AT and AAC: Practical Tips and Strategies : early intervention

Free Book App

Angela Desideri — Wed, 30 May 2012 12:09:00 GMT

"The Biggest Pizza Ever" by JibJab Jr. is a fun book app that you can use to work on answering "wh" questions, teaching verbs, stating emotions and much much more.

Here's how it works:

Choose who is going to be the main character of the book and then choose Create Character and add photo, name, and skin type.
Now you are ready to go (here's a picture of my daughter Mya as the main character.)

How I use this book app:

Since only one student can be the main character at a time, this provides an excellent opportunity to practice problem solving skills. In one class a solution everyone agreed on was to do a raffle and pick names. There is no better way to learn how to wait then with a super fun story.

Some of my favorites features of this app:

Ability to add your own pictures is what helped maintain and sustain my students attention throughout the entire book. My students loved seeing themselves and their friends doing all of the fun things in this app. They got to ride a bike, drive vehicles like a forklift, operate a dump truck, operate a grab crane, and fly a helicopter (here's my daughter Gia flying her helicopter) all while in pursuit of making their giant pizza!

Provides an opportunity to act out the verbs in the story by:

flipping the pizza

rolling the dough

looking for the perfect location (using binoculars)

pouring the pizza sauce

sprinkling the cheese

Provides an opportunity to express a full range of emotions, such as:

happy

excited

surprised

worried

relieved

The problem and solution were simple and provided a great way to practice asking for help.

Ideas to Expand Beyond

Have students choose other people they would like to see as the main character. Some possible choices include family members, teachers, peers, or even favorite characters.

Since this is a free app it's a great one for families to read at home.

I encourage you to try out this free and super fun app!

Toca Monsters

Angela Desideri — Wed, 02 May 2012 11:00:00 GMT

Toca Boca has done it again! An amazing free app for the iPhone, iPod and iPad called Toca Monsters.

How it works:

Begin by selecting your monster. Gomez is the brown monster, and Nebula is the blue monster.
Choose from 8 ingredients to feed to your hungry monster.
Prepare the food by choosing to cut, blend, boil, fry, mix or microwave.
Feed the food to the monster.

How I use it:

I take screen shots of the food choices and screen shots of the appliances/food preparation page. We start by choosing the ingredients and then choose the items used to prepare the food. My students tell me what to do, and then they watch me do it on the iPad.

Goals that can be targeted:

Following directions
Vocabulary skills
Social language skills - practice watching and reading the monster's nonverbal body language and make predictions if the monster will like the food based on reading their nonverbal cues.
Core words - eat, like, stop, go, on, off, more.
Commenting
Descriptive language
Verbs

Some of my favorite features of this app:

The reaction on the monster's face when it doesn't like a food.
The surprise you find when you boil the blue fire ball.
Shaking the salt and pepper on the food and adding too much.
Option to have only vegetarian foods (if selected in the main settings)
Can be used to support any language.
All of the language you can elicit when you use this app interactively!

Have fun selecting, preparing, and feeding the monsters!

Apps & Vegetables

Angela Desideri — Wed, 18 Apr 2012 11:00:00 GMT

This past week my theme for therapy has been vegetables. Here's the list of vegetables I decided to use:

cabbage (green and purple)
carrots
green beans (great to snap in half)
broccoli
lettuce (easy to tear)
peas
peppers (green, yellow and orange)
tomato
eggplant
cucumber

I put each vegetable in a tightly sealed clear container to help elicit the most language and worked on the core words of help, open, look, that and more while we looked at each vegetable.

Talk about descriptive language! Vegetables are the key to eliciting it, especially when they are touched. Here are some examples of students comments: "yuck," "no sorry," don't like," "put in," "all done."

We then described the different colors and worked on preferences such as "I like" and "I don't like." It was so easy and fun to see what vegetables were liked and, of course, those that weren't.

App Used to Expand on Vegetables

After everyone was familiar with the vegetables, I expanded on it with an app called "Grandma's Garden" by Fairlady Media. This app allows you to adjust the settings and to work on specific concepts (counting, matching, coloring, first letters and shapes). In the app settings I selected "Color the vegetables." This setting asks you to color the vegetables. Every student was provided with a vegetable board of the vegetables in the app to use as a visual support.

