Friday, August 14, 2015

21 Days of AAC Challenge!




If you are a member of an AAC family, you have likely heard that the most important thing that you can do (after providing your child with a robust ready-to-support-language system and presuming competence) is model. Modeling (also known as aided language stimulation, aided language input, and ALgS) is when you use your child's AAC system to communicate, with several variations:

(words spoken via AAC are in bold)

  • Use your child's system to highlight certain words as you also speak: "We are having fun." 
  • Use your child's system to build whole phrases/sentences instead of speaking. "Your turn."
  • Use a separate device with the same language file (this works if you have 2 iPads and your child is using a communication app) as your own AAC device. (This is also called dual device modeling). (Same examples as above, just with your own talker.)
Of course, you could also highlight words without speaking them, or build whole phrases/sentences while speaking them, or use a combination of single and dual device modeling, or probably a bunch of other possible modeling plans that I haven't listed. 

(Is this starting to feel complicated?)

And then there's the question of which words/phrases to model. There's a lot of emphasis on core words and core vocabulary (core words = the words that make up the large majority of a person's vocabulary; including versatile, simple words like eat, push, go, stop, in, up, this, it) . . . but we also know that sometimes the stuff that gets our kids most interested in talking are the fringe words (names of tv characters, favorite toys, words like fart, poop, gross). And then there may be essential words/phrases/topics that we know are important for our child to start incorporating (communication repair phrases like That's not what I said, social interaction phrases like What's your name, questions, words to describe pain/seizures/medical conditions, introduction strategies, etc.)  Not to mention the wealth of questions that immediately arise as soon as you try to model:

For beginners:
  • Wait, which words should I highlight? 
  • Should I only model present tense verbs or should I use all of the tenses?
  • Do I need to pick a set of words and only model those 5-10 words until my child is using them?
  • Should I model one word at a time or more than one? When should I ever model full sentences?
  • What if my child isn't paying attention when I'm trying to model? Should I wait? Make him/her watch? Quit and try again later? Keep going?
For intermediate/advanced:
  • My child usually knows where words are better than I do, am I really adding much by continuing to model?
  • How can I balance between hitting new language targets while also remaining fluid and flexible in conversation (rather than feeling like a lesson)?
  • When should I recast/correct my child's production (eg. using AAC to restate their sentence while correcting verb tense, or adding articles, etc), and when should I ignore the errors?

It can be overwhelming.

Depending on your degree of over-thinking-ness, it can be really overwhelming. (My over-thinking-ness degree is high, for the record).

And yet, undeniably, modeling is essential. 

Modeling provides children with accessible language input (input in a language that they will be able to access and then also use, whereas they may not be able to attempt to use the speech that they are hearing constantly). Children are immersed in speech from birth, but AAC users receive only a tiny fraction of that accessible language modeling in their AAC language. While many families can count on AAC to be modeled during weekly speech therapy sessions, consider these thoughts from Jane Korsten:

The typically developing child will have been exposed to oral language for approximately 4,380 waking hours by the time he begins speaking at about 18 months of age. 
If someone is using a different symbol set and only has exposure to it two times a week, for 20 – 30 minutes each, it will take the alternate symbol user 84 years to have the same experience with his symbols that the typically developing child has with the spoken word in 18 months!!! 
The typically developing child will demonstrate language competency around 9 – 12 years of age having been immersed in and practicing oral language for approximately 36,500 waking hours. For 9 – 12 years that child has been using and receiving corrective feedback while practicing with the spoken word. 
At twice a week, 20 – 30 minutes each time, it will take the alternate symbol user 701 years to have the same experience.

If we are to make any sort of dent in closing that gap, AAC modeling needs to become something that we do at home (and in the grocery store, and while out on a walk, and in the doctor's office, and . . . you get the idea)---for AAC beginners, of course, but even for our intermediate/advanced users. 

Here are some things that are great about modeling:
  • Provides children with an increased amount of accessible language input (as mentioned above)
  • Hands-on modeling time sneakily forces the modelers to become more familiar with the vocabulary placement and to increase their fluency with the system
  • Modeling will undoubtedly lead to programming/opening more words in the system, as you will notice things that you want to say but can't, because words are missing
  • Using AAC will validate your child's system, in a subtle-but-real way that says I think this is such a great way of communicating that I want to use it, too!

Things that are challenging about modeling (aka "reasons that maybe sometimes I don't want to model") and why those are also great:
  • My child wanders away when I am modeling and then the whole thing seems pointless. Keep modeling anyway. Children who use AAC need to be determined to get their point across: AAC is slow, sometimes hard to hear, sometimes awkward or cumbersome. Our kids will have listeners who wander away----they need to see that it's worth sticking it out to communicate your thoughts. You're not just modeling the words, you're modeling what it looks like to use a communication system. You're modeling that you are comfortable using AAC, that you value it and don't quit just because listeners are indifferent. Stick it out. 
  • My child finds the words much faster than I do. I feel awkward searching for so long between each word.  You are not only modeling words, you are modeling what to do when you are looking for a word that you don't know (I guarantee that our kids have words in their heads that they don't attempt to say with their devices simply because the words aren't programmed in or they don't know where to find them).  Use this opportunity to say things like "Huh, I want to say enormous but I don't know where that is . . . do you have enormous in here? . . . let's take a look" while you model how to use the search feature. You can model how to use a synonym if the exact word isn't in there, or how to use a button like "I don't have the word that I want" or "I need a new word." You are modeling how to fight to get your message across, how to not quit because it is hard. (Also, if you ask your child for help finding words they may love being the expert :) )
  • I feel awkward using the device while out-and-about. Of course, I want my child to use his/her system anywhere, but I am a speaking adult, and I feel strange wearing an iPad and using it to talk in line at Starbucks. I get it. I want Maya to feel empowered and proud and awesome when she wears and uses her talker, and yet I sometimes feel sheepish doing the same. I'm not a big fan of drawing extra attention to myself in public, and holding an electronic device and tapping on it with your kids is going to solicit some looks (and maybe comments too, about how we are all addicted to devices now). But we are awesome when we model in public. Maya has shown me, time and again, that she is generally resistant to using the talker in new places (so much to see and do that it's hard to care enough about communicating to slow down and do it). I need to model that it's worth taking the time to communicate everywhere---that we can pause on our walk to comment on something we see, that I can stop to ask a question, that it's ok (more than ok!) to take the time to use the device whenever, wherever.
  • My child sometimes pushes my hands away when I try to use his/her talker. This one, actually, is the one reason that I would back off (temporarily) on the modeling. If you don't have a second device available for modeling and your child is showing this type of possessiveness over his device, I would honor it and simply try again later. I would ask permission ("can I use your talker to say something?") and/or choose a time when he isn't much interested in using it. 

