AAC and Assessment- Free tools and trials!

As a travelling Speech and Language Therapist, I find that the size of my handbag is ever increasing due to the sheer amount of resources that I carry from place to place. Toys, stickers, games, therapy materials and a full battery of comprehensive assessments….I can just about lift the bag!

When working with my AAC caseload, I find my bag is somewhat lighter. I considered this recently and came to the conclusion that this is due to the lack of formal, standardised assessments for this population….And yet, assessment is so important when it comes to working with children using AAC. It helps us to set targets, monitor progress and highlight those areas that a child really requires extra support within.

A few years ago, I made my own informal assessment screening tool. It’s not that impressive- it’s a word document with tick boxes that requires you to have a bank of core symbols, communication boards, switches and motivators to hand!

But more recently, a number of new AAC assessment tools have been developed…And being a Geek SLT, I am loving trying them out! So I thought I’d list some of the tools I’ve been experimenting with and provide a brief low-down for teachers and SLTs who are keen to expand on their AAC assessment range!

The Dynamic AAC Goals Grid

This is a pretty exciting resource that I am currently a little obsessed with. Created by Tobii Dynavox it can be downloaded for the iPad alongside their fabulous communication app ‘Snap + Core First’. The sister app is called Pathways and it’s within this app that you find the Goals Grid.

One of the things that I love most about the Goals Grid is that it considers Janice Light’s well established research within the field of AAC. She discusses the 4 key areas of communication competency required to be a successful AAC user: linguistic competence, operational competence, social competence and strategic competence.

The Goals Grid takes these 4 areas and gives you a checklist for each. The iPad app then provides you with a handy percentage so that you can quickly see the ‘level’ that your child is functioning within- emergent, emergent transitional, context dependent, transitional independent and independent.

You can then quickly see the areas that the child needs to focus on to progress to the next level. The clever thing about the app is that there is also a ‘Build Skills’ section which provides you with top hints, handouts and in-depth information on targeting specific core words! Amazing!

If, like me, you quite like a paper version of your assessment, here’s the link: https://www.mydynavox.com/Content/resources/slp-app/Goals-Goals-Goals/the-dynamic-aac-goals-grid-2-dagg-2.pdf
Handy to print out, fill in and place in a student’s file to frequently review progress!

The Communication Matrix

This is a fabulous free (love that word!) online resource. All you need to do is create an account here: https://communicationmatrix.org/Matrix/MatrixChart/Mobile/270538
You can then create profiles for multiple students.

The Matrix asks you a series of questions about skills that the child you are working with may be displaying. One of the nice features is that it also shows you a video clip of the skill in question e.g. examples of how a child might attract attention/protest/request more of something, etc. This includes non-verbal responses that may be used pre-AAC such as body movements or vocalisations.

When you have completed the question section, you are then presented with a colour-coded grid, clearly demonstrating skills that are consolidated, emerging or not yet present.

I find that this is a useful tool for starting out with a child on their AAC journey as it starts with the basics and considers simple factors such as non-verbal cues and vocalisations. It can give you an indication of the first steps for a child who doesn’t currently have a formal communication system. You can also save and print the Grid and return to it as an when you need to update information.

The Pragmatics Profile for People who use AAC
If you are an SLT you are probably aware of the standard Pragmatics Profile and have spent many an afternoon completing it with parents and teachers!

This is a clever adaptation of the original profile but specifically for AAC users. You can find it here, on the ACE Centre website: https://acecentre.org.uk/resources/pragmatics-profile-people-use-aac/ Again, it’s FREE!!

This is a nice way to gather information and evidence about a child’s communication skills, involving the people who know them best- family and/or education staff. It provides really comprehensive information that you can then consider when setting goals.

CARLA (Computer based accessible receptive language assessment)
One of the reasons why typical standardised assessments can be tricky  to use with  some children who use AAC is that they require direct access e.g pointing to a picture or manipulating objects in Derbyshire Language style assessments. Yes, you can adapt a BPVS with something such as an E-TRAN frame but it’s highly time-consuming!

The unique feature of the CARLA software is that it has multiple access methods- eye-gaze, auditory scanning, switching and finger-pointing!! How clever is that?! You can download a free trial here: https://www.techcess.co.uk/carla/

The assessment looks at understanding of basic vocabulary from nouns and concepts to verbs. It then examines understanding of information carrying words- Can the child listen for 2 or 3 key words in an instruction? Clear, colour photographs are used to make the assessment visually accessible. Results are then transferred into a Microsoft Excel document.

