this instance, spelling is preferred.
Eventually, on analysis of the spontaneous communication sheets, the facilitator should add any frequently used words that are spelt. The facilitator should remind the user of the symbol or symbol sequences of any forgotten vocabulary.
The context in which the expression was given should be noted. This may give vital clues where (and why) a user is more likely to initiate communication. It will also help to distinguish between elicited, managed and truly spontaneous communication.
Finally, the date of the initiation should also be recorded to see if there is a progression of the quality and quantity of expressions over a period.
An example record sheet for spontaneous utterances is given in the next overhead. Recorded spontaneous utterances build into a picture of a person’s expressive ability.
A spontaneous utterance:
C Is not a parrot fashion response to a spoken or visual stimulus:
AThis is a glass Jimmy. What is it?”
C Does not involve echoing:
AIt’s a nice day today isn’t it Jimmy?”
AYes, it nice day today”
The other is putting words into the user’s mouth. This is not a spontaneous utterance. However, if the response had been:
AYes, the sky’s blue, but I bet it will rain later.”
then, this would be classed as spontaneous although it was given in direct response to a spoken stimulus. The facilitator should add a note in the context column which might say something like, AIn response to ‑ ‘It’s a nice day today isn’t it?’”
C Occupies the far left position in the continuum
Spontaneous ‑ Managed ‑ Elicited - Parroted
C Does not involve describing an environment which has been purposely structured and tutored. If , after a lesson on cutlery, a knife and fork is place in front of a user and the facilitator asks, AWhat can you see?” The response, AI see knife fork” is not a spontaneous utterance. However, if the user enters the room and without prompting, asks, AAre we going to eat?”, or AWhy knife fork table?” then this is recorded as spontaneous.
C Is initiated by a user, or given as a functional response to a direct question which does not prompt the use of words. All functional communication that is initiated by the user (the user begins the conversation) is classed as spontaneous and should be recorded. However, a functional response to a direct question may also be regarded as spontaneous. Consider the following:
AIt’s bacon and egg or, cheese on toast, for breakfast. Which would you like?”
ABacon egg” NOT SPONTANEOUS
AWhat would you like for breakfast?”
AIce cream” ELICITED (NON-FUNCTIONAL)
is an elicited non-functional response (unless ice cream is a standard breakfast dish in the household or it is what the user really wants for breakfast)
............................
AWhat would you like for breakfast?”
ABacon egg please” ELICITED
is an example of an elicited response, but may still be recorded (with notes in the context column) unless it is a stereotyped response (something the user always says in response to this question having earlier been prompted to do so).
...........................
However:
ABacon please eggs breakfast” SPONTANEOUS
when initiated by a user is spontaneous.
Only the last two examples should be considered as spontaneous; the first with the phrase ‘in response to what would you like for breakfast’ recorded in the context column. If the user had said the latter phrase at tea time, it would not be functional, although it may be recorded with an appropriate comment in the context column.
C Is functional but not necessarily grammatical. A functional response does not have to be grammatical and should be recorded. In the example ‘bacon please egg’, a grammatical response may have been:
AMay I have bacon and eggs please?”
The response given was appropriate. The verbatim phrase is recorded on a spontaneous communication sheet and the words transferred to the mastery sheet. The phrase:
AWheelchair garage Friday”
would also be recorded if it made sense to the facilitator. In this case
it might mean ‑ ‘The garage is coming to mend my electric wheelchair on Friday’. It is wise to go and check that the garage is coming to mend the wheelchair on Friday.
AYellow dog man fruit go Saturday” is a non-functional expression. Do not be tempted to read functional messages where none exist, that is, to make sense of non‑sense:
AOh! He means our dog. He’s brown but you could say he was a sort of yellow, he’s male too, is going to eat some fruit on Saturday. We go shopping on Saturday sometimes and I occasionally buy fruit, and Danny loves to feed the dog.......”
The rule is:
If you are not positive then do not record.
The facilitator can not be everywhere at once. Nor will it be possible to follow the user round all day long recording everything that may be said. The facilitator must involve all significant others in this. However:
AHe said what?”
AThe mosquito is the prime cause of malaria in the tropics.”
AAre you positive you didn’t prompt him?”
AYes, he just came out and said it.”
ABut he doesn’t have mosquito or malaria on his board.”
AHe spelt them.”
ABut he can’t spell!”
AWell, he spelt them well enough for me to know what he was saying.”
ABut ........”
It is essential that significant others understand what constitutes a spontaneous utterance and how to fill in the form. Several copies of the form may be placed in different locations for each user: user’s room; user’s home; main corridor; physio room; communication classroom; etc. A master sheet can then be collated from time to time.
Words that are spelled out should also be recorded on the sheet provided. They should be underlined or highlighted to distinguish them from spoken (symbol selection) words using the system.