Despite knowing how important modeling is, sometimes I drop the ball. ("Sometimes" has sometimes been for a while, for the record.) Sometimes it's hard to stay motivated. Sometimes life gets in the way, or I forget, or it starts to seem not that important. Sometimes we all need a jumpstart.

So here's my proposal: For the next 21 days, join me in committing to modeling with renewed vigor and enthusiasm. Do not worry about whether you are doing it "right", just do it. I will post daily threads on our Facebook page that provide an example of some type of modeling that I did that day (because sometimes simply seeing what someone else is doing is enough to have you thinking "Oh, that's it? I can do that."). I (strongly) encourage you all to jump in---post to the daily thread, check in, share pictures or stories from your day of modeling. Ask questions. Share ideas/activities.  Just keep going.

21 Days of AAC Challenge Frequently Asked Questions*:


-Why 21 days?
Once upon a time, I learned that it takes 21 days of doing something (like exercising or waking up early) to form a habit. When the idea of this AAC challenge sprang into my head, along with it came the 21 day time frame---perfect for forming the habit of daily modeling, I thought. Then I googled and learned that the whole 21-days-to-form-a-habit thing is an odd, non-scientific myth . . . but I think it's still a great amount of time for a challenge, so I'm sticking with it. 


-How long do I need to model for it to count? 10 minutes? 30?
This is a made up challenge without points or prizes. You earn your "day" of modeling by actively deciding to model and jumping in. Extra imaginary points will be assigned if you model throughout the day. (I think this is the sort of thing where success compels you to do it more---I have found that making myself model actually makes me want to do it more.)

-I'm kind of new to modeling and don't know where to even start--help?
Here are a few great getting started resources:

But remember, the whole point of this is just to get more comfortable with modeling, and to form the modeling habit----it doesn't have to be structured or magical, it just has to happen.

-My kid isn't a beginner anymore---is my modeling really that useful?
Yes. You are modeling how to be an active, determined AAC user in a fast-paced world. You can pick higher-level language targets (using comparative and superlative adjectives, using contractions, increasing the number of questions asked, taking a larger number of conversational turns, starting to use and introduction strategy, modeling sentences with active verbs and then their counterparts with passive verbs, etc etc etc) to model. 

-This is a great idea, but  . . . (we're about to go on vacation//it's the first week of school//we are throwing a family barbecue this weekend//insert other life-gets-in-the-way excuse here) . . . maybe I could start next week instead?
No, you have to start now. 

Ok, actually I am just some lady on the internet and I can't hold you accountable for anything . . . but I think you should start now. Life is busy, and it will always get in the way. Particularly for our AAC users, who have to stop, form an idea, find the words to say the idea (often dealing with motor challenges while doing that) and then communicate it. That's a struggle. It's not fair for us to think "gah, it's too hard to start today" while our kids have to do it everyday. Suck it up, buttercup.



Join me, guys. This is going to be really fun! 

I'll share a few bonus ideas (like, "If you're looking for something to focus on today, try incorporating more adjectives" or something) along the way, in case you're struggling to come up with fun new stuff. This is going to be Facebook based (rather than blog posts) because it's still too painful to type a lot (my arm is on fire right now), and FB allows for it to be more interactive---I want to see your ideas and pictures and stories, too. At the end of the 21 days maybe I'll try to compile it into one giant blog post so that it will be easier to find. 

Happy modeling!






*"frequently asked questions" = "questions that I just made up right now"





Thursday, July 9, 2015

The Holy Grail of the "Developmental Delay"

Yesterday I spent time cleaning out some toys and books, donating and trashing and reorganizing. I came across a good number of toys with memories that started like this:  I remember this! It was a birthday gift that we asked for because the little pieces were supposed to help with developing a pincer grasp! I know now, as a seasoned therapy-participating parent, that literally any toy can be used in a way to target therapy goals (fine motor, gross motor, imaginative play, speech games) but when Maya was small, missing milestones, and difficult to motivate (if you moved a toy from her reach, she would generally just find something else to look at, or wait to see if it would come back) I was constantly hunting for some thing, any thing, that would be the thing. The thing that she loved enough to fight for . . . the thing that was so rewarding that she would work her fingers to activate it . . . the thing that she wanted so badly she would do the work of trying to pull up to get to it. 

These type of memories, in which I thought meeting milestones was somehow just an issue of motivation and willingness to work a little harder, sting in a particularly specific way. It's not really a memory of the toy, it's a memory of the way that I thought about the toy . . . a little time-hop into the mind of the mom that I was back when we were just delayed on the path of typical development, when I thought that if we worked hard enough and smart enough we could still catch right up . . . into the mind of a mom who doesn't see yet that we're on a totally different road. 

I cleared things out and thought "I should write about this, this stuff of special needs parenting, the pursuit of some object that will elicit some behavior that will solve all of the problems."

And then I remembered that once upon a time (four years ago), I did write about it, but it never got posted. So, here it is:



The Holy Grail of the "Developmental Delay"

“I really think you should put up a barre,” Karen said, gesturing to the wall in our hallway, about 2 feet off the ground. 

“A barre?  Like, a ballet barre?”  I doubtfully looked where her hand was, the walls smooth and light blue, and imagine the screws and rods that would support a barre.   A week earlier I had managed to create three extra holes in the bathroom wall just attempting to hang a picture frame . . . I could probably do some  impressive damage trying to install something sturdy enough to bear weight.   Big holes and crumbling plaster.  Sounded like a terrible idea.  And yet . . .

“You really think it would help?” 

Karen started talking, slowly at first and then with increasing excitement, about the benefits of putting up the barre . . . and I let myself get swept in.  I could see it too---the physical therapy sessions of pulling to stand, then creeping sideways with both hands holding on, eventually to learning to walk with only one hand on the barre.  Maybe even taking steps backwards?  Sure, why not!

Amid this animated conversation about the impressive physical feats that she would undoubtedly accomplish, if only she had a ballet barre, Maya sat, a bewildered 18 month old lump.  A relatively new master of sitting and slow crawling, she wasn’t showing any inclination to stand up, let alone walk.  

I envisioned the ballet barre and subsequent wall wreckage and thought to myself, Well if that’s what she needs to learn to walk then we’ll just have to put it in, walls be damned.  “Interesting idea,” I tell Karen, “let me think about it.”  We’ll see her again soon enough, in two days she’ll be back for another PT session.

The day wore on and I thought about it.  I rolled the idea around in my head while making dinner, cleaning up, putting Maya to bed.  I didn’t mention it to Dave, who would ask a lot of questions and then taint my thought process by adding in his opinion.   There was a little voice in my head saying Don’t do it.  Don’t get your hopes up, and I couldn’t see where it was coming from.

Then I started straightening up the apartment, and I saw.  Oh, I saw.