So at last we have a tool that can provide quantitative data for a child who needs an alternative access method….And we can then pinpoint areas of understanding that the child may require support with before working on that area expressively through AAC.

For example, I recently used the CARLA assessment with a young girl who I work with who uses an eye-gaze communication aid. She seems to have got ‘stuck’ on single words and carrier phrases and I wanted to get to the bottom of why this may be. It soon became clear that her understanding of verbs was inconsistent. So by targeting her understanding of verbs we can then begin to develop her use of them, building towards 2 word phrases such as person + verb.

 

You may have noticed a theme in the assessments that I have listed… They are all free to use or trial! That’s always a bonus!

It’s definitely worth considering how each assessment can further examine different areas of an AAC user’s communication- from the beginnings of intentional communication, to receptive language, functional communication and operational use of an AAC device…There is so much to consider! Setting goals for children who use AAC just got easier!

 

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Tricks for transitions- Reducing anxiety in daily routines

 

If you were asked to brainstorm all the words that you associate with ‘change’, what kind of words would come to mind? Adjectives such as ‘difficult’? Emotions such as ‘anxious’?

The truth is, most of us aren’t that keen on change. It takes us out of our comfort zone and places us somewhere unfamiliar….And while change is a normal and necessary part of life, children with speech and language difficulties or Autism can find it pretty terrifying.

I don’t just mean big changes like moving house, changing teachers or going somewhere new- everyday transitions can be equally baffling and scary.

How can we make it easier? How can we maintain some consistency in a fast-paced, ever changing school day?

1. Use simple, familiar language

First of all, it’s important to signal that a change is going to occur. But let’s really consider our language when we do this…

e.g “Ok it’s nearly time to tidy up but before we do that let’s wash our hands and then after that we’ll get ready for PE…”, etc, etc!

There’s a lot to process in this instruction- sequencing words such as ‘before’ and’ after’, vague time concepts such as ‘nearly’… For a child with difficulties understanding language, this could be an overload of information, causing them to feel more anxious!

However, if at every transition you used a similar phrase such as “Art is finished. Now it’s lunch time”, this is much more straight forward. The child knows what is happening and when it’s happening. You can accompany this with a visual such as a sign(e.g. the Makaton sign for ‘finished’)/symbols or photographs to visually reinforce understanding.

2. Visual timetables/timelines

I’m sure most of you reading this article have used visual timetables before and don’t need me to greatly elaborate on the process. But it’s important to consider that one size does not fit all...! We need to consider the needs of the child before we start printing and laminating copious amounts of symbols from twinkl/Boardmaker/Insert other software here….!

We’ve got to consider these things:

a) What representation of an activity will the child understand best- an object, a photograph, symbols..?
For some children, symbols or line drawings are too abstract. Maybe we need to start with objects of reference e.g. a fork to represent lunch, a book to represent carpet time, etc.
Other children respond well to photographs of themselves partaking in the routine e.g a photo of them sat on the carpet to represent registration.

B) How many transitions we visually display- Yes, it’s easier to lay the whole day out first thing in the morning, placing all the symbols on the timeline. But for some children this is a visual overload that then loses meaning.

For some children a ‘Now and Next’ style transition board is enough. Other children might be able to cope with 3 visuals- ‘First, next, then’. Some will be fine with the whole day laid out on the timeline.

Don’t forget- make the timeline portable! There’s nothing sadder than seeing a beautifully made visual that’s stuck to the wall and never used!

3. Transition songs

Ah YouTube…It has a child-friendly song for just about everything! A quick search and you can soon find plenty of songs that can be used to signal transitions…From good morning songs, tidy up tunes, lunch time beats to home time hits! It’s a fun and simple way to support the structure of the day.

4. Traffic light system

Possibly one of the simplest visual aids to make, requiring only 3 coloured circles- green, amber and red. These can easily be attached to a lanyard so that they are always to hand!

The idea is that each colour represents a different stage of the activity. You show the child the coloured circles to make them aware of what stage of the activity they are in.

Green means go- the activity is starting.