When the app began, I asked the students, "What vegetable do you see?" I then asked, "What color is it?" When they told me, I started to color the cucumber and then quickly stopped. I then said, "What should I do now?" I waited until they told me "color it" or "more color" or signed "more." I repeated this process throughout the app. When I was finished coloring the vegetable, Grandma clapped, and all of us imitated her clapping. All of my students were communicating, engaged with the activity, and not even touching the iPad. Who would have thought that vegetables would be so much fun!

AAC Use and Speech

Angela Desideri — Wed, 04 Apr 2012 19:50:00 GMT

Recently, I have been doing workshops on the topic of AAC. One frequent question from parents has been "Will AAC prevent my child from speaking?"

The answer is no.

Decades of research have proven that AAC systems don't impede the development of speech. Rather, AAC provides a means for individuals to communicate and express their wants, needs, desires, feelings and preferences and to engage in conversations.

Despite hearing this, many parents are still hesitant to use AAC with their children due to their fears that speech won't develop. While I understand the fear of the unknown, it's critical that we provide parents with the resources to help them make informed AAC decisions.

In addition to what research tell us, I thought I would add some of my clinical impressions regarding AAC use.

When my students use AAC, I have seen improvements in the following areas:

Increased self-confidence
Motivation to communicate and learn
Decrease in behaviors
Increase in participation
Increase in ability to express wants, needs and preferences and to engage in conversational exchanges

As SLPs, it's important for us to listen to parents' concerns related to AAC. For many families this process is new to them. Listed below are resources to share with those who are trying to decide on whether AAC is the right choice. In addition to sharing resources, I found it extremely helpful to have parents speak with other parents whose children use AAC. Connecting with other AAC users provides invaluable insights.

Resources:

Considering AAC

AAC Connecting Young Kids: Yaack

The Center for AAC & Autism

Get to Know Your Students

Angela Desideri — Wed, 21 Mar 2012 13:30:00 GMT

Recently, I discovered a new app called Music Color. Music Color is a universal app that's available on the iTunes app store and supports 20 languages.

How It Works

Select a color from 12 possible options: blue, yellow, red, pink, brown, white, green, gray, orange, black, purple and light blue.

Once you select a color, a page with six items in the color you selected opens, and classical music is played. When you press the item on the page, it displays a large, vibrant picture that changes each time the same picture is pressed.

The question mark opens a page that requires you to receptively identify the colors in a field of four.

Interacting in the App

I begin by modeling all of the colors and items. Then I give all of my students screenshots of the main page that contains the 12 colors. Be sure to refer to my previous blog Screenshots: An Easy Way to Create Visual Supports to learn how to take screenshots. The students take turns requesting their preferred colors and items that they want to see. We then take turns commenting about the pictures. I comment and describe using core words, and my students follow along. The pictures are so exciting that you will be amazed at the spontaneous language they elicit.

Observing Your Students' Favorite Items in the App

I observed my students interacting within the app and discovered some of their favorite things. One of my nonverbal students kept choosing the color orange, and when on the orange page, she kept pressing the basketball picture over and over. We gave her a basketball, and she immediately began bouncing it. Had it not been for this app, I never would have discovered her love of playing basketball. This is just one example among many that demonstrates how my nonverbal students use this app to communicate their favorite activities.

Expanding Beyond the App

I bring in objects that are the same colors as in the app. Some of the objects I used were marshmallows, different color squishy balls, different color putty, Play-Doh.
I made a board with 12 blank icons and then had my students glue colored squares on their boards. They loved their finished products and enjoyed telling me their favorite colors!
I created sensory boards with different colored items that we used to elicit descriptive language.
Stephanie Bruno-Dowling recently wrote about making Rainbow Punch in her blog "Drink Recipes for St. Patrick's Day!" We made rainbow punch, and it was such a fun activity to generalize the colors that were learned.

I encourage you to observe your students using this app and report your findings to me in the Comments section. Please describe the colors/items you observe are of particular interest to them.

Keeping Your iPad Safe and Clean

Angela Desideri — Wed, 07 Mar 2012 15:30:00 GMT

With cold and flu season in full force, I thought it would be beneficial to share some tips on cleaning your iPad screen to keep it germ-free. Apple recommends wiping the screen with a damp, lint-free cloth. (Click here to read Apple's recommendations.) While this may protect your screen from being permanently smudged or damaged, it will not disinfect your iPad or rid the device of germs. Since I use a screen protector on my iPad (I highly recommend you do the same), I've had great success using ZAGG Foam to clean the screen. ZAGG Foam sells for $9.99 and can be purchased at Target or on Amazon. It's an antibacterial cleaner and a great way to keep your screen germ-free and sanitary.