First, on the kitchen counter, I saw the rice bin.  Literally, a bin filled with rice, hiding a handful of buried toys.  The rice bin had initially taken up residency in a corner of the living room, bringing with it the promise of sensory stimulation.  Touted by her occupational therapist as a possible solution to the fact that Maya’s chubby little hands tended to ball themselves up into tight fists, we were going to rub her hands through the rice.  Her fingers would open and she would paw through the rice in hopes of finding buried treasures, if only we had a rice bin.  So we got one. 

Did she unclench?  Well, a little, I guess.  Long enough to grab a fistful of rice and shove it into her mouth, causing gagging and tears and some panic (the first two from her, the last one from me).  She learned that use a quick slide of her balled fist across the rice would send a hundred little grains skittering across the wood floor.  We kept at it occasionally, but threat of another mouthful of rice combined with the sharp little grains that lingered and stabbed my unsuspecting bare feet for days after a rice bin session outweighed any inklings of progress.  That sucker was just waiting to be dumped down the garbage chute.

I walked toward our bedroom, picking up a loose sock in the hallway, and saw the ball pit.  The red-and-blue-and-yellow inflatable ball pit (big enough for one adult & two children), filled with 200 plastic balls.  Well, not quite 200, as they were constantly on the escape, rolling under dressers and bookshelves, joining the scattered rice in dark corners.  The ball pit was a gift from a therapist, arriving with the promise of increased proprioception (awareness of your body) and sensory stimulation.  She would wiggle among the balls, and they would press on her body and give her feedback (“you’re lying down!  you’re rolling and applying pressure to your right side!”) and her muscles would respond.  She would make a lot of progress and be stronger and more balanced and have a lot of fun too, if only she had a ball pit. 

The day that it arrived I inflated the ball pit and filled it with balls, and I picked Maya up and whispered excitedly to her about going to play in the balls.

“Oh my goodness, what fun!  You can sit in here and play with the balls!” I lowered her carefully, the sea of plastic balls parting and plonking as her weight shifted them around.

She looked up at me, eyes widening.  She stiffened, and fell backwards.  A sea of balls rolled up over her neck and arms, threatening to swallow her entirely.  She started to wail.

Not exactly what I had hoped for.

Subsequent tries were less tear-inducing, but not exactly progress filled, either.  Don’t get me wrong, we eventually had fun with the ball pit, but I didn’t see any direct developmental fallout.  The balls were fun, but that was about it.

The small anti-barre stirrings were getting stronger.

I threw the sock in the hamper and got changed, trading jeans for yoga pants, and headed to the living room.  Dave sat on the couch, typing quickly on his laptop.  The tv was on, but he wasn’t watching it.  I picked up stray board books and tossed them into Maya’s book bin, gathered the plastic farm animals and stuck them in their appropriate plastic container.  Stuffed animals went into the big wicker basket.  Our living room was a great divide---computer saddled adults on the couch to the right, children’s toys and debris on the giant red foam mat (a birthday present, special ordered from a therapy warehouse, to cushion Maya’s falls, which tend to be hard) to the left.  With the smaller stuff cleared away, I turn and eyed the trio of large gym cushions.  Dave kept typing.

The gym cushions were a discovery on Craigslist---an amazing deal, a set of three for half the price of what one mat typically sells for.  They were old but in great condition, and big—each coming up to about knee height---a large blue square with a tunnel shaped cut-out, a green mini-staircase, and a red ramp.  We had to have them.  Winter was coming and we wouldn’t be able to use the playground for physical therapy anymore---these mats would be perfect for learning to climb, balancing, and motivation.  She would be climbing up and down the stairs and sliding down the ramp in no time, if only she had these gym cushions.   When Dave arrived home from work that night I breathlessly handed Maya over to him and said “I have to drive downtown to buy gym cushions---the seller is holding them for me until nine---bye!” and rushed out the door.  Two hours later I returned, carrying each one in triumphantly (with Dave applauding), trying not to notice that they looked kind of large and clunky in the middle of our living room floor. 

Maya loved them.  She loved hitting them and smushing her face into them.  Putting toys on them and crawling through the tunnel and licking them.   They were a welcome addition, breaking up the boredom of being trapped inside during the winter months.

But they didn’t make her stand.

And they didn’t teach her to climb.

And they really were big and cumbersome, which I was reminded of every night.  Trying to stack them into the corner of the room was no small feat.  It often took more than one try to get the balance just right, and create the gym-mat-totem-pole that reached my eye level.  Dave had stopped typing.  I took two steps back, willing the pile to not fall over.  It stayed.  I clasped my hands over my head victoriously.  Dave laughed, and resumed typing. 

I sank into the couch and pulled my computer from the side table onto my lap.  I clicked my way through email and Facebook, paying only the slightest attention to the screen.  I did a mental inventory of the other therapy-based stuff that we’ve accumulated.  Oral motor tools fill a drawer in the kitchen, along with modified spoons and cups for kids with feeding disabilities.  A child-sized walker waits in Maya’s closet, along with walking wings and outgrown orthotics.  A stretchy blue therapy body suit sits in her top dresser drawer.  Even her toys, toys that plenty of typical children have, were purchased with ulterior motives---this piggy bank will be great fine motor practice, this gumball machine will be great for crossing midline to deposit the balls in the top of the machine. 

Not often do we just think hey, let’s get this—it looks fun.

And that’s ok, I think.

I don’t have any issues with getting things that look fun and will (maybe) be helpful.   The ball pit and the gym cushions were nice additions, even though they didn’t yield any miraculous results, because they’re also fun. (The rice bin?  Well, I could have done without the rice bin.)  But I can’t, I won’t, pin my hopes on things anymore.  I’ve realized now that there is no thing that is going to rock our world.  There’s not a thing that will help Maya to suddenly catch up.  We will never look back and say “Thank god for that ballet barre---she wouldn’t be walking today if we hadn’t installed it!”

The therapists haven’t gotten there, though.   They think of the limitations of our environment (like the absence of a ballet barre) and become fixated.  Karen will mention it many times, I know.  And why bother to burst that bubble?   Her belief that the lack of a barre is holding us back just shows how much faith she has in Maya---“Oh, this strong girl would surely walk faster if her parents would install a barre.”  Yes, she should keep thinking like that.

I will decline the barre project, likely blaming it on Dave, who doesn’t have to face Karen three times a week like I do.  Let him be the bad guy.  “Oh, Dave really doesn’t want to rip up the walls,” I will say, “maybe instead she can work on the gym cushions or along the sections of fencing that we put up in the living room for her to practice pulling up on?”  And she will relent. 

And a year later, with a lot of work, but no ballet barre, Maya will walk.  


Maya, 20 months, on the first day that she pulled to stand 
(next to one of the giant gym cushions, on her side of the living)

Thursday, May 28, 2015

Knowing vs. Showing

I've said it before, more than once, (and others have said it better), but I will say it again: Nonspeaking, complicated children can not be "sized up" by what they are able to communicate, demonstrate, or accomplish externally. The inner workings of children who are complicated (communicationally complicated, medically complicated, neurologically complicated, sensory-ly complicated) can't be assessed by their day-to-day expressive communication, or by success on performance tasks.