Amber means getting ready to finish– the child is made aware that the activity is ending soon. You don’t have to put a specific time on this (it can be difficult to quantify when an activity will end!) but make sure it is no longer than 5 minutes.

Red means stop- the activity is finished.

A very simple but effective visual!

5. Social stories

You may have noticed that certain parts of the day seem to cause more anxiety than others…Maybe it’s P.E; moving rooms might cause confusion. Maybe it’s lunch time; the child might struggle to socially interact with their peers in the playground.

Once we have identified aspects of the school day that may cause issues for the child, we can write them a tailor-made
social story. The story should explain the situation to the child, describe what might happen and how they can respond. Use photographs, symbols or the child’s own drawings to personalise the story even more!

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Small transitions occur frequently in our daily lives. As adults, we are accostumed to them and we take them in our stride. In fact, we hardly even realise they are occcuring at times- How often do we go into auto-pilot as we move between places or activities?!

Let’s take a minute in the busy school day to consider how we can support our students to begin to experience these seamless transitions. Choose one of the transition tricks above to start with and then persevere! Nothing works over-night; using an approach consistently will help the child to understand the purpose of the transition trick and to link it with changes in their daily routine.

‘Curiouser and Curiouser’… The importance of asking questions

“Judge a man by his questions, not by his answers”- Voltaire.

My curiosity led me to Google this morning. I typed into the search box:
“How many questions does the average adult ask per day?”

Unfortunately, my Google search really left me with more questions than answers (which often seems to be the case when I find myself thirty minutes later, trawling through Google Scholar/The Guardian/You Tube, with questions only slightly related to the original…!)

Anyway, I did find out a few interesting pieces of information:

1. A study commissioned by Littlewoods in 2013 found that the average British mother is asked almost 300 questions a day,
2. The amount of questions we ask per day decreases with age and varies depending on gender- 4 year old girls ask approximately 390 questions per day while 9 year old boys ask around 144.

So, let’s say that the average child asks a question every 5 minutes…What about children with speech, language or communication needs (SLCN)? Do they ask more/less than their peers? Do they ask a variety of questions? Do they ask the questions that they NEED to ask? I’m sure there is a research study in these questions alone!

But more importantly- do we make asking questions an important part of language learning?

We often prioritise requesting, commenting, answering questions…But as it turns out, asking questions is a massive part of a ‘typically’ developing child’s everyday language!

And questions have so many functions… we ask questions to start conversations, to gain information, to connect with people, to discover new things, to reduce anxiety/increase clarity…

It’s recently come to my attention that the children who I work with who use augmentative and alternative communication (AAC) such as communication books and voice output devices, ask fewer questions than their verbal peers.

I think one of the reasons for this might be that we target so many other functions of language that we deem to be motivational; questions seem to be more difficult to approach.

But actually, isn’t there something quite motivational about being nosey/inquisitive…?!

For example, if I put a massive box in the middle of the table, with ribbons and bows around it and didn’t mention it; what child wouldn’t want to ask, “What’s in the box?!” or “Can I see?!”

Here are a few ‘thinking points’ to develop inquisitive minds within our AAC users:

1. Think about question structures

Speech and Language Therapists often talk about ‘Wh questions’- These refer to question starters such as who, what, where, when, why and how (‘How’ breaks the ‘Wh’ rule…!). It’s important to have these words as part of a core vocabulary- to introduce the symbols and model how to use them and combine them with other symbols to form questions.

I like to do this during turn-taking games. In fact, I’ve made a massive A2 sized ‘Question board’ for both myself and my children using AAC to use for asking questions during games e.g
“Whose turn?”
“Where’s the dice?”
“What’s next?”
“Can you help?”

And depending on the game, you can build in lots more questions- ‘Guess Who?’ is the ultimate question asking game!!

2. Think about the questions that kids ask kids!

Listening to children’s conversations I’ve noticed that these simple question structures crop up again and again:

1. Do you have….? (a dog/an x-box/ a barbie/ a football, etc, etc…!)
2. Do you like….? (Paw Patrol/ Taylor Swift/ Swimming/ Man United, etc, etc…!)

So bearing this in mind, it’s nice to practice these questions in social situations or as part of a group activity.

I’ve made some page sets related to social questions for a child who uses the Grid 3 software- A cell for “Do you like…?” jumps to some of the child’s favourite activities/music/TV…That way, the child can find out what they have in common with others.

