My Top 5 “Ah Ha Moments” From #ISAAC2016

Originally posted on NWACS blog

It’s hard to believe that it has been a full 3 months since the ISAAC conference in Toronto!  As a first timer, I have to admit that I was both in awe and overwhelmed at the amazing depth of this conference.  I felt a lot like a groupie amongst some of the most well known and infinitely respected “rock stars” in our field!  It was a wonderful time and place to learn, to be reminded, to be inspired, and to connect.  It was definitely hard to pick just a few takeaways to share, as I left each session inspired to try something new, pumped to be on the right track, and at the same time thinking “oh dear, I’ve been doing it all wrong!”  But, here are a handful of my big “Ah Ha Moments”:

1.  There’s More to Life (and AAC) Than Facebook

In a clever and captivating pre-conference session, Dr. Carole Zangari of PrAACtical AAC and Chris Bugaj of the A.T.TipsCast podcast and companion blog shared some cool new ways for busy AAC professionals to use technology in their service delivery.  Sure, Facebook was in the mix-but also, so much more!    And this duo didn’t just stop at social media but revealed some powerful online tools that I hadn’t even heard of! 

Amongst the tips and tricks shared:

·      Tools to build interactive activities and images-such as, Screencasts. Image Captures, and Infographics.  My favorite in this category- ThingLink, where you can take a catchy image and create little hot spots of interactivity, linked to videos, other pictures, text and more!  I really saw some nice teaching opportunities in this tool, not only for my clients but for therapy students and parents.

·      Tools for digital curation-such as the well known Pinterest and some lesser known web link curation options like Diigo and Livebinders.

·      Tools for disseminating information to both professional and client audiences-such as Facebook Groups and pages where you can create a place for professional collaboration between care or education teams and parent/caregiver support.  Speaking of valuable groups and pages on Facebook-if you’re interested in collaborating with other tech savvy SLPs looking to use social media and web technology in their service delivery, join the closed Facebook groupAAC Practitioners in the 21st Century (created by Carole and Chris for this ISAAC talk)  If Facebook isn’t your thing, you could also check out the Google+ AAC community here

·      Digital tools for teaching- such as creating short “How to” videos for parents and other professionals on your care team using Vine (check out the slide show from this talk for great examples of this in action)

Unlike many other “app” and “tech” talks in the AT/AAC field that I’ve attended, this one actually had some well developed case examples for many of the tools provided which not only helped me trust the evidence basis, but also really get a picture for how to apply the technology to clients on my caseload.  And because they really are the sharing type, you can find the slides for this presentation here.    AAC Practitioners in the 21st Century: Leveraging Our Efforts through Social Media and Digital Technologies

2.  Communicating in Boxes (or Grids) Isn’t For Everyone

 Dr. Janice Light of Pennsylvania State University presented on some eye-opening research relating to grid-based communication displays and language intervention for early communicators (under the developmental stage of 4 years).   This was one of those talks that left me thinking “oh dear, I’m doing it all wrong!”-but, I was jazzed to try these new ideas on for size with some of my little guys in the EI setting.  Dr. Light and her team at PSU continue to explore the use of visual scene displays as a means of creating a context for early communicators that grid-based displays (i.e., vocabulary arranged in a grid of boxes) lack.  She also discussed some considerations for the layout of these scene displays, including the use of personal photographs versus drawings or stock photographs, and the necessity to include people in the scene.  The PSU team is exploring the use of theSnapScene app by Tobi Dynavox as one possible tool for creating AAC displays that may be more appropriate for early communicators.   The AAC at PSU website has some great resources on considerations for the design of AAC displays here.   There is also some great info on additional considerations for AAC intervention with young children here

I always enjoy the research and evidence basis of Dr. Light’s talks and I was additionally excited to hear about some practical clinical strategies that I had already been using but didn’t know the name for!  One of the strategies discussed:  “just in time programming”- a fancy term to describe what you’re doing when you add a new word or phrase to a communication display as the opportunity arises during a communication interaction with the communicator.  Dr. Light discussed the efficacy of this strategy, as well as some considerations in the development of AAC technology that makes implementing this strategy easier for communication partners (e.g., SLPs, educators, and parents).  Here’s a poster presentation with just a snap shot of this research. 

3.    PECS CAN Help Early Communicators Be Spontaneous Communicators (If We Follow the Protocol!)

 I admit that PECS is not usually a go-to strategy for me in my daily work these days, but nonetheless, I really appreciated this talk by Dr. Pat Mirenda which emphasized the use of PECS to support initiation of communication (i.e., spontaneity) in individuals with Autism Spectrum Disorder.   This talk highlighted a common experience for me: encountering child after child in my work who have been “using PECs” for years and continue to require adult prompting to initiate communication using their system.  It was suggested that this failure may be largely due to mistakes we make as communication interventionists in the implementation of the PECS protocol.   Dr. Mirenda shared a great resource for continuing education on the correct implementation of PECS-the PECS module in Autism Internet Modules on the OCALI website.  This resource has a full training-outlined step by step in written and video format- to correctly implement all phases of the PECS protocol.  Whether you have been using PECS for years and need a refresher, are asking yourself “Wait-AM I doing this right?”, or are brand new to PECS, this resource is a must see.  It’s free to sign up and you can even get CE credit for completing this or other modules on the site.    

Dr. Mirenda also shared that there is a series of PECS apps that might be appropriate for certain users of the static system moving to a voice output option.  Lastly-she started “speaking my language” when she emphasized the necessity to “move beyond PECS” and support communication with core and fringe vocabulary displays-simultaneously with PECS, or as a next step.  This was definitely a moment of validation for me as my work revolves each day around core and fringe!