I know this is true. I am a believer.

I tell people who work with Maya "She understands everything you say, all of your body language, maybe some things that you spell aloud. She is very smart, and also unreliable. Expect that she will be challenging (in both the positive and negative meanings of the word). Sometimes she will look like she is not listening----she is always listening. You may think it's cute that she watches you as you write notes----she can read those notes, at least to some degree (and possibly "some degree" is a very large degree). Do not underestimate her."



I do not underestimate her.



I try so hard not to underestimate her.



I probably underestimate her.



I definitely, from time to time, underestimate her.



I hope that the space covered in that "to" between the "time"s is significantly large.



I don't know if it is.



Maya has had a rough few weeks. It's allergy season here in NYC, and this season is packing a punch. Maya switched from her 2 daily allergy meds (used year-round) to 4-7, depending on the day. She is tired and uncomfortable. She started an unrelated new medicine directly before allergies, and we didn't have enough time to really suss out whether that had side effects before the allergy boom hit. She is acting out at school in a big way, which is likely part medical, part influenced by her peers (a few are having a rough time as well), and part behavioral. There have been a string of no-good-very-bad days. It's challenging not to be frustrated, not to feel like she sometimes veers toward the path of most resistance. I feel that her choices have a way of alienating the people who we most need to believe in her, to fill her days with learning and happiness.

At home things are mostly unchanged. I try to model on a talker, hers or ours (I know that this is the most important thing that I can do, and I have preached about it, but I also know the reality of living-with-AAC is different than working-in-AAC, and, well . . . life). I model new words, or infrequently used words, or---more often, now---full sentences. She sometimes pays attention, sometimes pays intermittent attention, and sometimes leaves me talking to myself (literally and figuratively, it seems).

We also continue to see Maya's home SLP (H), who visits once a week and does a beautiful job of working on total communication. H is targeting full sentences more and more . . . but Maya's formation is spotty. Sometimes she creates new sentences based on an earlier model (eg: she might say She is mad because it is rainy while looking at the model He is happy because it is sunny), but more often she will wait for H to form the sentence on her own iPad, and then copy it word for word into Mini, looking back and forth between the two screens.

Maya's use of total communication is, to me, gorgeous. I can see how she chooses to use speech, AAC, gestures, intonations, and other modalities to communicate in a way that is perfectly Maya, and mostly understandable-to-me. But I worry for her. A novel communication partner (as in, someone who is not familiar with her methods of communication) won't be as patient, intuitive, or discerning as I am. And so, I push her to use AAC when I can . . . I feign ignorance (sometimes it doesn't require feigning). I say "Say that in a whole sentence" (when I can see that she has the motivation, curiosity, and energy to try). I walk the line between I-understand-you-don't-worry and You-need-to-try-harder-to-make-yourself-understood in the way that the parent of a young AAC user has to and hates to.

Her spontaneous use of Mini could be described in three ways: functional, regularly startling, and primarily telegraphic. First, I have to note that there are a good number of times when she won't use the talker. I know she wants to say something, she makes some sort of effort with speech, and then loudly balks at the idea of using the talker. (I think that sometimes it's too much of an effort, from a motoric and sensory perspective, to make it worth her while. She sometimes seems to care less about us getting to hear her thoughts than she does about not doing the work.) But when she does use it, she can say what she's trying to say---and she can also tell us to add words, or that she needs a word that isn't in there. She uses as few words as possible to get the point across (that's the telegraphic piece, for you non-speech-immersed folks) . . . like if I asked "What do you want to do today?" then she would reply list instead of make a list, or maybe playground instead of go to the playground. The regularly startling component of her AAC use centers around her impressive knowledge of the vocabulary in the device. There are well over 5,000 words in there, and she is somehow able to use words like cubicle or rough in exactly perfect contexts, leaving me to scoot closer, squinting, and say "Wait, can you show me where it says cubicle?"

The regularly startling, perfect timed productions have the general effect of expectation-raising among the people who bear witness to them. Seeing is believing, and that believing is often enough to carry them to the next episode of seeing. But I long for sentences. Spontaneous, non-formulaic sentences. First, because I know she's thinking a ton of spontaneous, interesting stuff, and I don't trust my ability to accurately fill in the gaps around her words. Second, because I need to see her inner grammar. I've spent the past months working with a few different professionals trying to get a solid look into what she knows about sentence structure, word order, verb conjugations, etc---and we've gathered no consistently reliable information (this makes it difficult to know what to focus on in speech sessions). And third, I just want to know that she can do it. I want to know that it's in there, that maybe I can ease a little worry over will-she-be-able-to-really-truly-speak-up-for-herself. I try to stay in believing, but we've been in this rough patch and a new episode of seeing would be really nice.

And on Tuesday night I saw.

Apparently Maya wasn't ready to go to sleep at bedtime on Tuesday. She spent about an hour reading, sorting, and redistributing the 20ish books currently inhabiting her bed (I checked the video monitor every so often to see if she had settled in). Suddenly I heard Mini, and while I couldn't make out what was being said there was a good 15 minutes of talking before I decided to go in and re-tuck her in. She watched me as I crossed her dark room, her face brightly illuminated by Mini's screen. She didn't dive under the covers, and she kind of angled Mini ever so slightly my way . . . an invitation. I looked at the screen and then did what can best be described as a double-take, in the style of bad sitcoms or old cartoons. In the sentence strip of her app was this*: (I added the dashes for clarity)

 Maya had fighting day--she is wrapped--hi Mommy--bad day Maya had

This is a narrative. There's a story there, written with an intended listener in mind (hi Mommy). She did, in fact, have a bad day---although this isn't fully accurate, since she wasn't "wrapped." (She craves compression, which we call squeezing or squishing or wrapping in a big hug, but none happened yesterday,) Regardless, she told a story. A story that contains 3 properly conjugated verbs, and even a verb crafted to use as an adjective (fighting day). Any person could pick this up, read it, and understand. It isn't telegraphic. There aren't gaps to fill in. She did the whole thing, without a model, spontaneously.

And there was more.

I asked her if I could see what else she had been saying, and she cheerfully replied "let's see!" which is her permission granting to open the history feature and read through what she had been upto. I could see that the previous 15 minutes had been filled with utterances that were very atypical:

1- Today is Wednesday May  This was saved in Hold That Thought, a feature that allow her to access the entire sentence with only two pushes in the future. I believe she saved it with the intention of using it in class the following day.

2- I going to speech with B   This was also saved in HTT. Her classroom rules require her to "check-out" with the teacher before she leaves, reporting where she is going and with whom. I believe this was saved with the intent to use to check out for speech.

3-Maya had better day--she has fish  Maya really wants to get new fish for her aquarium if she has some good days.