Isn’t this how friendships form?!

3. Think about what intrigues the child!

It goes without saying, but if you are asking a question it’s because you want to know the answer! So we may need to motivate our children to want to find out some information.

The big, surprise box that I mentioned earlier is a starting point…But what else might intrigue the child?

Perhaps writing a letter to their favourite celebrity- you could spend some time discussing together which questions they could ask. Or similarly, maybe a group interview session with the Head Teacher?!

Maybe a Hide and Seek type game or a scavenger hunt- hiding a motivational object somewhere in the room.

Or perhaps, we withhold information and then pause…The power of the pause cannot be underestimated!

For example, if the class teacher was to say, “We’re going on a trip next week” and then paused, not providing further detail; that’s surely going to incite some curiosity! Everybody will want to know where they are going to….and to find out, they are going to have to ask!

 

The statistics I found on Google would suggest that children’s curiosity eventually peaks…It seems that teenagers and adults don’t feel the need to enquire so much, to ask those interesting ‘why’ questions that a 4 year old would (The Telegraph suggests one of the most common, interesting questions asked by children is: “Why is water wet?!”).

So let’s harness that period of curiosity and make it a language learning opportunity for children who use AAC! You might be asked some bizarre questions along the way, but isn’t that part of the fun?!

Talking through the tough stuff- Using symbols to talk about emotions

About a year ago, I received a phone call from a lady with an interesting request.

This lady was a children’s counsellor, supporting children to talk through issues such as depression, bereavement and trauma.  She had been asked to work with a child who was non-verbal and naturally, she was a little bewildered- How could she attempt ‘talking therapy’ with a child who didn’t ‘talk’ in the traditional sense?!

And this is where I came in, armed with a toolkit of symbols and a Talking Mat (If you don’t know what a Talking Mat is you will by the end of this blog post…!). It was a fascinating morning, supporting this lady in an alternative version of ‘talking therapy’- AAC therapy in a different sense to what I am used to!

The whole experience got me thinking- Our children with disabilities, with ASC, with PMLD…They go through a lot, don’t they? On a daily basis they have become accustomed to dealing with issues such as pain, isolation, lack of privacy, having decisions made for them, being patronised or overlooked…

If I had to deal with these issues on a daily basis, I would feel pretty depressed, frustrated and maybe angry at times.

Yet do we equip our children to really talk through these issues? To actually discuss how daily life can be a challenge at times?

So in today’s blog, I’m going to think about a few ideas as to how we can encourage our children to be open, giving them the language to really tell us how they’re feeling.

• Provide access to ‘emotion words’

One of the core words that someone who uses AAC should have access to is ‘help’.

However, when a child says “Help”, I think we often automatically gravitate towards physical needs, pulling out symbols for ‘hot’, ‘thirsty’, ‘uncomfortable’, ‘tired’, etc.

But what if a child wants to express that they are sad, frustrated, bored, worried, scared…? Or equally if they want to express a more joyful emotion such as excitement, happiness or amazement?!

Like with any vocabulary, our children need to be exposed to these words and their corresponding symbols- They need to link the symbol to the emotion and as always, this is done through modelling. Whilst reading a story we can talk about how the character feels whilst using the symbols ( “They are scared of the bear!”), we can use symbols to talk about our own emotions (“I feel excited today!”) or we can comment on others around us, explaining their emotions using symbols (“Lucy is a bit sad today because she has lost her teddy”).

More importantly, we need to ensure that children who use AAC have access to a ‘feelings’ page within their communication book or device and encourage them to use it by asking them how they feel about things that are happening around them. This also shows that we value their emotions; that we are interested in listening to their thoughts and feelings.

• Practice talking about emotions

I run a weekly communication group with 7 children who use alternative forms of communication. We start every session by talking about how we feel today. I’ll kick things off by saying I’m happy or tired (a common feeling on a Thursday morning…!) and then the children will use symbols to say how they feel.

