The routine, working practice & AAC
Routines have their strengths:
Routines are activities which the child comes to know and expect in certain situations. We strengthen desirable behaviours by eliciting them in the context of routines. These should be carried out in the home , at school and in the therapy room. The care giver can establish routines during bathing, feeding or storytelling. Classroom routines include snack time, music time, and lunch hour. As professionals we can develop activities that create expectations and motivate the child. (KATZ MENDOZA A. 1990 page 105)
Daily living routines can provide many opportunities for communication, if they are structured with this purpose in mind. In most homes and classrooms, routines such as dressing, bathing, toileting, eating, and changing the motorically involved child’s position occur at regular times and intervals throughout the day. If this is not the case, these routines should be regularized as much as possible so that the child can begin to anticipate their occurrence. In addition, routines should be conducted in the same sequence each time, again so that the child can begin to anticipate what happens next. Finally, whenever possible, sufficient time should be included in the routine so that contextual communication instruction can be conducted concurrently with the activity. (BEUKELMAN D. & MIRENDA P. 1992 page 176. My italics)
and their weaknesses:
Individuals with extensive motor impairment often have such fixed routines that they have few opportunities to communicate. The objective for these individuals is to create a more varied everyday situation and produce communicative situations in which the conversational partners do not always know in advance what will be said. (VON TETZCHNER S. & MARTINSEN H. 1992)
Routines are activities which the child comes to know and expect in certain situations. We strengthen desirable behaviours by eliciting them in the context of routines. These should be carried out in the home , at school and in the therapy room. The care giver can establish routines during bathing, feeding or storytelling. Classroom routines include snack time, music time, and lunch hour. As professionals we can develop activities that create expectations and motivate the child. (KATZ MENDOZA A. 1990 page 105)
Daily living routines can provide many opportunities for communication, if they are structured with this purpose in mind. In most homes and classrooms, routines such as dressing, bathing, toileting, eating, and changing the motorically involved child’s position occur at regular times and intervals throughout the day. If this is not the case, these routines should be regularized as much as possible so that the child can begin to anticipate their occurrence. In addition, routines should be conducted in the same sequence each time, again so that the child can begin to anticipate what happens next. Finally, whenever possible, sufficient time should be included in the routine so that contextual communication instruction can be conducted concurrently with the activity. (BEUKELMAN D. & MIRENDA P. 1992 page 176. My italics)
and their weaknesses:
Individuals with extensive motor impairment often have such fixed routines that they have few opportunities to communicate. The objective for these individuals is to create a more varied everyday situation and produce communicative situations in which the conversational partners do not always know in advance what will be said. (VON TETZCHNER S. & MARTINSEN H. 1992)
ROUTINE 2 - Task & Discussion Sheet
Uncover the information section. Allow the staff time to study the examples. Ask for further examples from their experience. Uncover the tasks. Allow the time (5 - 10 minutes is reasonable) to complete the tasks. Work through the discussion topics. Some of the issues that may be raised are outlined below.
Routine is often seen as time saving and efficient. However,nothing is static. That which was once efficient may be outdated. New technologies (such as dishwashers) may forcere-thinking of old working practices (washing by hand).
What is efficient for one person may have serious consequences for another. Suppose a father always ties his daughter’s shoe laces to get her ready for school. Will she ever learn to tie them for herself? We often take for granted the commonplace and everyday. If my meals arrive at the same time each day will I ever question where they come from? How they are prepared? Maybe I will, once in a while but, if I have no means of asking such questions, what then? It would appear that I am disagreeing with the Beukelman & Mirenda quote given earlier in this section. I’m not. I’m arguing for the use of active communication strategies within any daily routine.
Routine can have advantages for all. However, it should not be allowed to prevent the development of the very thing we are trying to promote - communication skills. If the routine is negative, it is time for re-evaluation.
Routine is often seen as time saving and efficient. However,nothing is static. That which was once efficient may be outdated. New technologies (such as dishwashers) may forcere-thinking of old working practices (washing by hand).
What is efficient for one person may have serious consequences for another. Suppose a father always ties his daughter’s shoe laces to get her ready for school. Will she ever learn to tie them for herself? We often take for granted the commonplace and everyday. If my meals arrive at the same time each day will I ever question where they come from? How they are prepared? Maybe I will, once in a while but, if I have no means of asking such questions, what then? It would appear that I am disagreeing with the Beukelman & Mirenda quote given earlier in this section. I’m not. I’m arguing for the use of active communication strategies within any daily routine.
Routine can have advantages for all. However, it should not be allowed to prevent the development of the very thing we are trying to promote - communication skills. If the routine is negative, it is time for re-evaluation.
ROUTINE 3 - Don't allow working practices to negate....
The cartoon depicts Jimmy Jones with his Bliss Board tucked safely away under his arm in interactions with three different people through his day. In each case the adult has an excuse for not communicating at this time.
If the result of communicative initiations is continual rebuttal then it is likely that such initiation will be reduced. For anyone with a learning difficulty or an acquired passivity, initiation of communication may be a rare event. A rejection of this opportunity, for whatever reason, may lead to the negation of active communication skills.
Do not negate - communicate!
If the user is already an active communicator then there are other skills to consider. The person may need to develop pragmatic interaction skills, to learn, for example, that there are times when it is appropriate to talk and times when it is appropriate to wait or to be quiet.
If the result of communicative initiations is continual rebuttal then it is likely that such initiation will be reduced. For anyone with a learning difficulty or an acquired passivity, initiation of communication may be a rare event. A rejection of this opportunity, for whatever reason, may lead to the negation of active communication skills.
Do not negate - communicate!
If the user is already an active communicator then there are other skills to consider. The person may need to develop pragmatic interaction skills, to learn, for example, that there are times when it is appropriate to talk and times when it is appropriate to wait or to be quiet.
The Environment and AAC
... reminds us that we cannot ignore the environment in which the user functions. The environment should provide opportunities that support and promote communicative interactions (SHANE H., LIPSCHULTZ R., & SHANE C. 1982). Dawn’s early environment did not support typical interactions with nondisabled peers... 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)
Daily living environments for adolescents and adults who are moderately and severely developmentally delayed are rich with activities which have the potential to foster functional, interactive communication. (ELDER P. & GOOSSENS C. 1993 page 35)
Daily living environments for adolescents and adults who are moderately and severely developmentally delayed are rich with activities which have the potential to foster functional, interactive communication. (ELDER P. & GOOSSENS C. 1993 page 35)
ENVIRONMENT 2 - Task & Discussion Task
Uncover the information section. Allow the staff time to study the given definition. Ask them to give further examples of a ‘handicapping’ environment (not necessarily for people with a disability). Uncover the task. Allow time (5 - 10 minutes is reasonable) to complete. Select from and work through the discussion topics.
ENVIRONMENT 3 - Create a visual label...
The cognitive structure of the classroom can facilitate the use of pictures and symbols by making them integral to the structure of the day (BURKHART L. 1990 page 13)
The technique of labelling the environment has positive benefits for the AAC user.
The cartoon depicts a cat pulling a cart which has been labelled with the appropriate symbols. There is no suggestion that this is a good or correct way to label an animal. How would we label a cat? A photograph on the wall; a label attached to the cat’s collar; a picture in the family album......