4-Jane had better speech question mark  Jane is a classmate. Maya actually included "question mark" instead of knowing how to access the ? in her keyboard . . . but she made a question, a natural one that could only be formed with inflection, and new to include punctuation that would indicate it was a question and not a sentence.

5-John had better speech question mark  John is another classmate.

These sentences were interspersed with other things---single words, activation of previously saved phrases (from HTT), a good bit of typing on the keyboard. Some of the strings of "gibberish" typing were saved, leaving me to wonder whether she was maybe alternating between the two-handed rapid-fire indiscriminate typing that she is sometimes a fan of with more purposeful one-fingered tapping. Maybe she was typing sentences that she wanted saved, too.

This production is incredible. It shows use of correct word order, proper conjugation of verbs in the present and past tenses, proper use of the HTT feature to plan ahead and save utterances for the future, use of punctuation, and use of imagination (#3).

We have never seen her use her talker like this before.

No one has ever seen her use her talker like this before.

No one knew that this was a thing she could do.

I think it's likely that the environment was her biggest ally while she was writing this. It was dark. The air conditioner was running, so she couldn't hear any household noises above its steady rumble. No one was interrupting her thoughts with conversation or demands, and she could take her time to proper target and execute the fine motor movements to effectively hit each button and build her sentences. She had very little sensory input to process, and all the time and calm that she needed to organize herself to properly produce the output that she desired.

I told her how much I loved reading her thoughts, and what great things she had to say. I talked about Jane and John and their speech sessions, and about getting fish, and about having a better day tomorrow. I tried to respond to the utterances that I saw, to make the point that I so loved hearing them, and I retucked her. I staggered out to the couch and showed Dave the picture I had taken (on my phone) of her screen. "I don't understand," he said, "She said that? By herself? Really?" I felt the same way. We opened the history file (which I had emailed to myself from Mini) and read through the other things that she had been saying, and then kind of just sat and let it all marinate.

I try, always, to presume competence. To believe that she understands, makes connections, thinks interesting complicated things, learns constantly, etc. But this incident, these sentences, have reminded me that presuming competence sometimes needs to be presuming awesomeness, presuming genius, presuming that sometimes the visible parts of a person are so far disconnected from the inner workings that you have to consciously remind yourself, frequently, to disregard what you are seeing and trust completely in something that you can't see at all. Maya tosses me reminders to believe, but nothing like this. This was like . . . imagine you had a spouse who was trying to learn to roller blade, but rather prone to taking falls, and you were holding onto hope that someday he would be able to skate without falling and would keep up with you as you skated around the park. And then you found out that after you go to bed at night he's actually in the roller derby. That's what this was like. My presumption of competence was for non-clumsy skating in public. She's got the roller derby in her.

Her output doesn't reflect her inner working. She is always, always listening and learning. She will occasionally open the window, tossing us something new to see to help us remember to believe, but our job is to keep believing regardless of the last seeing.  To presume competence always, but also to try to shift into presuming awesomeness. It's easy to presume awesomeness now, in this moment, but if we have a hard few weeks, this high will fade. On the hard days I will try to presume competence and capability and cleverness. But on the other days, I'm going to work on pushing even harder to raise my inner bar, to model amazing interesting sentences. I will work on remembering that Maya's learning doesn't look like "typical learning", it doesn't look like focus or rapt attention, it looks like sometimes attending and sometimes wandering and sometimes ignoring and sometimes rejecting, but it is learning and it is happening all the time.

I just have to believe.



random photo of my kids, included to make this post more easily pin-able


 
*sensitive information in Maya's utterances have been modified, while maintaining integrity of the grammatical structure and length that she produced. 


Saturday, April 18, 2015

AAC-using Popsicle Puppets

 Do you have a young AAC user in your life who loves characters? Then this (very simple) project is for you:

Hi friends!

Maya loves characters. Recently in therapy she made a few popsicle stick character puppets, and I thought about how easily they could be modified to use with AAC. They are highly motivating and can be used in a ton of different ways. Here are the instructions and some ideas for use:


Step 1: Print pictures of characters. Or trains. Or people from TV shows. Or trees. Basically anything. I printed mine on cardstock for a bit of extra durability.


Step 2: Use a hole puncher (or whatever) to make a finger sized hole in the picture.


Step 3: Glue on a popsicle stick. Don't leave too much sticking out at the bottom, as that could get tricky for modeling later. Just enough that you can grab it and make it walk/hop/jump/drive around during pretend play.



Step 4: After the glue dried, I covered mine in clear packaging tape. This is optional, but I think if you don't do it there's a good chance the finger hole will tear. As you can see, I didn't waste much time on this---just get it all taped up, it doesn't matter if the tape is hanging over the edges. You'll fix that in a minute.


Step 5: Cut off the extra tape from around the edges, and cut the tape out of the finger hole. (I used the hole puncher to punch a hole through it first, then cut.)


Step 6: Pat yourself on the back.

Maya helped me make these and was extremely excited. As soon as the first one was done she grabbed it up and went straight to Mini to show me that Mike Wazowski wanted a smoothie. Interestingly, she had a better idea for use than I did---I thought I would stick my finger through the back-----but she showed me that sticking your finger through the front lets you see the character and do the speaking/modeling at the same time. Super fun!



This is what it looks like when I model with the finger puppet. For kids who aren't highly motivated to attend to modeling, this is way more fun than just watching a finger.



Possibilities:

  • Use during pretend play to model what the finger puppets are saying/doing/thinking. Ex I love jumping on this table, I am hungry, I want to go in the bus
  • Use to practice interviewing/questioning. The puppet can ask the child questions (What is your favorite color) or the child can ask the puppet. 
  • Two puppets can talk to each other----one on the finger of the child, one on the finger of the communication partner.
  • The communication partner can play the role of the puppet, or can act as a narrator independent of the puppet (Like "I wonder what he's going to say next" or "Let's ask him what kind of ice cream he likes . . . Hmm, it looks like he's going into the dessert screen, I wonder which flavor he's going to pick!")
There are a ton of possibilities, I imagine---these are just a few that we played with today. Please feel free to chime in below and share ideas for how these might be used----or with ideas of other fun puppets to create!

(Also, I shared this previously on the blog's Facebook page, but this also works with actual puppets. We did this a little while ago and it was fun for a bit, but I have a feeling that the characters will have more staying power---my kids love characters.)



puppet with a finger hole cut out for modeling

Thursday, April 16, 2015

Communication Repair at 2: Speech, Gestures, and AAC

This is Will. Will is a "typically" developing 2.5 year old who has had access to his own AAC device since the age of 17 months. This happened partially because he really really wanted to get his sister's talker (she is an AAC user with complex communication needs), partially because I think that all toddlers could use the help of AAC sometimes, and  . . . partially because I had spent the previous 3 years shouting from the mountaintops that AAC will not impede the development of speech and now it was time for me to kind of put my money where my mouth was.

But I'll talk more about that another day.