But emotions can be integrated into many different activities and lessons. I particularly like to use sensory activities to practice talking about feelings. These are just a few ideas:

• Playing a range of emotive songs (classical may be best for this activity) and asking the children how it makes them feel (scared, excited, happy, etc),
• Using a feely bag or a magic potion (green jelly with lots of yucky things hidden inside like plastic spiders and eye-balls!)- ask the children how they feel before they put their hands in (worried, excited, disgusted, etc),
• Sensory stories- As I mentioned before, talking about how a character feels in a story can be a useful way to discuss emotions…but sometimes this is a bit abstract, requiring the child to use inference, putting themselves in another’s shoes. A sensory story helps to bridge that gap as the child is more of an active participant, experiencing the same sensations that the character in a story might feel; a perfect time to practice talking about feelings! There are a few nice examples of sensory stories with accompanying switch activated powerpoints on this site: http://www.portlandcollege.org/curriculum/resources/
• Talking Mats

I mentioned Talking Mats at the beginning of this blog as this is my ‘go to’ tool for finding out a child’s opinions, thoughts and feelings.

Basically a Talking Mat is an old car mat, used with a selection of laminated symbols with velcro on the back- it might not sound glamorous (unless you can get your hands on a sparkly, purple car-mat…) but it’s simple and effective!

The idea is that you have a top line of symbols placed on the mat e.g. ‘happy’, ‘sad’, ‘not sure’ . The child is then given a variety of symbols representing activities or aspects of their daily life and they can sort the symbols under the heading that it applies to e.g. ‘playing with friends’ may make the child feel happy, whilst ‘being alone’ may make the child feel sad.

You begin to build up a picture, almost a graph on the mat, which helps you to see a child’s feelings at a glance. I normally take a photo of the end result, print it, date it and then when I re-do the activity at a later date, see how (or if) things have changed.

Some specific occasions when Talking Mats might come in handy?! Here are just a few examples…

–Talking about transitions– if the child is moving class or even school, it’s a helpful way to gauge their feelings and then understand how best to support them with the issues that they identify as being difficult.

– Getting to the bottom of a challenging behaviour– You know there is a trigger but you’re not sure what. Finding out the child’s thoughts and feelings on daily activities may help you uncover the issue together.

–Making one page profiles or communication passports– It’s important to have the child’s input when making these documents. Only the child can provide accurate information on what they like or don’t like to talk about. Using a Talking Mat is a fun and informative way to do this.

These are just a few suggestions off the top of my head! If you want to know more about Talking Mats, have a look at their website which provides more information on the approach and also training dates: http://www.talkingmats.com/

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Once our children with communication difficulties have access to the appropriate vocabulary and have opportunities to talk about emotions, there is one more important factor to remember- We need to create an environment in which the child feels safe to chat about how they feel.  Pausing, taking time to consider their opinions, responding with warmth and without judgement….Just generally being approachable!

Talking about tough stuff is tough! But we can meet our children with communication difficulties half way, providing them with the right tools within the right environment. It might still be tricky but at least as parents, teachers and health professionals, we can help to make it a little easier!

 

The ‘is’ and ‘isn’ts’ of Speech and Language Therapy

When people ask me what I do and I tell them I’m a Speech and Language Therapist, I’m usually met with 1 of 3 responses:

Response 1- “Oh, I better make sure that I speak properly around you!”

Response 2- “So you work with people who stammer?”

Response 3- “What, with your accent?!” (I’m from Northern Ireland and I work in England…This seems to blow some people’s minds…!!)

It strikes me that Speech and Language Therapy is quite a misunderstood profession.

It doesn’t necessarily bother me that people don’t understand what I do. What concerns me is that if people don’t fully understand the remit of a Speech and Language Therapist (SLT), children with more subtle speech and language difficulties may fly under the radar. They may not be referred for speech therapy because parents or educators may not see the child’s difficulties as being ‘language’ related.

The statistics for undetected and therefore unsupported language difficulties are quite harrowing:

-Children with vocabulary difficulties at the age of 5, have a higher rate of unemployment at age 30,
-Primary school aged children with developmental language disorders are more likely to experience mental health issues in adulthood,
-Up to 60% of young offenders have Speech, language or communication difficulties. *

I could continue to provide you with many similar statistics but they all amount to the same fact- good communication skills = a better quality of life.

That’s why I thought I’d use my blog post today to clear up a few misconceptions about speech and language therapy. Instead of ‘dos’ and ‘don’ts’, this is my list of ‘is’ and ‘isn’ts’- what speech and language therapy is and what it isn’t!