AI want go cinemaA
A word that has been spelt may, nevertheless, be contained in the symbol set of the system. A word may be spelled because:
C the symbol (sequence) has not been taught;
C the user has forgotten that it is there;
C the user has forgotten where it is;
C in this instance, spelling is preferred.
Eventually, on analysis of the spontaneous communication sheets, the facilitator should add any frequently used words that are spelt. The facilitator should remind the user of the symbol or symbol sequences of any forgotten vocabulary.
The context in which the expression was given should be noted. This may give vital clues where (and why) a user is more likely to initiate communication. It will also help to distinguish between elicited, managed and truly spontaneous communication.
Finally, the date of the initiation should also be recorded to see if there is a progression of the quality and quantity of expressions over a period.
MONITORING 10 - Jimmy's Spontaneous Communication Chart
The chart is simple to avoid being demanding on time. It should be filled in as soon as is possible, preferably at the time of the utterance. Alternatively, recordings of lessons, etc. (video and cassette), can be transcribed later.
The chart is comprised of three columns. The first column is for the date and time of the utterance. The second is for the utterance which must be recorded verbatim. This is for what was said not what people think or what people wished the user had said. Any word which is generated by means other than through the AAC system (for example pointing) should be highlighted and noted. The third column should be used for the context in which the utterance occurred. Later, the meaning of the utterance as well as its function can be recalled.
EXAMPLE
Date and Time
Utterance
Context / Explanation
12/5/94
10.30am
watch man soup a bird
Student telling me that he watched Superman on TV last night. Spelt ‘Super’
It is a good idea to keep a pencil attached by a piece of string to the chart. Having to search for writing materials delays the lesson and may cause the facilitator to miss other spontaneous utterances. Completing the spontaneous charts may be undertaken by other staff within the room so that the lesson may proceed without interruption.
The chart is comprised of three columns. The first column is for the date and time of the utterance. The second is for the utterance which must be recorded verbatim. This is for what was said not what people think or what people wished the user had said. Any word which is generated by means other than through the AAC system (for example pointing) should be highlighted and noted. The third column should be used for the context in which the utterance occurred. Later, the meaning of the utterance as well as its function can be recalled.
EXAMPLE
Date and Time
Utterance
Context / Explanation
12/5/94
10.30am
watch man soup a bird
Student telling me that he watched Superman on TV last night. Spelt ‘Super’
It is a good idea to keep a pencil attached by a piece of string to the chart. Having to search for writing materials delays the lesson and may cause the facilitator to miss other spontaneous utterances. Completing the spontaneous charts may be undertaken by other staff within the room so that the lesson may proceed without interruption.
MONITORING 11 - Core Vocabulary Checklist
This is an idea for the recording of progress. The five columns detail:
C Word: The item of vocabulary studied (word or phrase).
C Learning: The date on which tuition began.
C Knows concept: The date on which a successful assessment of comprehension of vocabulary took place. If a user is already cognisant of a particular concept the learning and knows concept dates will be identical.
C Knows sequence: The date on which the user was assessed for knowledge of the symbol sequence. Knowing the concept and knowing the symbol(s) involved in generating that concept are two different things. Check if a user knows a sequence - hold up an item and ask AWhat is this?” (preferably blind).
C Used spontaneously: This is the goal - the spontaneous function utterance. It would be nice if it is a grammatical utterance but this is the ‘icing on the cake’. The spontaneous utterance date can be copied directly from the spontaneous utterance chart.
Copies of the vocabulary list should be displayed. This makes everyone aware of:
C the concepts studied and retained;
C knowledge of the system;
C use of the system;
C ability and progress.
It also:
C is motivating for the user;
C maintains significant others’ awareness of user abilities;
C helps staff to frame their language when communicating with the user.
The charts must be frequently updated. They could be copied to a display board such that entries may be easily changed as the user’s vocabulary increases.
C Word: The item of vocabulary studied (word or phrase).
C Learning: The date on which tuition began.
C Knows concept: The date on which a successful assessment of comprehension of vocabulary took place. If a user is already cognisant of a particular concept the learning and knows concept dates will be identical.
C Knows sequence: The date on which the user was assessed for knowledge of the symbol sequence. Knowing the concept and knowing the symbol(s) involved in generating that concept are two different things. Check if a user knows a sequence - hold up an item and ask AWhat is this?” (preferably blind).
C Used spontaneously: This is the goal - the spontaneous function utterance. It would be nice if it is a grammatical utterance but this is the ‘icing on the cake’. The spontaneous utterance date can be copied directly from the spontaneous utterance chart.
Copies of the vocabulary list should be displayed. This makes everyone aware of:
C the concepts studied and retained;
C knowledge of the system;
C use of the system;
C ability and progress.
It also:
C is motivating for the user;
C maintains significant others’ awareness of user abilities;
C helps staff to frame their language when communicating with the user.
The charts must be frequently updated. They could be copied to a display board such that entries may be easily changed as the user’s vocabulary increases.