Today I want to share this video of Will, taken yesterday morning right before we headed out to our playgroup. He was sitting in the stroller and making some sort of gesture, accompanied by word approximations that I couldn't quite understanding. Maybe something about a book? I assumed it was an item that he wanted to bring with him (he had just asked for the little Daniel Tiger popsicle stick puppets in his hand) but I couldn't guess what he was asking for.

I had just handed him the puppets, started singing a song about walking to playgroup, and moved toward the door to leave when he started gesturing and talking to me. We backed up a step and I grabbed my phone and started filming.

I don't want to spoil the ending by talking about what he was saying (we did, in fact, arrive at the answer in the end) so go ahead and watch this first----see if you can guess the answer before I did:



In hindsight, it seems so obvious. So obvious.

So, a few take-aways:

1. This is pretty great stuff. I'm so happy that he has another tool in his communication toolbox that can help him get his point across. He knew to ask for the talker when he realized that we weren't going to get there with just speech and gestures. He is a speaking child, but AAC does many things for him (again, that will be a big post), including providing a means to repair communication breakdowns. (For more on communication breakdowns and AAC, see here.)

2. I'm going to pat myself on the back for my wait time in this video. When he starts poking around, looking for some word to provide me with a clue, it was hard not to jump in. When he was on the character page, I resisted the temptation to name characters whose names have similar sounds to "doe wahn." When he was on the academic page, it was hard not to point to the tile for "book" since I thought that might be his target. But I'm glad I kept my mouth shut (and my fingers still).

3. I thought field trip was an error.  I'm glad that I wasn't dismissive or negative about that selection---I could have said "No, not field trip" and reached across and deleted it. That probably sounds awful, but I've seen it happen time and again in videos---the communication partner is sure that they know what the child is trying to say, and they keep redirecting and redirecting until they get that answer. (For more on we-can't-read-their-minds, please see: I Am Not A Mindreader (And Neither Are You).)  Instead, I asked "field trip?" and when he said "No" I repeated "No" to confirm what he was saying (my tone was a little dismissive---I wish I had asked "No?" instead).

4. This whole exchange brought me right back to two years ago, when Maya was (persistently, amazingly) trying to tell me to add a word to her talker, and I was (desperately) unable to understand what word was missing. Similarly, there was a happy ending, but boy---the emotional rollercoaster leading up to it was a bit gutting. You can see that here (and the creator of the TV show being discussed actually swung by to comment, which was pretty neat): I Need A New Word

And finally, here is a picture of Will holding a stop sign. Without a picture, this post isn't pinnable and is more difficult to share, and I like this one. I'm including two different symbolic interpretations below the picture. I prefer the first one, but if I'm being honest with myself the second is equally (if not more) accurate.

Stop! Wait! Give me time to use my device without interrupting!
Stop singing that atrocious made up song about going to playgroup! It's Wheels on the Bus or nothing at all!



Sunday, April 12, 2015

Cartoon Character Guess Who (with download)

Nearly a year ago, I wrote about Maya's great love of characters. At the time she was fairly determined to learn the name of every cartoon character under the sun, and to have them all added to Mini (her talker). (You can see that post here.)

Soon after that blog post, I found the old game Guess Who at a thrift store and grabbed it. I didn't totally remember how the game worked, but I know that it's a favorite among SLPs and teachers because it can be used to practice labeling with adjectives, discussing characteristics, and asking questions. I knew that Guess Who would be most compelling for Maya if the human faces were replaced with some of her beloved characters  . . . and so that's what we did.

It took a little fiddling to get the dimensions right, but eventually they were perfect. 

The document containing all of the characters above can be downloaded here . . . and if you don't like those characters, feel free to use the grid and just add pictures for your preferred people! Hint: Print this on cardstock so that you can easily slide the characters in and out.

Oddly, it's taken a year to post this---I have no idea why I didn't put it up when it was first created (I think that maybe I shared it on my Facebook page and forgot to write something here?). I only noticed today because I scrolled back through my blog to find the printable sheet (we needed some replacement tiles) and realized that somehow I never put it up. In case you're curious, this is what Maya's character page looks like today:



And we've got a new one growing, too:


(we also have Disney princesses, but they started out on a separate page)


For what it's worth, we still walk the line of figuring out when to add every-single-new-character she encounters, and when to wait a bit. But these pages sure are invaluable when she wants to chat with new kids in a waiting room or other similar situations. I imagine she uses it with her friends at school, too. Kids need the vocabulary of other kids, even when that vocabulary includes hoards of cartoon characters :) 




Friday, April 10, 2015

A typical conversation, using AAC and speech

This is a video of nothing particularly interesting.

Now I bet that you're dying to watch it, right?

I realized yesterday that it's been a while since I got video of Maya and I chatting, or using AAC, or really anything. This is due to the fact that she generally strongly protests to sitting and being video'd, I generally honor her request not to be recorded (because, you know, right to privacy). I set up the tripod yesterday while Will was napping and eventually persuaded her to hang out and chat and let me record a little. 

Here's a brief summary of the recording (spoiler alert): we chatted about things to do during the last few days left of our break, and then Will wakes up and we look at him on the video monitor.

It's not really noteworthy, but also it's a good representation of what our home communication looks like. Maya is an AAC user, but she's also a speaker, a gesturer, a user of facial expressions and some intonation. In choosing to honor total communication, we mostly let her choose the method she wants (typically, a combination of methods) to get her point across (the mostly is because she sometimes needs prompting or questioning to know that her message wasn't clearly received, and she needs to use a different method to help clarify). 

You might notice that I'm not doing a lot of modeling. If you're an AAC professional (or experienced AAC family) then you know that modeling language is basically the most important thing that any communication partner can do for an AAC user . . . and you might be wondering why I'm not modeling more. The answer is kind of two-part, but it really boils down to knowing my kid: First, I don't always model everything when I talk to Maya. She knows where a lot of vocabulary is, and if she's very interested in a conversation and I start to over-model, she gets fidgety and bored and wanders off. Second, the video camera + over-modeling combination feels kind of like a contrived activity, rather than what a spontaneously multi-modal conversation really feels like. You'll see that at the end when I'm trying to prompt for synonyms she gets tired, physically starts to move away, and keeps saying "no"----we would have hit that exhaustion/rejection sooner if I was trying to make it more "teachable" and less "conversational".