–Speech therapy isn’t elocution!
A few years ago I received an email asking if I offered ‘execution lessons’…While I can only assume someone’s autocorrect was playing tricks on them, as much as I don’t offer execution lessons (!!) I equally don’t offer elocution lessons!

SLTs do support children and adults who have difficulties producing speech sounds. This may be a simple developmental issue such as sound substitutions (e.g using ‘t’ instead of ‘c’ so that ‘cat’ would be pronounced ‘tat’) or something more complex such as verbal dyspraxia in which an individual struggles to coordinate their oral muscles to sequence speech sounds.

-Speech Therapy isn’t just something that takes place in clinics and hospitals!

I think traditionally, people view Speech and Language Therapists within a ‘medical model’, based in clinics or hospitals. And yes, some SLTs do work in these settings…But we also work in the community, in people’s homes and in schools.

I split my working week between special schools and mainstream schools. In a school setting, health and education merge to meet the child’s needs. Having a good understanding and use of language is crucial to enable children to access the curriculum.

–Speech and Language Therapy isn’t just about talking!

Communication is a complex, multifaceted skill. To chat with others, you must understand the conversation, be able to remember what has been said, interpret body language, select the words you want to say, structure them in a sentence, etc, etc!!

Speech and Language Therapists support people who struggle with any element of communication. That may be by developing a person’s understanding of language, working on auditory memory skills, developing vocabulary, supporting verbal reasoning skills, etc..!

This is what I love about my job- the variety! Of course, all SLTs will specialise in specific areas but we have to draw on our knowledge of all aspects of communication to support each individual.

–Speech therapy advice is beneficial for supporting ALL children, not just those with identified needs.

Training is quite a significant aspect of an SLT’s role….And while we provide training on supporting children with speech and language difficulties, SLTs can also provide whole school training on approaches that can benefit all children. Vocabulary development, memory, verbal reasoning skills- these are just a few training sessions I’ve run within school settings, focussing on supporting every child in the classroom! After all, every child can benefit from a language rich environment, with strategies to support their learning!

–Speech therapy is tried and tested!

SLTs are getting better at the majorly important concept of evidence based practice! We understand that it is crucial to use tried and tested therapy approaches. The Communication Trust even have this handy database on their website known as ‘What Works?’ (http://www.thecommunicationtrust.org.uk/projects/what-works.aspx) to keep us up to date with researched interventions and their efficacy.

But in simpler terms, within daily working life you can see results occurring- from supporting  someone who was non-verbal in beginning to use a communication aid successfully, to watching a child grow in confidence in communicating with their peers…There are all kinds of little (and large!) victories that can occur with a little help from a Speech and Language Therapist!

 

This isn’t an exhaustive  list of what SLTs do and/or don’t do; just an attempt to make our role a little clearer. As us SLTs continue to fly the flag to promote our cause, I’m curious if I will begin to get a range of new responses when I tell people I’m a Speech and Language Therapist…!

* For more information on the statistics included in this blog post that specifically focus on the impact of speech, language and communication difficulties, this document by The Communication Trust is well worth a read: https://www.thecommunicationtrust.org.uk/media/31961/tct_genadrift.pdf

 

Laminators at the ready! Making an effective communication book

It’s time to heat up your laminators and get your hole-punches ready…. We’re talking communication books today!

I love high-tech communication aids as much as the next Speech and Language Therapist but I still find it hard to beat a ‘no-tech’ communication book;  it doesn’t run out of battery and even when it’s looking a bit tired and tattered, there’s that satisfying feeling of knowing it’s been well used!

If you have made a communication book before, you will know it is no mean feat…There’s a lot to consider before you even get to the ‘production stage’.

As someone who has made quite a number of communication books, I have found that there are a few general ideas that seem to contribute to putting together a top class communication book! So here are a few points to consider:

1. Organisation!

Most people who know me would probably say I can be a little disorganised. Now the problem with that is that I can’t always find things when I need them…

Why am I telling you this?! Well, our children need to be able to find what they want to say in their communication book as easily as possible…And the only way to do this is by having an organised system.

I view communication books as having 3 main organisational systems.  Here are some pros and cons to each system:

• Category based-The contents page is organised in terms of categories e.g. food, people, feelings, etc.
• 

Pro: This can be useful for children who are verbal but need something to supplement their speech, providing a bit of context. It’s also a very simple, easily understood format for children who may struggle to navigate through a communication book.