If a small team of people, say five, each create a single label for one item each working day then, in a year, almost a thousand labels will have been produced. Further, if the person using the AAC system is involved in making the labels a learning experience is created. Why stop with just the person using the system? Why not involve all the group or class? Have a label making lesson. Label everything with the written word, the sign (ASL, BSL, other?) and the symbols used (Bliss, Rebus, Makaton, Minspeak, Other). If there is to be more than one symbol set in use then this has the potential disadvantage of being confusing. However, if the class is involved in making them they can be asked to figure out a way of making each set of signs and symbols distinct. They might suggest using the same spatial arrangement in each location as well as using colour encoding.
Facilitators should ensure that the new labels are noted; for example, a facilitator could point out a new label and make reference to the user’s communication system - AOh look some symbols on the toilet door. Hmmm, those symbols are on your VOCA. I wonder what it would say if you pressed them?” or AThat symbol is on your board - it’s the symbol for toilet. Look here it is.”
Existing labels should be used creatively and not just left to a chance glance by an augmented communicator as they pass a particular display. If time is invested in creating labels then make use of them:
AOk, today we are going to talk about furniture. We haven’t talked about furniture before. Furniture is the name for things like chairs and tables and bookcases. The furniture in this room is labelled. The chairs have this label on them (hold up symbol or symbols). Here’s a chair (point to one). How many chairs are there in this room?”
There is a fundamental reason for labelling the environment. It involves the user’s immersion in and experience of language. Children, as they grow, only require that they hear their native language in order to ‘re-invent’ it (PINKER S. 1994). How children are able to ‘learn’ language from their parents when they do not hear enough of it to explain their precociousness still remains something of a mystery. Chomsky has suggested that there is an innate ability to acquire language (CHOMSKY N. 1972; see also INGRAM J. 1992; JACKENDOFF R. 1993; PINKER S. 1994)(see PUTNAM H. 1971 for a critique of Chomsky’s theory in this area). Given the correct environmental factors it is difficult to stop a child from acquiring his or her own native language. Children of parents who speak a pidgin language (language without a grammar) impose a set of grammatical rules so that, within a generation, a creole is created (BICKERTON D. 1981,1984; HOLM J. 1988; INGRAM J. 1992 ch. 18; JACKENDOFF R. 1993 chapter 10; PINKER S. 1994 ch. 1). A creole, while it may appear to some as an inferior form of language, nevertheless has a grammatical structure equivalent to that of any other language in the world. This ‘need’ to impose a grammar is also true for individual children experiencing a poor parental language model, even if the language is sign (SINGLETON J. & NEWPORT E. 1993).
For work on the ‘development’ of syntax in ‘pidgin-like’ situations see - BICKERTON D. 1981,1984; HOLM J. 1988; GOLDIN-MEADOW S. & MYLANDER C. 1990; INGRAM J. 1992 ch. 18; JACKENDOFF R. 1993 chapter 10; SINGLETON J. & NEWPORT E. 1993; PINKER S. 1994 ch. 1; HORIZON 1997;
In a study of deaf children without experience of a sign language other than that of the pantomime gestures of hearing parents, Goldin-Meadow and Mylander (1990) showed that the children developed a gesturing system with some fundamental language rules in advance of the system of parental gestures. However, by the age of six, they had not developed a language system commensurate with that of a deaf child of a similar age exposed to ASL or BSL (or other signing system).
In order to explain the invention of these systems of home sign, we have to suppose that children are looking for something - anything in the environment that looks remotely like language, something out of which their Universal grammar can construct a mental grammar. (JACKENDOFF R. 1993 page 130)
If exposure to native language is all that is required for a child to develop language skills, why do many potential users of AAC have delayed language development and difficulties with aspects of semantics, syntax, and pragmatics? Is their exposure in some way deviant or can their failure be explained by the originating trauma which has resulted in neurological damage to that part of the brain which is responsible in some way for developing syntactic skills? Perhaps, for full syntactic development, it is not enough just to be exposed to language through the receptive channels but an expressive component is also required within a critical period of development (For ‘critical period’ see the section INTERACT 4).
‘Relating Neville’s data to Genie’s case suggests that language development may be the crucial factor in hemispheric specialization,’ Curtiss wrote in her 1981 paper. ‘When language develops, it determines what else the language hemisphere will be specialized for. In its absence, it prevents the language hemisphere from specializing for any higher cortical functions.’ The insight promised to redefine some basic intertwined ideas: what does it mean to say that something is a language? Language is a logic system so organically tuned to the mechanism of the human brain that it actually triggers the brain’s growth. What are human beings? They are beings whose brain development is uniquely responsive to and dependent on the receipt at the proper time of even a small sample of language. (RYMER R. 1993 page 180)
As the receptive channel need not be aural (the deaf community have a visual medium), likewise, the expressive channel need not be oral. However, I suggest that, the expressive medium must allow the child to experience the fullness of syntax. I do not know of any empirical evidence to support this claim. Indeed, the hypothesis could not account for any child who has developed a functionally intact syntactic system and yet has been without, at least, a quasi-grammatical mode of expression during the critical period. However, if there is a possibility of a shred of truth in this hypothesis what-so-ever then shouldn’t it be taken into consideration?
The young brain is especially ‘plastic’ (For works on the plasticity of the brain see - LENNEBERG E. 1967; LURIA A. 1973; DOMAN G. 1974; STEIN D. 1974; ROSE S. 1976; RUSSELL P. 1979; DENNIS M. 1980; SPRINGER S. & DEUTSCH G. 1989; SEGALOWITZ S. 1983; RAUSCHECKER J. & MARLER P. 1987; SINGER W. 1987; NEVILLE H. 1990; ANDREW R. 1991; ROSE S. 1992; GREENFIELD S. 1997 page 24 -;). It has the capability to transfer specificity of function to other undamaged areas of the cerebrum:
Brain damage can interfere with acquisition of language early on, but if it happens during the critical period, other parts of the brain can fill in. (RYMER R. 1993 Quoting Neville. Page 169)
We do know that the language-learning circuitry of the brain is more plastic in childhood; children learn or recover language when the left hemisphere of the brain is damaged or even surgically removed (though not quite at normal levels), but comparable damage in an adult usually leads to permanent aphasia. (PINKER S. 1994)
Work in the last decade has shown how plastic the cerebral cortex is, and how the cerebral ‘mapping’ of body image, for example, may be drastically reorganized and revised, not only following injuries or immobilizations, but in consequence of the special use of individual parts (SACKS O. 1995)
If a cerebral lesion is the culprit, why is linguistic specificity not transferred? Could it be that the originating trauma has also affected the plasticity of the neonate’s brain? If this is true then why should some neurologically damaged brains maintain plasticity and others not?
some neurologists have argued that the recovery of language function following severe damage to the language hemisphere in some cases is a result of a process by which the intact hemisphere assumes many of the functions of the damaged one. The intriguing questions are why some people can do this while others cannot, and whether language is learned by the intact hemisphere after the injury or has been present, but lying dormant, for much of the patient’s life. (SPRINGER S. & DEUTSCH G. 1989)
We just don’t know the answers to such questions. Perhaps the trauma affects areas in both hemispheres reducing the opportunity for transference of function.