Now that you know the best way to clean your iPad, let me share with you an accessory that can keep it almost permanently protected. The iBallz is my favorite case to use while conducting speech and language therapy sessions with the iPad.

iBallz is sold for $19.95 and comes in four colors: pink, grey, black and blue. The blue one happens to be my favorite color as it reminds me of one of my favorite stores. (Can you guess which store? Not much on sale for $19.95 at the one I'm thinking about, so this is a real bargain.)

Here are some reasons I like using the iBallz accessory:

Lightweight. This makes transporting, carrying and using the iPad so nice and easy. When I have iBallz attached to my iPad, I can easily hold up the device. This helps my students see the screen more easily and allows me to adjust it toward the group or individual. The cord allows me to quickly access the iPad so I can move it in and out, which is exactly what I need when working with students.
Elevated. The four balls provide elevation, which allows me to glide the iPad along the table. This is a great thing to have when you're working with small groups. I've found this really makes my group iPad interactions super efficient.
Protected. I can't tell you how many times I've dropped my iPad with the iBallz attached. In every case, my iPad has not been harmed. With the iBallz, I have peace of mind in knowing my device is protected, which allows me to focus on service delivery rather than protecting my iPad.

In my opinion, iBallz is the perfect companion accessory for SLPs and their iPads. I use it everyday and I don't know what I would do without such an innovative product!

Core Words: Are You Teaching Them?

Angela Desideri — Wed, 22 Feb 2012 14:45:00 GMT

Core words are a relatively small amount of frequently occurring words that are found in every language and make up about 85 percent of the vocabulary used. Core words are powerful and are the basis for communication. They are found in speaking, reading and writing and are mostly comprised of pronouns, verbs, adverbs, adjectives and prepositions. Personally, I like to think of core words as the foundation for communication. Therefore, I highly recommend that you add them to your AAC toolbox.

By teaching core words you are providing more communicative opportunities. Here's an example of how I used the following core words for two word combinations using "go," "stop," "like" and more in a play-based 'train activity':

train go (directive)
train stop (directive)
like train (comment)
more train (recurrence)

These same words can be used for a music activity:

like music
more music

And outside on the playground:

like swing
go swing
more swing
stop swing

Think about all the settings and places that core words can be used. They can be used throughout the school day, in speech therapy, in the classroom, outside, during transitions, and at home.

Now, think about the activities you are doing with your students and generate four to five core words that you can use within that activity. Here are a few word lists to help you get started: Toddler Vocabulary Word List and Preschool Vocabulary Word List. Additionally, Prentke Romiche AAC Language Lab has excellent free resources on ways to teach and use core words in AAC.

Start using core words with your AAC users and you will be amazed at all of the communication possibilities!

Resources

Banajee, M., Dicarlo, C., Stricklin, S.B. (2003). Core vocabulary determination for toddlers. Augmentative and Alternative Communication, 19, 67-73.
Baker, B., Hill, K., Devylder, R. (2000). Core Vocabulary is the same across environments. Presented at California State University, Northridge. http://www.csun.edu/cod/conf/2000/proceedings/0295Baker.htm.
Cannon, B., Edmond, G. (2009). A Few Good Words: Using Core Vocabulary to Support Nonverbal Students. The ASHA Leader (April 14).

Screenshots: An Easy Way to Create Visual Supports

Angela Desideri — Wed, 08 Feb 2012 13:10:00 GMT

One of the ways I have been using my iPad with my students who require visual supports such as the Picture Exchange Communication System (PECS), communication boards, and AAC overlays is by taking and using screenshots.

You may be asking yourself, "What is a screenshot?" If that's the case, let me explain. Screenshots are images that are taken by the iPad, iPhone or iPod Touch that, once taken, are stored in the photo library. If you look through your photo library you will more than likely discover random pictures that you don't recall taking. These are most likely screenshots that you snapped without knowing it. The good news is now you will learn how to take and use screenshots to enhance your therapy sessions.

Here's how to take a screenshot:

Your picture is now stored in your photo devices library.

Now your pictures can be emailed, messaged, assigned to contacts, used as wallpaper, tweeted, printed or copied.

I have screenshots for all of the pages in the apps that I use. I then print them on card stock and laminate them. I provide these to my students and they can be used as choice boards to make requests or comments, as well as making descriptions and assisting with answering and asking questions. The possibilities are endless!