Con: It  can limit what a child can communicate about, making it difficult for conversation to ‘flow’.

• Socially focused- This type of communication book focuses on 2-way conversation, encouraging the communication partner to also use the book to communicate with the child providing aided language input. You may have heard of PODD books (Pragmatic Organisation of Dynamic Display…Thanks goodness for the acronym!!) which are the gold standard for socially organised communication books! They have topic ‘branches’ that enable the child to expand on their message.

You can read more about PODD here: https://www.novita.org.au/equipment/podd-communication-books/

You can also find PODD book templates on Boardmaker Online by simply typing ‘PODD’ into search!

Pro: PODD books are an amazing way for a child to have a proper, flowing conversation, adding rich detail. Following the ‘branches’ in the book helps the child to develop a motor plan as to where certain vocabulary is stored.

Con: Parents and school staff are sometimes initially overwhelmed when they see a PODD book- they are big and may look complicated. But with a bit of practice, it soon becomes easy to navigate!

• Pull-out tabs-Some communication books offer constant access to the same core vocabulary with a pull out tab that can be used with every page of the book. This also frees up space for more vocabulary on the pages!

Pro: Important words are always available and are always in the same place!

Con: It can be a little fiddly and it may be tricky for the child to initially get used to using the page and the pull out-tab. But the consistency of having the same words to hand, helps the child to soon over-come that hurdle!

It doesn’t matter what system you opt for, so long as it is clearly laid out, accessible for the child and frequently modelled, the book will be a success!

2. Sentence Building with colour coding

Imagine a child using a communication book that only gave them access to nouns. Their food page might have symbols for chocolate, yoghurt, banana, toast, juice, apple, etc.

How would the child tell you that they didn’t want their yoghurt? Or that they liked their juice and wanted some more? Or that their apple had rolled off the table and fallen on to the floor?!

They just couldn’t! That’s why we need to consider giving our children access to a wide range of vocabulary on each page, enabling them to build sentences.

To support sentence building, there are some very clever colour-coding strategies that help children to visually see the building blocks of a sentence.  One of the most popular methods is known as the Fitzgerald Key. Different types of words are represented by different colours. This helps the child to understand the function of words and how they fit together to make sentences.

I also like to lay the page out in a logical order, so that common sentence starters are in the first few columns, followed by verbs and/or adjectives in the next columns and then finally, nouns towards the right hand side of the page. This visually helps the child to understand the structure of a sentence.

3. Personalisation!

It’s important that the child identifies the book as being ‘theirs’. The more personalised, the better! Add photos of important people, places; Google images of favourite TV shows, frequently visited fast food restaurants, etc.

It’s also useful to have the child’s picture at the front of the book and a message from them about how to support them to use their book e.g. “Hi, I’m Becca! This is my communication book. Help me to use it by flipping to the page that I point to…..”, etc.

4. Protecting the book!

So you’ve spent an entire day, printing, laminating, hole punching….The last thing you’d  want would be for pages to be torn and dog-eared within a few weeks! Communication books are precious! We need to ensure that they are given the respect they deserve!

And for me, the best way to do this is to purchase a sturdy binder…. I love, love, LOVE these purpose made communication book binders from Ability World: http://www.ability-world.com/podd–communication-book-binder-a4—rigid-covers-4475-p.asp

They come in a variety of designs and they are flexible so pages can be flicked through easily. They might be a bit pricier than a lever arch file but they are much more user friendly which is of high importance for communication book users!

 

So there you have it- the golden rules that I follow each time I make a communication book!

While it may be time consuming and laborious at times, the results of a well designed communication book are worth the effort. Let’s make great communication books that our children are excited to use!

Right, I’m off to do some more laminating….!!

‘The difficult second word’- Moving from single words to forming phrases

Thomas Jefferson is famously quoted as saying, “The most valuable of all talents is that of never using two words when one will do”- Wise words that I often try to remind myself of when I’m typing an overly wordy email!

However, most of the time, one word or even a short phrase is simply not enough to convey what we mean.

If you work with children who use AAC you will know that moving from single words to combining words is a big deal!! You know the way musicians talk about ‘the difficult second album’? I sometimes think of it in these terms when working with children who use AAC- ‘The difficult second word’..!