If the human brain was simple enough for us to understand, we would still be so stupid that we couldn’t understand it. (GAARDER J. 1991 page 276)
Perhaps, as Sacks has suggested (SACKS O. 1995) partially impaired functions are not transferred resulting, in this instance, in an impaired language function. Perhaps the problem doesn’t lie with nature but with nurture; with the differential treatment of people with disabilities (or some of both?). Perhaps transference does occur but isn’t supported by the use of appropriate techniques by significant others; the child being unable to make sense of their language without the support of alternative channels of cognitive input. It is known that congenitally deaf children and children who become deaf before learning language do not develop intellectually at the same rate and to the same level as their hearing peers ( MEADOW K. 1980; WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984: WOOD D. 1986, 1988; WOOD H., GRIFFITHS A. & HOWARTH I. 1986).
Most very deaf children ..... eventually solve concrete operational problems but not formal operational ones. ...... The vast majority of them also fail to achieve functional literacy. ... Deaf children face enormous problems in learning to read and only a tiny minority reach the eleven-year-old level when they leave school (WOOD D. 1988)
.... the average deaf child leaves school .... performing in mathematics at a level typical of twelve-year-old hearing children. (WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984)
This appears to be because the communicative process is impaired in both directions:
They find learning more difficult because the process of communication with their teachers is difficult. Their acquisition of knowledge is consequently impeded. (WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984)
If the language function is switched between hemispheres or there is bilateral speech control then the side of the brain with primary responsibility for perceptual processing is now also involved in language:
it has been determined that over 95% of all right-handers without any history of early brain damage have speech and language controlled by the left hemisphere; the remainder have speech controlled by the right hemisphere. . . . Data have also been collected using the Wada technique in patients who were known to have some damage to their left hemisphere early in life. These patients show a much higher incidence of right-hemisphere or bilateral speech. . . . This evidence points to the adaptability of the brain (SPRINGER S. & DEUTSCH G.1989) (Author note: For the WADA technique see WADA J. & RASMUSSEN T. 1960)
Environmental support for language development may be crucial. At the very least, it can only complement the other strategies that communication professionals use to help develop language and augmented communication skills. Communication between significant other and the learner and the learner and the significant other is vital. If children with language impairment are exposed to alternative and augmentative communication from the point at which the problem is recognised then there may be an amelioration of their language skills. The child needs to be immersed in the alternative language form. I use the acronym TILE - the Total Immersion in Language Experience. The environment must reflect this alternative language. What the child sees must support what the child hears and the AAC system in use.
It has been reported that left hemisphere damage during infancy is not as likely to cause permanent language impairment as it is in later childhood or adult life (LENNEBERG E. 1967; RUTTER M., GRAHAM P., & YULE W. 1970). However, if the child has a disability that prevents the acquisition of language through the auditory channel, and a visual method of learning language is not provided during the child’s first four years of life, then it is likely that persisting language deficits will result.
(HOOPER J., CONNELL T., & FLETT P. 1987)
If the ability to decode language is problematic for some children then providing more of the same is a futile exercise:
Verbal auditory agnosia does not preclude the acquisition of language, provided that the input is not acoustic and the output is not speech (HOOPER J., CONNELL T., & FLETT P. 1987)(See also STEIN L. & CURRY F. 1968)
A child’s appreciation of the spoken language form through the aural channel must be supported by his or her other senses. A child will naturally attempt to make sense of the speech of significant others primarily through the visual experience of contextual cues:
Significant other places an orange and an apple on the table.
Significant other looks at the orange and says AShow me the orange”
Child looks at the orange.
The child’s response does not mean that the child has understood the language used in the significant other’s request. However, from the significant other’s perspective, it appears that she or he does and this can create further problems:
....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)
Thus, the environment can be used to support a user’s understanding of spoken language:
These individuals, in contrast, must begin the AAC acquisition process by establishing the relationship between AAC symbols and their real-world referents, relying, perhaps almost exclusively, on contextual clues in the communicative environment to extract meaning through the visual modality (ROMSKI M. & SEVCIK R. 1993)
Lacking the ability to progress through the ‘normal’ channels of linguistic development children may be significantly cognitively delayed:
In recent years pediatricians have saved the lives of many babies with breathing abnormalities by inserting a tube into their tracheas or by surgically opening a hole in their tracheas below the larynx. The infants are then unable to make voiced sounds during the normal period of babbling. When the normal airway is restored in the second year of life, those infants are seriously retarded in speech development, though they eventually catch up, with no permanent problems. Deaf children’s babbling is later and simpler - though if their parents use sign language, they babble, on schedule, with their hands! (PINKER S. 1994)
If there is no means of compensating for the delay or it is permitted to continue for years then children may not catch up with their vocal peers. Thus, it is not just the aural (or visual in the case of the congenitally deaf child) experience of language that is vitally important but also the oral or expressive experience. The child who has a significant speech impairment is unlikely to have the expressive experience of an non-impaired sibling. As we have seen, a deaf child, whose parents sign, intellectually fairs better than a child born into a non-signing family (SACKS O. 1989;WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984; WOOD H., GRIFFITHS A. & HOWARTH I. 1986; WOOD D. 1988). Providing an augmentative means to communicate as early as possible is therefore extremely important. Supporting and training the infant in the chosen augmentative system through positive environmental experiences is as important to the child’s development as is correct nourishment.
Supporting language comprehension through the use of labels and the use of sign are recommended practices. They will not diminish an augmentative communicator’s ability to vocalise (as some significant others fear) but will enhance whatever capability the user possesses. The decision to support language comprehension can never be made too late but the rule is the earlier the better:
In sum, acquisition of a normal language is guaranteed for children up to the age of six, is steadily compromised from then until shortly after puberty, and is rare thereafter. (PINKER S. 1994)
The late beginning of communication intervention with this child has had an adverse effect on her potential for the future development of her communication system. Early introduction of a nonspeech system may have resulted in a different prognosis. (HOOPER J., CONNELL T., & FLETT P. 1987)
Labelling the environment is thus an important factor in TILE-ing (Total Immersion in Language Experience) the augmented communicator’s educational life. By coincidence, TILE relates well with Mirenda’s analogy of AAC as the grout in a mosaic. AAC is part of the grout:
I am talking about AAC as a part of the grout here, not as one of the tiles. (MIRENDA P. 1993, p. 5)
As children are likely to have an improved grasp of foreign languages if they are immersed in the language, so augmented communicators can benefit from being immersed in a linguistic and symbolically rich environment which supports and develops AAC skills:
Augmentative communication is effectively taught in an environment comparable to foreign language immersion. Research in foreign language learning has shown us that children learn a foreign language best when taught in an immersion environment. That is to say, the children learn to speak the language by hearing and speaking it in normal use and not by being taught individual vocabulary and grammar. Learning to use augmentative systems may be compared to this because the child is being asked to communicate in a manner which is foreign to those around him. It is still English, but the means for retrieving messages, the way the vocabulary is coded, and the speed and methods for relaying information is different. This results in a lack of pragmatic models for the child who is using the augmentative system. This is especially significant for children who are in the process of developing their first language (BURKHART L. 1990 p. 10)
Labelling is an aspect of a system that has been suggested for the development of language in children who are deaf (See DALGARNO G. 1680; BELL A. G. 1883; STEINBERG D. & HARPER H. 1983; STEINBERG D. 1984; SUZUKI S. & NOTOYA M. 1984; STEINBERG D. 1993 chapter 4). In this approach, the use of the written-visual form of the language replaces the spoken-auditory channel:
The essential idea of this approach is that the meaningful written forms of an ordinary speech-based language such as English or Spanish (its words, phrases and sentences) are acquired through direct association with objects, events and situations in the environment. Thus, just as hearing children learn language by initially associating the speech sounds that they hear with environmental experiences, hearing impaired children can learn language in a similar way, but through an association of written forms with environmental experiences. (STEINBERG D. 1993 page 85)
Labelling the environment with words is necessarily only one aspect of the above approach which, together with other strategies, it is hoped, will develop into a language for a person deprived of language acquisition through auditory channels. In the same sense, labelling the environment with symbols is but one aspect of TILE-ing for an augmented communicator; further aspects are dealt with in other areas of this manual.