Want to see more?  Check out #ISAAC2016 on Twitter for a collection of highlights shared by ISAAC attendees from around the world!  You can also visit ISAAC’s website for a full list of 2016 conference speakers and topics.

And see you in Australia for ISAAC 2018!

What was your Ah-Ha moment from ISAAC?


10 Reasons Why ALL Children With Autism Need AAC

Children with Autism Spectrum Disorder (ASD) have become a large part of my practice as an SLP.  I am always surprised, however, that even with all that we know about the social and communication challenges facing these kids in the short and long term, many will reach school age having minimal to no exposure to a reliable AAC system.  Communication and social interaction begins for all children at birth and these early foundations are what successful relationships and learning experiences are built upon.  All children with ASD will struggle to talk to some degree throughout their lives.  Some won’t talk at all, some will be slow to learn to talk, while others may talk more freely but be difficult to understand.  These children will also struggle with the overfall process of learning language, understanding others, engaging in important interactions, and realizing that communication makes the world go ‘round!  The struggles and triumphs of ALL children with ASD are best supported when we offer the tools needed to access the world.  One of the most important tools that we currently have to offer is AAC- here are a few reasons why:

1.  AAC breaks down barriers   

Communication is not just talking and in fact, all children-including those without ASD- will use forms of AAC to communicate as they learn to speak.  Speech is a motor skill that requires the coordination of many systems in the body with planning that occurs in the brain.  This skill is a complex one that works in partnership with language to form verbal communication.  Language, however, is not a motor skill but a cognitive skill that can be learned and expressed with or without speech.  Many children with ASD struggle with the motor planning skills required to produce consistent and clear verbal speech-a condition often described as apraxia.  By providing frequent, motivating opportunities to learn and use language through AAC strategies, we allow language and overall communication to flourish without restricting opportunity in the presence of challenges with speech (motor) skills.  

2.  AAC improves access to learning opportunities

Research has shown that the use of AAC has a positive impact on other areas of academic and social development.  By providing a supportive system to improve receptive and expressive communication, children with ASD who use AAC are more able to access the classroom curriculum and participate in the daily routines enjoyed by their classroom peers.  Think about the learning opportunities that occur during a social (communicative) activity like circle time or show and tell that would go otherwise unrealized without a reliable means of communication.

3.  AAC provides opportunities to build relationships 

Communication plays a large role in social interaction and building relationships.  AAC strategies provide a child with ASD the tools to use communication for purely social purposes, rather than just to request wanted items or activities.  Using AAC, a child can gain the attention of another by calling his name, tell a joke, ask a question, or share information about himself with a new friend-acts which may be otherwise difficult or impossible with his current speech skills.  

4.  AAC makes spoken language visible

All children-especially children with ASD-learn through experiencing with their senses.  Visual learning and visual thinking have emerged as relative strengths for children with ASD.  AAC makes spoken language- an auditory message which is here one second, and gone the next-more visible and longer lasting.  With visual language provided by AAC, a child with ASD has more success understanding what is being said and more access to the vocabulary, language structure, and communication function needed to communicate his own message.

5.  AAC provides tools to manage challenging behavior

Many challenging behaviors emerge in children with ASD as a means of communicating with others in the absence of another way.  By providing a child who may be struggling to speak an alternate means of expressing such messages as discomfit, fear, or disagreement, we are able to offer tools to replace many challenging behaviors.  

6.  AAC provides opportunities for accidental communication 

"Accidental" communication shapes verbal language for children from birth.  As a baby plays with sounds he hears in the speech of his parents, he stumbles upon a few gems like "ma" and 'da' and is enthusiastically rewarded by his excited parents' reactions ("He said mama!")  That praise and encouragement leads to more and more repetition of these sounds which then leads to first words, and then to sentences and so on.  Children with ASD who struggle to speak and to engage in imitation and interaction with caregivers have minimal opportunities for such accidental communication.  AAC provides these kids with a way to "babble" and in doing so, to stumble upon a powerful word that results in enthusiastic reward and leads to more and more over time.  

7.  AAC supports spontaneous and novel communication 

Children with ASD often encounter restrictions when it comes to saying exactly what THEY want to say when THEY want to say it.  When a child has limited speech, we find ourselves asking many yes/no questions rather than open-ended ones, prompting for a request rather than allowing it to naturally occur, or anticipating needs and telling stories from our own perspectives.  AAC offers the building blocks for us as partners to model the language around important experiences as they occur and to provide each child with a menu of sorts for accessing that language later on-when THEY want to talk about THEIR experiences.

8.  AAC reduces frustration and improves communication success

Most of us don't particularly like doing things we don't feel good at and aren't particularly excited about being asked to do things we don't like to do!  AAC empowers children with ASD to communicate because it allows language to be more easily accessed.  With access, successful interactions with others, and a feeling of "I can do this!", we see children with ASD become more excited and less frustrated  about the prospect of communicating.

9.  AAC teaches language skills 

Sure, AAC is a tool for actually communicating but in addition to this important purpose (if not even MORE SO), AAC is a tool for LEARNING language.  What better way for a visual learner to learn word meanings, how to combine words into sentences, and how to use different words for different reasons than to present such lessons in pictures?  AAC provides kids with ASD a language roadmap that offers consistency, structure, and longevity in the frenzied world of spoken language.

10.  With AAC there is nothing to lose and everything to gain!

In short-AAC does not prevent or decrease speech!  in fact, research has shown that the use of AAC either has no effect on speech or improves speech-so what have we got to lose? Using AAC can be clumsy and it is certainly hard work for each child and everyone who supports him.  BUT, we certainly have so much to gain if we are up for the challenge!

What does your child with ASD gain from his AAC tools?  Please share comments and questions below!