Some children get ‘stuck’ at the single word stage for quite some time. Communicating through single words is not only limiting but it also leaves our message open to misinterpretation.

I’ll give you an example- I work with a young girl who uses an eye-gaze communication aid and who happens to be a Justin Bieber fan (Who doesn’t love a bit of ‘Despacito’?!). It is not unusual to hear her announce, “Justin Bieber!” (2 words but 1 symbol!)

Now what does this mean? I model combining 2 symbols- “Are you telling me that you  ‘like‘ ‘Justin Bieber’? Or you ‘want‘ ‘Justin Bieber’ on YouTube?” Equally, it could mean, “Look, Justin Bieber just walked past!”

Implausible, yes, but one word can have multiple meanings!

So how do we move our children using AAC past single words on to the tricky concept of making phrases? Here are a few ideas to try!

– Core words are key

Quite frequently, children starting out using AAC will have a very ‘noun heavy’ vocabulary. That’s because requesting has possibly been their main function of communication.

Typically, the most frequently used words by verbal children are NOT nouns- They are modifiers (more, different, some), verbs (help, like, stop), pronouns (I, you, they), etc. These are what we think of as core words.

Core words are the words that we use again and again in a variety of contexts. Here is a lovely list compiled by AAC Language Lab of 100 important core words. This list combines the research of multiple authors, interested in the high frequency words of children:

https://aaclanguagelab.com/files/100highfrequencycorewords2.pdf

The thing about core words is that they are often the foundation for forming a phrase. Have a look at the list and think of how many simple phrases you can make using these words alone! And then when you start to add in all those nouns that a child already knows, there are endless combinations of phrases that can be created and used in multiple contexts!

So when you are introducing an AAC system, don’t forget to always provide access to core words and constantly model their use!

– Expand!

This is a standard principle of language development; when a young, verbal child is learning to speak and they say a word such as “Car!”, an adult adds an extra word to model a phrase e.g “Yes, fast car!”

This principle is exactly the same for AAC users! The only modification is that we model this using their AAC device (this may be a high tech VOCA or a simple communication book).

The child points to “Cake” in their communication book and you then expand on this, adding an extra word, pointing to the symbols and saying, “Oh, ‘more’ ‘cake’!”

– Repeated phrase structures

There are lots of set phrase structures that we use in the English language again and again e.g Person + Verb (“Joe is reading”). It makes sense that we introduce our AAC users to certain phrase structures, creating opportunities to use variations of a phrase multiple times in one activity.

Here are a few possible word combinations that can be targeted in motivational activities:

– Person + ‘turn’– When playing a group game, give your child using AAC an important role- They have to tell the group whose turn it is using the person’s name + the word ‘turn’. This is a nice way to introduce word combinations as the word ‘turn’ remains the same each time, only the person’s name has to change! Also don’t forget to model ‘my turn’ and ‘your turn’, introducing pronouns.

– ‘More’ + artist’s name– Make a YouTube playlist of your child’s favourite songs. During each song, pause the track at least once. The child then has to request ‘more’ + the artist’s name. To expand on this, add a few songs that they can’t stand! Then you can work on ‘stop’ + artist’s name!

– Person + verb-  Play an adapted version of ‘Simon Says’;  the child has to choose a person and then an action for them to perform. Most children particularly enjoy involving class staff in this game (e.g “Mrs Smith dance”)…! Class staff might not enjoy it as much but hey, it’s all in the name of communication!

– Opinion + activity- Children like to talk about their hobbies…but even more than that, they like to give opinions! I tend to start with symbols for ‘like’ and ‘don’t like’ and then introduce more specific opinion words such as ‘funny’, ‘boring’, ‘exciting’, etc. This idea works well as a group activity. Each child can choose an activity and then give an opinion e.g ‘Like swimming’, ‘Don’t like cooking’, etc.

– ‘Want’ + body part/clothes- A simple game to play with Mr Potato Head! e.g. “Want eyes”. Easy but effective!

 

Once a child has a solid bank of 2 word phrases, it won’t be long before they start experimenting with adding more words. They will have now established the concept of joining words together and you can continue to model how to expand things further.

In the world of music, the third album is never as difficult as the second…In the world of communication, once those second words become spontaneous, three and four word phrases shouldn’t be far behind!