The notion of ‘equivalence’ is important in this section on labelling the environment (See REMINGTON B. 1994). It has been shown (REMINGTON B. & CLARKE S. 1983; CLARKE S. 1986; CLARKE S., REMINGTON B., & LIGHT P. 1986; CLARKE S., REMINGTON B., & LIGHT P. 1988; REMINGTON B., WATSON J., & LIGHT P. 1990; REMINGTON B. & CLARKE S. 1993a; REMINGTON B. & CLARKE S. 1993b) that equivalence can play an important role in the development of semantics, syntax, and pragmatics in AAC users. Put simply, equivalence refers to the generalisation and transference of skills from taught associations to others as yet untaught. An association between a label and an item, and an item and a word can lead to an untaught association between the label and the word. Thus, labelling the environment can help to create an untaught association between the label (symbol) and the word.
Equivalence has even been noted in chimps that have been taught to sign. Fouts, Chown, and Goodin (1976)( see also LINDEN E. 1976 page 121) at the Institute for Primate Studies in Oklahoma, working with a male chimp named Ally, believed that the chimp could recognise English words. To test this, Ally was taught 10 nouns and subsequently requested to get one of the taught words from a pile of objects and return with it. His trainers assumed he knew a word when he could retrieve an object in this way over five trials without error. Later, Ally was taught the signs for five of the words by saying the word (for example Aspoon”) and simultaneously signing it in ASL (American Sign Language referred to as Ameslan in the quote below). This was done without the presence of the object, through word and sign alone. To test the notion of equivalence, the trainer involved in teaching the word and sign correspondence left the room and another trainer came in. This trainer did not know which of the words had been taught and asked Ally to give the sign for objects which were presented to the chimp one at a time. Ally was able to give the signs for the objects which had been taught by word / sign association:
As in the double-blind procedure used in formal testing, this method prevented the investigator from cueing Ally to the correct answer..... While it had been known previously that Ally could acquire signs in Ameslan, in this case Ally learned the appropriate Ameslan word for a variety of objects solely on the basis of his previously knowing the English word. There was no spoon around when he was taught its Ameslan sign; the only stimulus around was the instructor’s word (LINDEN E. 1976 p. 121)
The technique of labelling the environment has positive benefits for the AAC user.
The cartoon depicts a cat pulling a cart which has been labelled with the appropriate symbols. There is no suggestion that this is a good or correct way to label an animal. How would we label a cat? A photograph on the wall; a label attached to the cat’s collar; a picture in the family album......
If a small team of people, say five, each create a single label for one item each working day then, in a year, almost a thousand labels will have been produced. Further, if the person using the AAC system is involved in making the labels a learning experience is created. Why stop with just the person using the system? Why not involve all the group or class? Have a label making lesson. Label everything with the written word, the sign (ASL, BSL, other?) and the symbols used (Bliss, Rebus, Makaton, Minspeak, Other). If there is to be more than one symbol set in use then this has the potential disadvantage of being confusing. However, if the class is involved in making them they can be asked to figure out a way of making each set of signs and symbols distinct. They might suggest using the same spatial arrangement in each location as well as using colour encoding.
Facilitators should ensure that the new labels are noted; for example, a facilitator could point out a new label and make reference to the user’s communication system - AOh look some symbols on the toilet door. Hmmm, those symbols are on your VOCA. I wonder what it would say if you pressed them?” or AThat symbol is on your board - it’s the symbol for toilet. Look here it is.”
Existing labels should be used creatively and not just left to a chance glance by an augmented communicator as they pass a particular display. If time is invested in creating labels then make use of them:
AOk, today we are going to talk about furniture. We haven’t talked about furniture before. Furniture is the name for things like chairs and tables and bookcases. The furniture in this room is labelled. The chairs have this label on them (hold up symbol or symbols). Here’s a chair (point to one). How many chairs are there in this room?”
There is a fundamental reason for labelling the environment. It involves the user’s immersion in and experience of language. Children, as they grow, only require that they hear their native language in order to ‘re-invent’ it (PINKER S. 1994). How children are able to ‘learn’ language from their parents when they do not hear enough of it to explain their precociousness still remains something of a mystery. Chomsky has suggested that there is an innate ability to acquire language (CHOMSKY N. 1972; see also INGRAM J. 1992; JACKENDOFF R. 1993; PINKER S. 1994)(see PUTNAM H. 1971 for a critique of Chomsky’s theory in this area). Given the correct environmental factors it is difficult to stop a child from acquiring his or her own native language. Children of parents who speak a pidgin language (language without a grammar) impose a set of grammatical rules so that, within a generation, a creole is created (BICKERTON D. 1981,1984; HOLM J. 1988; INGRAM J. 1992 ch. 18; JACKENDOFF R. 1993 chapter 10; PINKER S. 1994 ch. 1). A creole, while it may appear to some as an inferior form of language, nevertheless has a grammatical structure equivalent to that of any other language in the world. This ‘need’ to impose a grammar is also true for individual children experiencing a poor parental language model, even if the language is sign (SINGLETON J. & NEWPORT E. 1993).
For work on the ‘development’ of syntax in ‘pidgin-like’ situations see - BICKERTON D. 1981,1984; HOLM J. 1988; GOLDIN-MEADOW S. & MYLANDER C. 1990; INGRAM J. 1992 ch. 18; JACKENDOFF R. 1993 chapter 10; SINGLETON J. & NEWPORT E. 1993; PINKER S. 1994 ch. 1; HORIZON 1997;
In a study of deaf children without experience of a sign language other than that of the pantomime gestures of hearing parents, Goldin-Meadow and Mylander (1990) showed that the children developed a gesturing system with some fundamental language rules in advance of the system of parental gestures. However, by the age of six, they had not developed a language system commensurate with that of a deaf child of a similar age exposed to ASL or BSL (or other signing system).
In order to explain the invention of these systems of home sign, we have to suppose that children are looking for something - anything in the environment that looks remotely like language, something out of which their Universal grammar can construct a mental grammar. (JACKENDOFF R. 1993 page 130)
If exposure to native language is all that is required for a child to develop language skills, why do many potential users of AAC have delayed language development and difficulties with aspects of semantics, syntax, and pragmatics? Is their exposure in some way deviant or can their failure be explained by the originating trauma which has resulted in neurological damage to that part of the brain which is responsible in some way for developing syntactic skills? Perhaps, for full syntactic development, it is not enough just to be exposed to language through the receptive channels but an expressive component is also required within a critical period of development (For ‘critical period’ see the section INTERACT 4).