Some things worth noting:
  • Her speech is pretty great, right? She's got some clear, well produced words (Daddy, Mommy, happy) and some others that are clear to us (Will, wake up!). What you can't see here is how limited her clear words are. One of the interesting things about her speech is that she doesn't attempt words that won't be understood (so you don't hear her saying any unintelligible things here).
  • She will choose to speak something that is clear but might not be an exact fit for the situation, rather than trying to generate a novel word/sentence that she doesn't have the motor plan down for. For example, she wants to shout that Will "woke up!" or "is awake!" but she's never said either of those utterances, and it would take a lot of motor planning to form those words and put them together----so instead she shouts "Wake up!" which is something that we ofter say while playing (one person pretends to fall asleep and the other yells "wake up!") so it's easy for her to produce.
  • I think it's funny when uninformed critics have said that AAC users may become overly robotic because they "just stare at computer screens and type things" (I've heard this a lot from people saying nonspeakers should focus on learning sign language because it's "more expressive"). I think it's pretty clear from her expressions, clapping, etc, that using AAC isn't disconnective. 
  • I love at 3:21 when she runs her finger along the line of choices and selects the past tense verb "woke" very deliberately. (The picture below shows that row and the choices that she rejected, including "awake".) She wanted to say (appropriately) that he woke up. I helped finish the thought by modeling the addition of "up" and then said the whole thing together.
she chose "woke" on the far right

Here's the video:










Wednesday, March 11, 2015

The (Briefly) Open Window

Yesterday Maya and I were in the car, driving from school to therapy. Maya was doing a variety of things: looking out the window, answering questions about her day, and occasionally typing or saying something with Mini. She was very jazzed about a class trip happening the following day  (today) and she was saying “Legoland tomorrow!”  There was a period of frenzied typing, wherein she opens the keyboard in her app and hits a bajillion letters with both hands. It’s annoying (each letter shouts individually as she types: A! K! L! LDKDJJEVMVKEKSMAM!!!”) and it’s a favorite activity of hers. I try to allow the typing within reason (no typing at meals or when someone is trying to talk to her) as I’m sure the letter play is helpful, and so is exploring the keyboard, etc. I hummed along with the radio. I didn’t notice when she stopped typing. But I noticed when, after a pause, she started again:

L-E-G-O

Wait. What?

Maya has spelled her name for a long time, and she will spell Will’s name as well. But prior to yesterday I had never seen her spontaneously type another word. Ever. I have made gentle requests (including bribes) to see if she had spelling abilities (Hey Maya, can you tell me how you could write the word ‘cat’?) but was always shut down, directly (No) or indirectly (generally the dramatic typing of massive strings of letters or wandering away from Mini).  But now . . . lego.

Before I got too excited I asked her to hand me Mini, so that I could check and see that she didn’t have a screen open where she could see the word “lego.” For some time she’s been a fan of entering a button and then copying the spelling (Mommy. M-o-m-m-y.) but nothing was there. It was real.

I handed it back. I smiled a little, but I didn’t make a big deal of it.

A window had opened, slightly. Enough to let some light in and illuminate some of the dark areas of Maya’s knowledge. I spend a lot of time thinking about what she thinks, what she knows, what she understands, what she can do . . . and now, somehow, I was getting a glimpse.


I thought quickly and carefully. She was tapping out long strings of gibberish letters.

“Could you clear that out?”

She eyed me in the rear view mirror, cautiously, but I saw her hands tap around the screen silently and thought she must have done it.

“I’m going to ask you about a word and I would like to hear how you want to spell it.”

No response. I tried not to let any hint of I-really-care-about-your-answer come into my voice.

“Cat.” I said, clearly but nonchalantly.

C-A-T

“Hey-good spelling.” I smiled, but played it cool.

“What about ‘dog’?”

D-O-G

She started listing classmates then, moving around the app, talking about different things. I waited, then asked her to clear it again and offered the word “run”.

R-A-N

I kind of liked that spelling error, because it gave me the idea that she might really be thinking about how the words sound, rather than just reporting sight words.

Good job! Run actually has a u in the middle, but you typed ran—that’s so smart. What about ‘mop’?”

A pause.

M-O-P  

That’s definitely not a sight word, that’s phonics. That’s fantastic. She has some writing abilities now, for real. Things are happening! This is amazing!

She’s not interested in playing my game anymore and wants to listen to the radio, she recognizes a song from the school bus. She looks at the snow and the river, and I try one more, asking her to spell “like.”

L-A-K-E

A valiant try, and she included the silent e! Amazing!

We got to the office, did homework, and she had a great session. I kept thinking about the open window, the opportunity that I had been surprised with  to see a new ability. I had no idea she could generate text. She has literally done nothing like that before. As we walked back to the car an hour later, I was anxious to ask her a few new words that I had thought of, hoping to feel out the edges of her phonics awareness. I waited a few minutes, while she drank a chocolate milk box and we talked about going home to see Daddy and Will. Then I asked, casually,

“Hey Maya, do you think you could tell me how to spell ‘food’?”

She typed F- and then looked at me, deliberately in the rear view mirror as she continued –JKKLLKJLKLKNKMKJKJKJKJN

And the window shut.

I can't wait to see the new things waiting the next time it opens up. It's always there, you know, this knowledge and thinking and processing and analyzing, but it takes a stars-aligning type of situation to get to see it all (sensory stuff, cooperation stuff, motivational stuff, attention stuff, muscle/motoric stuff). Just another story to file in my "this-is-why-we-all-need-to-always-presume-competence" folder.




If you're interested in reading more about the "sudden" emergence of skills or ability, this post is great: Night-blooming Flowers: Sudden skill acquisition and extreme context-dependence



Monday, February 23, 2015

Ponderings on Icons, Text, and AAC, via a mini experiment

Like many children with global challenges, Maya has always been a child with a large number of goals. I realized early on that, as a human with limited energy and resources, it wouldn't be possible for me to approach all areas of development with universal enthusiasm and passion, and I decided to focus on communication and literacy. These seemed, to me, to be the cornerstones of everything else---communication is a right, and I was pretty determined to help her find a system that would serve her well. Literacy opens the doors to basically all learning (Want to learn about nature? Let's read a book about it. You like geography? We can find a book on that.). In the world of children with complex communication needs, literacy and AAC are two fields that, when displayed in a Venn diagram type of way, have a solid overlap. To someone with decent (but not deep) knowledge about the two, they seem to mostly compliment each other, except for a few fuzzy points.

This is where I note that the bulk of my reading and learning is about AAC, and I'm not a literacy expert.

Here's one area of conflict: With regards to literacy, there is research that indicates that the pairing of words with icons (like in early reader books where there is a little picture of Dora directly above the word "Dora" in the sentence) is not beneficial, and may be (or is? I don't remember) actually detrimental. This makes sense, as icons would distract the reader from the words being read, and also kind of pull their eyes out of the left-to-right flow of the sentence. 

The goal of AAC, though, is not to teach reading but rather to facilitate communication (although immersion in text-via-AAC seemed to accelerate Maya's reading ability). I imagine that there are apps/systems that only display text in their sentence strip, and there are others that display one or more icons along with their words. I imagine that "should the icons be displayed with the text in AAC" has been a question discussed and debated, particularly among those who develop these systems.