I find that screenshots really help with kids who are impulsive, as this is a way to structure your therapy session while using apps, especially with groups. Screenshots are an easy way to provide visual supports while engaging interactively in the apps. I encourage you to practice taking screenshots and start using them in therapy today!

Expanding Communication Skills? There's an App for That!

Angela Desideri — Wed, 25 Jan 2012 14:30:00 GMT

What better way to get children excited to learn language and communication skills than a birthday party? Toca Boca's "Birthday Party" is an interactive app that provides numerous opportunities to help speech-language pathologists expand language use and teach social skills, as well as AAC skills, in a fun and motivating way.

Here' s how it works:

Select a birthday cake design from the following choices: Panda, Dragon or Rainbow.
Select the plates/dishes from the three choices provided.
Select one of three presents.
Sing "Happy Birthday" and blow out the candles (by touching them).
Time for the birthday party celebration! Eat the cake, pop the confetti, pour the juice, put the cake on the plates, eat the cake, open the present, and drink the juice.
Once all of the cake is eaten it's time to clean up and wash the cups and dishes.
The birthday party is over!

Here's how I use it in therapy:

Requesting items such as the type of cake, blow out candles, eat cake, pour juice, drink juice, open present, pop confetti, wash dishes, and wash cups by using signs, PECS, AAC systems or visual supports.
To practice labeling items.
To practice stating preferences: "I like______."
To review and practice using core words like eat, drink, more, look, like and open.
To teach social language skills related to birthday parties.
To review the schedule of a birthday party.
To practice expected vs. unexpected behaviors at a party.
To work on asking questions such as "Do you want cake?" "Do you want juice?" "Which juice do you want?" and much more.
To practice social skills related to birthday parties.
To work on turn-taking skills.

My Favorite Apps for Speech Therapy Part 1

Angela Desideri — Wed, 30 Nov 2011 15:44:00 GMT

I wanted to share some of my favorite apps that I use for speech therapy. Please feel free to comment and tell me your favorite apps so I can add them to my wish list for the holidays!

My Play House by Shimon - This is an interactive play house that I use to work on play skills, turn taking, linguistic concepts, following directions, cause and effect, and much more.

The Social Express by The Language Express - This is a new app that was just released and it works on teaching social language skills. It's a comprehensive app that targets all aspects related to social thinking including: feelings, eye contact, interpreting non-verbal cues, conversational skills, learning how to be a part of a group, teaches the hidden social rules, sequencing and inferencing, coping skills, and much more! The app also contains the option to turn on "Teacher Tips" where it tells you what to say to your students when engaged in the app. It even comes with printable activities and lesson summaries.

Cinderella by Nosy Crow - I use this to work on comprehension, vocabulary development, following multi-step directions, choice making, social skills, narrative development and emotions. Some of the pages in the app I love are the invitation page, garden scene and the dancing scene where you can change the music.

What are your favorite apps?

AAC and Literacy

Angela Desideri — Wed, 10 Aug 2011 12:42:00 GMT

As SLPs, we can help support literacy development with our students who are AAC users. Here are a few tips that you can use in your everyday practice to help with this process:

Importance of Research Based Literacy Programs: Learning to read is a complex process and can be a frustrating one for individuals with Complex Communication Needs (CCN). Many of the programs require students to sound out letters and/or words without providing them with much needed adaptations.

As a result of this lack of exposure to such adaptations, many individuals are not included in the entire process. The good news is that literacy programs do exist for individuals with CCN.

One such program is available through Penn State University. Dr. Janice Light and Dr. David McNaughton developed and researched a complete literacy curriculum for individuals with CCN. They have a website with a wealth of information about their literacy instruction program that includes step by step instructions and videos.

Another alternative is you can purchase the entire program, Accessible Literacy Learning (ALL) Reading Program, by clicking on the link right here.
Access, Access, Access: Another important area is creating access to literacy by modifying and creating books. A great way to do this is by using PowerPoint. Here's a link to help you create Talking Books using Power Point. This is an easy and fun way to provide access.
Teaching AAC Use and Literacy Skills Simultaneously: Teaching core words is a good starting point. These are words that are used most frequently in reading, writing and speaking.

You can begin by choosing a "core word of the week." By focusing on the "core word of the week," you will provide your students with ample opportunity to practice (as you all know it can't be overemphasized how important practice is in determining a successful AAC outcome).

At the end of the year, you will be pleasantly surprised by how many core words your AAC users have learned!