‘Relating Neville’s data to Genie’s case suggests that language development may be the crucial factor in hemispheric specialization,’ Curtiss wrote in her 1981 paper. ‘When language develops, it determines what else the language hemisphere will be specialized for. In its absence, it prevents the language hemisphere from specializing for any higher cortical functions.’ The insight promised to redefine some basic intertwined ideas: what does it mean to say that something is a language? Language is a logic system so organically tuned to the mechanism of the human brain that it actually triggers the brain’s growth. What are human beings? They are beings whose brain development is uniquely responsive to and dependent on the receipt at the proper time of even a small sample of language. (RYMER R. 1993 page 180)
As the receptive channel need not be aural (the deaf community have a visual medium), likewise, the expressive channel need not be oral. However, I suggest that, the expressive medium must allow the child to experience the fullness of syntax. I do not know of any empirical evidence to support this claim. Indeed, the hypothesis could not account for any child who has developed a functionally intact syntactic system and yet has been without, at least, a quasi-grammatical mode of expression during the critical period. However, if there is a possibility of a shred of truth in this hypothesis what-so-ever then shouldn’t it be taken into consideration?
The young brain is especially ‘plastic’ (For works on the plasticity of the brain see - LENNEBERG E. 1967; LURIA A. 1973; DOMAN G. 1974; STEIN D. 1974; ROSE S. 1976; RUSSELL P. 1979; DENNIS M. 1980; SPRINGER S. & DEUTSCH G. 1989; SEGALOWITZ S. 1983; RAUSCHECKER J. & MARLER P. 1987; SINGER W. 1987; NEVILLE H. 1990; ANDREW R. 1991; ROSE S. 1992; GREENFIELD S. 1997 page 24 -;). It has the capability to transfer specificity of function to other undamaged areas of the cerebrum:
Brain damage can interfere with acquisition of language early on, but if it happens during the critical period, other parts of the brain can fill in. (RYMER R. 1993 Quoting Neville. Page 169)
We do know that the language-learning circuitry of the brain is more plastic in childhood; children learn or recover language when the left hemisphere of the brain is damaged or even surgically removed (though not quite at normal levels), but comparable damage in an adult usually leads to permanent aphasia. (PINKER S. 1994)
Work in the last decade has shown how plastic the cerebral cortex is, and how the cerebral ‘mapping’ of body image, for example, may be drastically reorganized and revised, not only following injuries or immobilizations, but in consequence of the special use of individual parts (SACKS O. 1995)
If a cerebral lesion is the culprit, why is linguistic specificity not transferred? Could it be that the originating trauma has also affected the plasticity of the neonate’s brain? If this is true then why should some neurologically damaged brains maintain plasticity and others not?
some neurologists have argued that the recovery of language function following severe damage to the language hemisphere in some cases is a result of a process by which the intact hemisphere assumes many of the functions of the damaged one. The intriguing questions are why some people can do this while others cannot, and whether language is learned by the intact hemisphere after the injury or has been present, but lying dormant, for much of the patient’s life. (SPRINGER S. & DEUTSCH G. 1989)
We just don’t know the answers to such questions. Perhaps the trauma affects areas in both hemispheres reducing the opportunity for transference of function.
If the human brain was simple enough for us to understand, we would still be so stupid that we couldn’t understand it. (GAARDER J. 1991 page 276)
Perhaps, as Sacks has suggested (SACKS O. 1995) partially impaired functions are not transferred resulting, in this instance, in an impaired language function. Perhaps the problem doesn’t lie with nature but with nurture; with the differential treatment of people with disabilities (or some of both?). Perhaps transference does occur but isn’t supported by the use of appropriate techniques by significant others; the child being unable to make sense of their language without the support of alternative channels of cognitive input. It is known that congenitally deaf children and children who become deaf before learning language do not develop intellectually at the same rate and to the same level as their hearing peers ( MEADOW K. 1980; WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984: WOOD D. 1986, 1988; WOOD H., GRIFFITHS A. & HOWARTH I. 1986).
Most very deaf children ..... eventually solve concrete operational problems but not formal operational ones. ...... The vast majority of them also fail to achieve functional literacy. ... Deaf children face enormous problems in learning to read and only a tiny minority reach the eleven-year-old level when they leave school (WOOD D. 1988)
.... the average deaf child leaves school .... performing in mathematics at a level typical of twelve-year-old hearing children. (WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984)
This appears to be because the communicative process is impaired in both directions:
They find learning more difficult because the process of communication with their teachers is difficult. Their acquisition of knowledge is consequently impeded. (WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984)
If the language function is switched between hemispheres or there is bilateral speech control then the side of the brain with primary responsibility for perceptual processing is now also involved in language:
it has been determined that over 95% of all right-handers without any history of early brain damage have speech and language controlled by the left hemisphere; the remainder have speech controlled by the right hemisphere. . . . Data have also been collected using the Wada technique in patients who were known to have some damage to their left hemisphere early in life. These patients show a much higher incidence of right-hemisphere or bilateral speech. . . . This evidence points to the adaptability of the brain (SPRINGER S. & DEUTSCH G.1989) (Author note: For the WADA technique see WADA J. & RASMUSSEN T. 1960)
Environmental support for language development may be crucial. At the very least, it can only complement the other strategies that communication professionals use to help develop language and augmented communication skills. Communication between significant other and the learner and the learner and the significant other is vital. If children with language impairment are exposed to alternative and augmentative communication from the point at which the problem is recognised then there may be an amelioration of their language skills. The child needs to be immersed in the alternative language form. I use the acronym TILE - the Total Immersion in Language Experience. The environment must reflect this alternative language. What the child sees must support what the child hears and the AAC system in use.
It has been reported that left hemisphere damage during infancy is not as likely to cause permanent language impairment as it is in later childhood or adult life (LENNEBERG E. 1967; RUTTER M., GRAHAM P., & YULE W. 1970). However, if the child has a disability that prevents the acquisition of language through the auditory channel, and a visual method of learning language is not provided during the child’s first four years of life, then it is likely that persisting language deficits will result.
(HOOPER J., CONNELL T., & FLETT P. 1987)
If the ability to decode language is problematic for some children then providing more of the same is a futile exercise:
Verbal auditory agnosia does not preclude the acquisition of language, provided that the input is not acoustic and the output is not speech (HOOPER J., CONNELL T., & FLETT P. 1987)(See also STEIN L. & CURRY F. 1968)
A child’s appreciation of the spoken language form through the aural channel must be supported by his or her other senses. A child will naturally attempt to make sense of the speech of significant others primarily through the visual experience of contextual cues:
Significant other places an orange and an apple on the table.
Significant other looks at the orange and says AShow me the orange”
Child looks at the orange.
The child’s response does not mean that the child has understood the language used in the significant other’s request. However, from the significant other’s perspective, it appears that she or he does and this can create further problems:
....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)
Thus, the environment can be used to support a user’s understanding of spoken language:
These individuals, in contrast, must begin the AAC acquisition process by establishing the relationship between AAC symbols and their real-world referents, relying, perhaps almost exclusively, on contextual clues in the communicative environment to extract meaning through the visual modality (ROMSKI M. & SEVCIK R. 1993)
Lacking the ability to progress through the ‘normal’ channels of linguistic development children may be significantly cognitively delayed:
In recent years pediatricians have saved the lives of many babies with breathing abnormalities by inserting a tube into their tracheas or by surgically opening a hole in their tracheas below the larynx. The infants are then unable to make voiced sounds during the normal period of babbling. When the normal airway is restored in the second year of life, those infants are seriously retarded in speech development, though they eventually catch up, with no permanent problems. Deaf children’s babbling is later and simpler - though if their parents use sign language, they babble, on schedule, with their hands! (PINKER S. 1994)
If there is no means of compensating for the delay or it is permitted to continue for years then children may not catch up with their vocal peers. Thus, it is not just the aural (or visual in the case of the congenitally deaf child) experience of language that is vitally important but also the oral or expressive experience. The child who has a significant speech impairment is unlikely to have the expressive experience of an non-impaired sibling. As we have seen, a deaf child, whose parents sign, intellectually fairs better than a child born into a non-signing family (SACKS O. 1989;WOOD D., KINGSMILL M., FRENCH J., & HOWARTH S. 1984; WOOD H., GRIFFITHS A. & HOWARTH I. 1986; WOOD D. 1988). Providing an augmentative means to communicate as early as possible is therefore extremely important. Supporting and training the infant in the chosen augmentative system through positive environmental experiences is as important to the child’s development as is correct nourishment.