From what I've seen of AAC using/learning, it seems to me that having the icons displayed in the sentence strip along with the words being spoken makes AAC learning/using easier----particularly for young AAC users or for AAC users who are learning their system. (Side note: I, as a part-time user, am perpetually learning the system. I can't imagine when it will be effortless for me to use it, even with the automatic motor planning element. Even as I become more fluent with frequently-used words, we are constantly adding new words to the vocabulary.) While I certainly can't make any grand claims on behalf of all AAC users, I want to share what I've seen with my kids, who present as an interesting case study.

Background: In Speak for Yourself, a word can take one or two taps to say (no word takes more than two taps). When a word is selected it is spoken aloud and move to the sentence strip at the top of the screen. The two icons that were tapped to select the word are displayed under the word, as shown below.
"I" is a 1-hit word, and has 1 icon displayed. "corn" is a 2-hit word and has 2 icons displayed. First the user selects the initial icon, and that takes them to a secondary screen where they can find the second icon.


Will (2.5 years) and Maya (6.75 years): Maya has been using SFY for the past 3 years, Will has been using it for a little over a year. Both were obviously pre-literate at the time they started using the app. It's difficult for me to remember much of Maya's early AAC use (because I'm old, my memory is spotty, and I was just so excited that it was working that I wasn't scrutinizing much)---but now I am watching Will become an elective AAC user through an increasingly academic eye. So here are my take-aways, with a few minutes of video of a small experiment (taken yesterday).

First, a video of Will. For this experiment I selected two words that I knew he had never seen in SFY. I selected one (while the screen was out of his view) and then placed the talker in front of him to see if he was able to properly follow the icon path to select the word without help. 



The big take-aways: Will understands left-to-right flow of (icon) language and is able to follow it independently. Also, having the icons displayed in the sentence strip allows him to practice and copy words that he would otherwise be unable to find.

Broken down:
1. For Will, use of the app has solidified the concept that text (or icons) read from left-to-right. I don't know whether he initially learned this concept from reading stories at home or from studying the order of the icons in the app, but he gets it. He doesn't hesitate when he sees the 2-button-path to Tyrannosaurus Rex, he knows immediately that the button on the left is pressed first, followed by the one on the right.

2. Will is now, I suspect, fully able to "read" Speak for Yourself. The best idea of a "Oh yeah? Prove it!" experiment that I can come up with would be to print off a sentence of icons without including the text, and see if he can recreate the sentence. My suspicion is that this would be easy for him.

Next, a video (in two clips) of Maya. First, to include her, I asked about Tyrannosaurus Rex and escalator, but she already knew where they were (her vocabulary knowledge of SFY outpaces mine). After that I picked a word that I was 100% certain she had never seen---"Trackball" (I don't know what a Trackball is, it's a pre-programmed word in the app). Then something interesting happened: after she viewed the word, I accidentally erased it, so she no longer had the icon path on screen to follow. This leaves two possibilities for how she found the word: a) she memorized both icons in the sequence, b) she memorized the first icon and scanned the page for a word that had the text features of "trackball." I think she did the latter, since she would easily recognize "ball" and also she has long mastered starting sounds.


The big take-away: Maya uses the icon path to help her navigate towards the target word, then either uses an icon OR reading text to locate the target. (I guess I could see if the latter was correct by showing her a novel target with only the first icon and not the final target icon, and see if she was able to use decoding to find the word.)

Maya is an early reader, and her reading has been loosely assessed as at-or-above grade level. I assume that she also read the icons of SFY and that following the icons made it easier for her to practice words in the app or to copy words modeled by other people (Will is currently doing both of those things). However, learning from the icons appears to not have negatively impacted her ability to attend to text.  From what I have seen, she studies the icons in order to locate words, but she also notes the text. For commonly used words she doesn't seem to notice the icons in the sentence strip at all, but if she's in a therapy session where new words are being modeled she will lean over to closely examine the screen of the therapist's iPad, and then she will select the same icons to produce the word on Mini.

Conclusion:  Ha! There's certainly nothing to be "concluded" here, from two specific kids with one specific app in one specific home. But I found it interesting to see Will already following the icon language, and to see that Maya still uses it now for new or less frequently used words. Also, when I use a novel word I find myself staring at the icons in the sentence strip, trying to memorize the path to that word. It seems valuable to have icons displayed to facilitate and solidify AAC use/learning.  

 

Disclaimer: As always, I'm not a professional (nor do I play one on the internet). Comments, critiques, links to research, and other thoughts are welcome below or on our FB page!



Thursday, February 19, 2015

AAC Sibling + Fantastic Search Feature = (Really Cute) Success!

Last week I wrote a post that highlighted the interesting (and kind of amazing) development of AAC siblings: both in terms of their inter-sibling spoken language and their inter-sibling AAC use. That post included a video in which Maya was delightedly using the search feature in her app (Speak for Yourself) to walk her way towards words. These were words that she already knew the location of, but it was more fun to practice spelling and navigating than it simply would be to select the words. (More on how the search feature works in a minute.)

Yesterday, in a development that shouldn't have been surprising (but still kind of was), I found Will sitting in his crib after nap time using the search feature in his talker. He was opening the search feature, entering "m", selecting m&ms, and then following the path to the button for m&ms. And he was very smiley and proud of himself for figuring it out.

The concept of "search feature" might be abstract for the non-AAC-users out there, so let me break it down. Speak for Yourself has what is arguably the best search feature in the world of AAC (certainly the best one that I've seen). A user taps the magnifying glass in the upper left corner, then begins to spell the word that they're searching for.

search feature open with "m" entered

Upon entry of the first letter a scrollable list drops down, and the user can scroll through and select their target word. Two things about this list are unique (and awesome): First, you don't have to spell the whole word correctly. Maya has been able to discern the starting sound of a word for quite some time, at this feature became useful for her as soon as she could type in that initial sound. Second, the icons appear right next to the word---so a child who knows starting sounds but is pre-literate can find their target by recognizing the icon next to the word.

When the word is selected a flashing purple square outlines the path to the word. First, it flashes around the button on the main screen . . .

main screen with the word WITH highlighted-the target word (m&m) is found under that screen

then it flashes around the target word on the secondary screen.

m&m highlighted on the secondary screen

The search feature makes it easy for Maya's teachers and therapists to quickly find words that they want to model. Maya enjoys experimenting with it, but I've also seen her attempt to use it purposefully---when I say "where's 'spectacular' " and she furrows her brow, pauses, and then opens up the search and types in "s." And now Will is in on the game.

Here he is (that's a chocolate ice cream mustache), searching:




AAC siblings are a special kind of awesome. And also, apparently the search feature in SFY is so easy to use that a two year old can use it.


Note #1: If you've got an eye for detail, you may notice that the coloring of the screen in the still pictures differs from the color-coding of the screen in the video. The still shots were provided by another user of SFY and reflect her color-coding. (I wrote this at my college library and didn't have a talker on hand to get still shots!) Different users and families choose to color code the buttons in different ways. 

Note #2: I am not an employee of Speak for Yourself.