Teaching literacy and AAC skills concurrently is a fun and exciting process. What activities you are doing to help support literacy development with your students who communicate using AAC?

AAC Competency Time!

Angela Desideri — Wed, 27 Jul 2011 13:00:00 GMT

In my last blog, I shared three important tips that every parent, educator and SLP should know regarding AAC. This blog will focus on implementation strategies to help with the AAC learning process. Individuals who communicate with AAC begin as novices, and when provided with the proper support, instruction, encouragement, and practice, they can progress to become advanced communicators.

Here are a few strategies to help with the teaching process:

1. Model, Model, Model

I recommend sitting next to the user and modeling anytime you are working on a skill and/or communication opportunity. I have found success using peer modeling. Last year, I had a student who enjoyed AAC technology and wanted to be a peer model. That same student then helped a peer with her AAC device in our speech therapy group and in the classroom. Both the peer and student had noted improvements in self esteem, self confidence, social interaction, learning, and communication skills. What a win-win combination!

2. Arrange the Environment to Support and Encourage Communication

"Sabotage" is an easy and fun way to increase communication opportunities in natural settings like the classroom or at home. Here's an example of how you can do this at school during snack.

Target Language Forms: Commenting, Negation, Recurrence, Protest, Requesting

Missing Item: Student needs a cup for juice, but he/she wasn't given one. Requesting: "Need cup"; "help."
Provide Incorrect Item: The student asks for a cup and you provide a bowl. Commenting: "Uh-oh." Protest: "No." Requesting: "Need cup." Negation: "Not bowl."
Incomplete Step/Item: Provide cookies in a bag, but the bag isn't opened, or just give them a few cookies. Requesting: "Help." Recurrence: "More cookies."

3. AAC Competency Takes a Team Approach

From the beginning, allow time for trainings, collaboration and support (remember there is no "I" in "AAC Team"). It's important to gather your team and meet frequently to develop goals, problem solve, and make sure everyone is headed in the same direction. It's helpful to assign responsibilities to each team member based on their strengths and interests. This will also help to ensure that everyone has an equal interest in assisting the communicator achieve communication success!

Resource

1. Goossens, C., Crain, S., Elder, P. (1992). Engineering the Classroom Environment for Interactive Symbolic Communication: An emphasis on the developmental period, 18 months to five years. Southeast Augmentative Communication Conference Publications: Birmingham, AL.

AAC: Three Things Every Parent, SLP and Educator Needs to Know

Angela Desideri — Wed, 13 Jul 2011 14:00:00 GMT

This month I have been doing a lot of traveling and presenting on AAC and AT. During the process of preparing for these presentations, I was reminded of these important areas related to AAC. Here are three important things that every parent, SLP and educator that lives and works with individuals who have complex communication needs (CCN) should know.

1. AAC Competency Takes Time

The average 18-month-old child has been exposed to 4,380 hours of oral language development (at a rate of 8 hours a day from birth). A child who communicates using a communication system and receives speech and language therapy two times per week for 20-30 minutes a session will reach that same rate of language exposure in 84 years. (Korsten, Jane. From "Considering AAC - Speech and Language, Common Myths & Resources," on: http://bit.ly/nmpKhV).

My Thoughts: It's imperative that families, therapists and educators realize that AAC use takes time. This realization minimizes the setting of unrealistic expectations. With the proper instruction, practice, support, and encouragement individuals with CCN can progress from novel AAC users to advanced users.

2. AAC and Literacy

"Approximately 70 percent of individuals with severe communication impairments are significantly behind their peers in learning literacy." (Koopenhaver & Yoder, 1992). Literacy skills are more important than ever considering the connection to employment, socialization, leisure activities, and much more.

My Thoughts: The good news is that research has led to the development of evidence-based literacy programs for individuals with CCN. Given the proper instruction, individuals with CCN can and do learn literacy.

3. AAC and Employment

Only a small percentage of individuals who use AAC are employed (15 percent at the most). It's a well- documented fact that individuals with CCN have difficulty securing and maintaining employment due to many factors, including lack of literacy skills, little or no work preparation, skill limitations, and barriers such as attitudes, transportation, policies, and other factors.

My Thoughts: Since this impacts many, it's important to examine the success stories of individuals with CCN as their experiences may help others maintain and secure employment. I look forward to sharing some of them with you, as they are truly inspiring!

Be sure to read my upcoming blogs where I will be discussing creative solutions to each of these three things.