Supporting language comprehension through the use of labels and the use of sign are recommended practices. They will not diminish an augmentative communicator’s ability to vocalise (as some significant others fear) but will enhance whatever capability the user possesses. The decision to support language comprehension can never be made too late but the rule is the earlier the better:
In sum, acquisition of a normal language is guaranteed for children up to the age of six, is steadily compromised from then until shortly after puberty, and is rare thereafter. (PINKER S. 1994)
The late beginning of communication intervention with this child has had an adverse effect on her potential for the future development of her communication system. Early introduction of a nonspeech system may have resulted in a different prognosis. (HOOPER J., CONNELL T., & FLETT P. 1987)
Labelling the environment is thus an important factor in TILE-ing (Total Immersion in Language Experience) the augmented communicator’s educational life. By coincidence, TILE relates well with Mirenda’s analogy of AAC as the grout in a mosaic. AAC is part of the grout:
I am talking about AAC as a part of the grout here, not as one of the tiles. (MIRENDA P. 1993, p. 5)
As children are likely to have an improved grasp of foreign languages if they are immersed in the language, so augmented communicators can benefit from being immersed in a linguistic and symbolically rich environment which supports and develops AAC skills:
Augmentative communication is effectively taught in an environment comparable to foreign language immersion. Research in foreign language learning has shown us that children learn a foreign language best when taught in an immersion environment. That is to say, the children learn to speak the language by hearing and speaking it in normal use and not by being taught individual vocabulary and grammar. Learning to use augmentative systems may be compared to this because the child is being asked to communicate in a manner which is foreign to those around him. It is still English, but the means for retrieving messages, the way the vocabulary is coded, and the speed and methods for relaying information is different. This results in a lack of pragmatic models for the child who is using the augmentative system. This is especially significant for children who are in the process of developing their first language (BURKHART L. 1990 p. 10)
Labelling is an aspect of a system that has been suggested for the development of language in children who are deaf (See DALGARNO G. 1680; BELL A. G. 1883; STEINBERG D. & HARPER H. 1983; STEINBERG D. 1984; SUZUKI S. & NOTOYA M. 1984; STEINBERG D. 1993 chapter 4). In this approach, the use of the written-visual form of the language replaces the spoken-auditory channel:
The essential idea of this approach is that the meaningful written forms of an ordinary speech-based language such as English or Spanish (its words, phrases and sentences) are acquired through direct association with objects, events and situations in the environment. Thus, just as hearing children learn language by initially associating the speech sounds that they hear with environmental experiences, hearing impaired children can learn language in a similar way, but through an association of written forms with environmental experiences. (STEINBERG D. 1993 page 85)
Labelling the environment with words is necessarily only one aspect of the above approach which, together with other strategies, it is hoped, will develop into a language for a person deprived of language acquisition through auditory channels. In the same sense, labelling the environment with symbols is but one aspect of TILE-ing for an augmented communicator; further aspects are dealt with in other areas of this manual.
The notion of ‘equivalence’ is important in this section on labelling the environment (See REMINGTON B. 1994). It has been shown (REMINGTON B. & CLARKE S. 1983; CLARKE S. 1986; CLARKE S., REMINGTON B., & LIGHT P. 1986; CLARKE S., REMINGTON B., & LIGHT P. 1988; REMINGTON B., WATSON J., & LIGHT P. 1990; REMINGTON B. & CLARKE S. 1993a; REMINGTON B. & CLARKE S. 1993b) that equivalence can play an important role in the development of semantics, syntax, and pragmatics in AAC users. Put simply, equivalence refers to the generalisation and transference of skills from taught associations to others as yet untaught. An association between a label and an item, and an item and a word can lead to an untaught association between the label and the word. Thus, labelling the environment can help to create an untaught association between the label (symbol) and the word.
Equivalence has even been noted in chimps that have been taught to sign. Fouts, Chown, and Goodin (1976)( see also LINDEN E. 1976 page 121) at the Institute for Primate Studies in Oklahoma, working with a male chimp named Ally, believed that the chimp could recognise English words. To test this, Ally was taught 10 nouns and subsequently requested to get one of the taught words from a pile of objects and return with it. His trainers assumed he knew a word when he could retrieve an object in this way over five trials without error. Later, Ally was taught the signs for five of the words by saying the word (for example Aspoon”) and simultaneously signing it in ASL (American Sign Language referred to as Ameslan in the quote below). This was done without the presence of the object, through word and sign alone. To test the notion of equivalence, the trainer involved in teaching the word and sign correspondence left the room and another trainer came in. This trainer did not know which of the words had been taught and asked Ally to give the sign for objects which were presented to the chimp one at a time. Ally was able to give the signs for the objects which had been taught by word / sign association:
As in the double-blind procedure used in formal testing, this method prevented the investigator from cueing Ally to the correct answer..... While it had been known previously that Ally could acquire signs in Ameslan, in this case Ally learned the appropriate Ameslan word for a variety of objects solely on the basis of his previously knowing the English word. There was no spoon around when he was taught its Ameslan sign; the only stimulus around was the instructor’s word (LINDEN E. 1976 p. 121)
ENVIRONMENT 4 - Show categorisation in action
.... we know that the superordinate categories of our conceptual system assist memory. If we have words like ‘chair’, ‘bed’, and ‘lamp’ organised under headings like ‘furniture’, we will find it easier to remember them. We develop a hierarchy of systematic contrasts which assist recognition and recall. The language-disabled child must be helped to develop this system through techniques which make explicit reference to these links between words. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
This is an extension to the previous idea. As a person’s AAC vocabulary grows so it must be encoded to make it accessible. If the vocabulary is 1,000 words a single sheet containing a different symbol for each word would be rather large if not unwieldy. It is normal to arrange sets of symbols by category on separate pages or through categorising symbols on VOCAs. The exception to this is the use of signing, although people with large vocabularies who use sign will cognitively benefit from an ability to categorise.
Creative ideas may be used to help develop categorisation skills. The first idea covered in the cartoon is ‘boxing clever’. This requires a number of small boxes which are clearly labelled on the exterior with the symbol choice for a particular category. Inside each box are examples of the elements of each set. Models, toys, photographs are all good ideas. Even the real thing if it is possible. For example, from the clothing category: an old sock; a tie; a doll’s dress; etc. The box can be used in the process of teaching both the items and the category. Items are taken from the box as needed and put back into the box when no longer required. If several boxes are used then the user can be asked in which box a specific item will be found and, later, to which of the boxes an item should be returned. If the boxes are small and the tutor is particularly creative then they could become drawers in a cabinet which resembles the user’s overlay. Pull out a drawer and there are the examples of the vocabulary.
Another idea is to label the environment itself. ‘Cupboard love’ is but one example. The contents of some cupboards may have to be re-arranged but that is a small price to pay to foster the growth of communicative skills. Label the exterior of cupboard doors to show their contents. This can be applied to any part of the environment where items of a single category are placed together: the wardrobe door; the sock drawer; the shoe rack; the bathroom cabinet; the fruit bowl; the vegetable rack; toy boxes. The list is endless.
There is a difficulty with labelling doors: how does a child know that it is the content that is being labelled and not the door itself?
CASE STUDY: While shadowing a user through a typical day at his school I noted that on one toilet door in the corridor outside his classroom was the symbol for‘toilet’. However, on another toilet door only a few feet away was the symbol for ‘door’.
This may be overcome by using a simple strategy. Label the outside of doors with the contents (thus the corridor side of the toilet door says ‘toilet’) and the inside of doors with the label for door. Consistency is important.
Labelling is not enough. The user of an AAC system should help create the labels and then help to position them. After this, the user may be asked where things are kept, or where to put something. If time is invested in the creation of such a linguistically rich environment then good use should be made of it!
Categories can be taught in many other ways too. For example, by playing a variation of Kim’s game:
C a user studies a tray on which there is one or two categories of items;
C the tray is removed and an intruder (from neither category) is added;
C the user has to identify what has been added.
A tray is presented with four toys and three fruits. The child studies the tray before a cup is added. What is new? This can be varied by adding an item to one of the categories. Which category?
Categories can also be taught during the daily routine. Consider one such example. In the morning ta person is asked to chose the clothes s/he wants to wear. Because the person is at a pre-categorisational level the child simply eye-points to the desired choice between two displayed items: green skirt or blue jeans; red sweat shirt or blue jogging top; etc. If, before this activity is started, at each dressing or changing session:
C the facilitator talks about the category of clothes;
C points to a symbol which represents the category prominently displayed on the bedroom wall;
C takes the person’s hand and gets him/her to touch a clothes symbol card (and the symbol on their system);
C gives the user an opportunity to select the category in which they will be involved (clothes or food?) by eye-pointing (in this instance) to one of two category symbols (clothes / food) held up.
then this person’s understanding of (the concept of) categories will be enhanced.
This is an extension to the previous idea. As a person’s AAC vocabulary grows so it must be encoded to make it accessible. If the vocabulary is 1,000 words a single sheet containing a different symbol for each word would be rather large if not unwieldy. It is normal to arrange sets of symbols by category on separate pages or through categorising symbols on VOCAs. The exception to this is the use of signing, although people with large vocabularies who use sign will cognitively benefit from an ability to categorise.
Creative ideas may be used to help develop categorisation skills. The first idea covered in the cartoon is ‘boxing clever’. This requires a number of small boxes which are clearly labelled on the exterior with the symbol choice for a particular category. Inside each box are examples of the elements of each set. Models, toys, photographs are all good ideas. Even the real thing if it is possible. For example, from the clothing category: an old sock; a tie; a doll’s dress; etc. The box can be used in the process of teaching both the items and the category. Items are taken from the box as needed and put back into the box when no longer required. If several boxes are used then the user can be asked in which box a specific item will be found and, later, to which of the boxes an item should be returned. If the boxes are small and the tutor is particularly creative then they could become drawers in a cabinet which resembles the user’s overlay. Pull out a drawer and there are the examples of the vocabulary.
Another idea is to label the environment itself. ‘Cupboard love’ is but one example. The contents of some cupboards may have to be re-arranged but that is a small price to pay to foster the growth of communicative skills. Label the exterior of cupboard doors to show their contents. This can be applied to any part of the environment where items of a single category are placed together: the wardrobe door; the sock drawer; the shoe rack; the bathroom cabinet; the fruit bowl; the vegetable rack; toy boxes. The list is endless.
There is a difficulty with labelling doors: how does a child know that it is the content that is being labelled and not the door itself?
CASE STUDY: While shadowing a user through a typical day at his school I noted that on one toilet door in the corridor outside his classroom was the symbol for‘toilet’. However, on another toilet door only a few feet away was the symbol for ‘door’.
This may be overcome by using a simple strategy. Label the outside of doors with the contents (thus the corridor side of the toilet door says ‘toilet’) and the inside of doors with the label for door. Consistency is important.
Labelling is not enough. The user of an AAC system should help create the labels and then help to position them. After this, the user may be asked where things are kept, or where to put something. If time is invested in the creation of such a linguistically rich environment then good use should be made of it!
Categories can be taught in many other ways too. For example, by playing a variation of Kim’s game:
C a user studies a tray on which there is one or two categories of items;
C the tray is removed and an intruder (from neither category) is added;
C the user has to identify what has been added.
A tray is presented with four toys and three fruits. The child studies the tray before a cup is added. What is new? This can be varied by adding an item to one of the categories. Which category?
Categories can also be taught during the daily routine. Consider one such example. In the morning ta person is asked to chose the clothes s/he wants to wear. Because the person is at a pre-categorisational level the child simply eye-points to the desired choice between two displayed items: green skirt or blue jeans; red sweat shirt or blue jogging top; etc. If, before this activity is started, at each dressing or changing session:
C the facilitator talks about the category of clothes;
C points to a symbol which represents the category prominently displayed on the bedroom wall;
C takes the person’s hand and gets him/her to touch a clothes symbol card (and the symbol on their system);
C gives the user an opportunity to select the category in which they will be involved (clothes or food?) by eye-pointing (in this instance) to one of two category symbols (clothes / food) held up.
then this person’s understanding of (the concept of) categories will be enhanced.
ENVIRONMENT 5 - Environmental Pollution
Often students are taught these words or symbols in a clinical setting or isolated classroom, which has proven less effective in promoting generalization than instruction in the natural environment (HAMILTON B. & SNELL M. 1993)
It is sensible to make full use of the environments both at school and at home. Teaching words and concepts concerning food are not best taught in a library. The environment itself may pollute the understanding of the student. Further, students with delayed language development may find the use of substitutions, such as a book as a pan, extremely confusing.
Some environments may be distracting and should be avoided if not directly related to the topic. The background noise and activity occurring within the communicating environment is equally important. For the user with a learning difficulty, a distraction during a conversation may cause a lack of attention resulting in a subsequent loss of meaning:
The ability to attend to a stimulus and to sustain that attention is essential for all forms of learning. It is particularly relevant to language learning which requires a fairly mature level of attention control. A child who cannot maintain his attention or becomes fixated will be unable to process the complex stimuli of language (COOKE J. & WILLIAMS D. 1985)
Classrooms are also noisy places, often with poor acoustics, making the detection of the correct words very difficult for some language-disabled children. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
Eliminating environmental distractions during a row column scanning task may improve concentration on the task as well. (RATCLIFF A. 1994)
Unwanted noise, interruptions, and other distractions can lead to a lack of selective attention skills (see ROSS A. 1977) which serve to block the learning of new concepts.
A further form of environmental pollution may be unwittingly created by a high staff turnover creating problems for staff training and such that an augmented communicator may not get the chance to form long-term and, by the user’s standards, safe communicative relationships with staff members:
In this respect, the ecology supporting people with severe disabilities may represent a particular challenge. Kennedy, Horner, and Newton (1989) reported that there is a tremendous turnover among people interacting with learners with severe disabilities. That is, few companions remain part of the learner’s social sphere for more than a few months. This means that learners must constantly be adjusting to different interactive partners who may bring a variety of interactional styles to the interaction. (REICHLE J. 1991 p. 154)
The mnemonic is ‘Teach within Reach’ - that is within:
C the student’s intellectual reach;
C reach of the items that are necessary to illustrate the topic in question;
C at a time in which the user is responsive and alert:
Pick a time when you are most likely to get .... co-operation: a time when he is alert and responsive. (JEFFREE D. & McCONKEY R. 1976)
Thus, Environmental Planning is important .....
It is sensible to make full use of the environments both at school and at home. Teaching words and concepts concerning food are not best taught in a library. The environment itself may pollute the understanding of the student. Further, students with delayed language development may find the use of substitutions, such as a book as a pan, extremely confusing.
Some environments may be distracting and should be avoided if not directly related to the topic. The background noise and activity occurring within the communicating environment is equally important. For the user with a learning difficulty, a distraction during a conversation may cause a lack of attention resulting in a subsequent loss of meaning:
The ability to attend to a stimulus and to sustain that attention is essential for all forms of learning. It is particularly relevant to language learning which requires a fairly mature level of attention control. A child who cannot maintain his attention or becomes fixated will be unable to process the complex stimuli of language (COOKE J. & WILLIAMS D. 1985)
Classrooms are also noisy places, often with poor acoustics, making the detection of the correct words very difficult for some language-disabled children. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
Eliminating environmental distractions during a row column scanning task may improve concentration on the task as well. (RATCLIFF A. 1994)
Unwanted noise, interruptions, and other distractions can lead to a lack of selective attention skills (see ROSS A. 1977) which serve to block the learning of new concepts.
A further form of environmental pollution may be unwittingly created by a high staff turnover creating problems for staff training and such that an augmented communicator may not get the chance to form long-term and, by the user’s standards, safe communicative relationships with staff members:
In this respect, the ecology supporting people with severe disabilities may represent a particular challenge. Kennedy, Horner, and Newton (1989) reported that there is a tremendous turnover among people interacting with learners with severe disabilities. That is, few companions remain part of the learner’s social sphere for more than a few months. This means that learners must constantly be adjusting to different interactive partners who may bring a variety of interactional styles to the interaction. (REICHLE J. 1991 p. 154)
The mnemonic is ‘Teach within Reach’ - that is within:
C the student’s intellectual reach;
C reach of the items that are necessary to illustrate the topic in question;
C at a time in which the user is responsive and alert:
Pick a time when you are most likely to get .... co-operation: a time when he is alert and responsive. (JEFFREE D. & McCONKEY R. 1976)
Thus, Environmental Planning is important .....
ENVIRONMENT 6 - Environmental Planning
... it is important that ..... the teaching of language and communication is located in natural settings where one can be sure that the skills being taught will be useful for the individual. This means that time must be spent assessing the environment and finding situations where communication can be used functionally and that are also suitable for training purposes. (VON TETZCHNER S. & MARTINSEN H. 1992)
Make use of the different environments regularly frequented by users. The environments will likely:
C suggest vocabulary developments;
C indicate strategies for tuition;
C contain materials for tuition;
C direct conversation into channels appropriate to the user’s vocabulary;
C help promote generalization (See KOEGEL R. , O’DELL M. , & KOEGEL L. 1987);
C help with memory:
Memory is also subject to situational variation. A phenomenon known as ‘state-dependent memory’ indicates that when we are put into the same situation where something was learned then we are more likely to remember it..... This phenomenon tells us that effective use of memory in classrooms or remedial clinics does not mean that it necessarily carries over to other contexts. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
The cartoon shows how the topic of conversation is directly related to the particular environment. Mr. Lissenbad is rewarding Sally for her contextual use of the available vocabulary. The fact that she is drowning does not appear to be relevant!
Teaching within reach, the use of natural environments, and state-dependent memory all suggest that the environment in which AAC is taught should be varied according to the subject matter. It follows that this may be best achieved by individual subject tutors working in their own curriculum area. That is, individual tutors should be made responsible for the tuition of specific aspects of a user’s vocabulary at given times designated by an AAC co-ordinator (normally the speech professional involved with the user).
Make use of the different environments regularly frequented by users. The environments will likely:
C suggest vocabulary developments;
C indicate strategies for tuition;
C contain materials for tuition;
C direct conversation into channels appropriate to the user’s vocabulary;
C help promote generalization (See KOEGEL R. , O’DELL M. , & KOEGEL L. 1987);
C help with memory:
Memory is also subject to situational variation. A phenomenon known as ‘state-dependent memory’ indicates that when we are put into the same situation where something was learned then we are more likely to remember it..... This phenomenon tells us that effective use of memory in classrooms or remedial clinics does not mean that it necessarily carries over to other contexts. (BEVERIDGE M. & CONTI-RAMSDEN G. 1987)
The cartoon shows how the topic of conversation is directly related to the particular environment. Mr. Lissenbad is rewarding Sally for her contextual use of the available vocabulary. The fact that she is drowning does not appear to be relevant!
Teaching within reach, the use of natural environments, and state-dependent memory all suggest that the environment in which AAC is taught should be varied according to the subject matter. It follows that this may be best achieved by individual subject tutors working in their own curriculum area. That is, individual tutors should be made responsible for the tuition of specific aspects of a user’s vocabulary at given times designated by an AAC co-ordinator (normally the speech professional involved with the user).
ENVIRONMENT 7 - Environmental Control
There are a number of environments in which users may not be able to use their normal AAC system. In the bathroom, on the toilet, and in bed are three such examples. If the environment, however, has signs or symbols on display then a person, who otherwise might have been unable to communicate, can continue to make his or her wishes known.
The environment is not being labelled as such as the symbols are not displayed for the purpose of teaching but for communication. Thus a symbol which represents tap or faucet is of little use for communication in the bathroom as the bather can point (by hand, eye, or other) to the real object (It does, however, have relevance for teaching the symbol for tap or faucet). Communicative symbol choices should be made with the user and the choices made should be relevant to the specific environment. The symbol choice for the word drink, for example, is not a particularly relevant symbol for the bather (unless the bather normally has a drink in the bath) but may be very relevant for the sleeper (a child wakes up at night and wants a drink). The symbols allow the augmented communicator to continue to communicate even though the primary AAC system is not available. While the symbol set represents a Temporarily Restricted Vocabulary (See the Vocabulary section), a good choice of symbols should allow continued control and some communicative ability.
Case Study: In a school I visited recently there were large communication charts on the walls in the toilets and by the baths. The staff reported these had been well received and now were an everyday part of school life.
The environment is not being labelled as such as the symbols are not displayed for the purpose of teaching but for communication. Thus a symbol which represents tap or faucet is of little use for communication in the bathroom as the bather can point (by hand, eye, or other) to the real object (It does, however, have relevance for teaching the symbol for tap or faucet). Communicative symbol choices should be made with the user and the choices made should be relevant to the specific environment. The symbol choice for the word drink, for example, is not a particularly relevant symbol for the bather (unless the bather normally has a drink in the bath) but may be very relevant for the sleeper (a child wakes up at night and wants a drink). The symbols allow the augmented communicator to continue to communicate even though the primary AAC system is not available. While the symbol set represents a Temporarily Restricted Vocabulary (See the Vocabulary section), a good choice of symbols should allow continued control and some communicative ability.
Case Study: In a school I visited recently there were large communication charts on the walls in the toilets and by the baths. The staff reported these had been well received and now were an everyday part of school life.