 |
||||||
|
||||||
|
 |
|
|
||||||||
 |
||||||||
|
Find out in this Q&A with the authors of AAC Strategies for Individuals with Moderate to Severe Disabilities |
|
About the authors
Susan S. Johnston, Ph.D., is a professor in the Department of Special Education at the University of Utah. She serves as director of International Initiatives for the College of Education and has served as associate dean for Academic Affairs. Dr. Johnston conducts research, teaches, and provides technical assistance in the areas of augmentative and alternative communication (AAC), early language and literacy intervention, and early childhood special education.
Joe Reichle, Ph.D., is a professor and American Speech– Language– Hearing Association (ASHA) fellow at the University of Minnesota. He holds a joint appointment in the Departments of Speech – Language – Hearing Sciences and Educational Psychology. Dr. Reichle is an internationally recognized expert in the areas of augmentative and alternative communication and communication intervention for individuals with significant developmental disabilities. At the University of Minnesota, Dr. Reichle has served on the executive committee of the dean of the graduate school, was associate chair of the Department of Speech– Language– Hearing Sciences, director of the Autism Certificate Program, and research director of the Leadership and Education Program in Neuro-developmental Disabilities.
Kathleen M. Feeley, Ph.D., is an associate professor in the Department of Special Education and Literacy, at the C.W. Post Campus, Long Island University. She is the clinical coordinator for the Certificate in Autism and Special Education program at C.W. Post Campus. She is also the founder and director of the Center for Community Inclusion at C.W. Post Campus. Dr. Feeley provides training and technical assistance to families, school districts, and adult service agencies as they include individuals with developmental disabilities within their communities. She is senior editor for the journal Down Syndrome Research and Practice.
Emily A. Jones, Ph.D., is an assistant professor in the Department of Psychology, Queens College, City University of New York. She teaches courses in applied behavior analysis and developmental disabilities, and provides training and technical assistance to families, school districts, and other service providers to support children with developmental disabilities in inclusive settings. Dr. Jones's research involves the development and demonstration of interventions to address early emerging core deficits in young children with developmental disabilities such as autism and Down syndrome. Her current interests are in the area of social and communication skills, including joint attention in children with autism and early requesting skills in children with Down syndrome.
Questions? Customer Service:
|
Q: Your new book outlines interventions to help learners with disabilities acquire functional communication. What sort of learner does your book focus on? And who do you foresee using the strategies outlined? A: The intervention strategies addressed in our book are designed for learners with moderate and severe developmental disabilities who have limited or no spoken language. The book is intended for transdisciplinary audiences, including speech–language pathologists, special educators, and other allied disciplines. Q: For an interventionist just beginning to work with someone with limited communication, how has the field changed since the early 1990s? A: There are far more intervention strategies available than in the early 1990s. We are implementing augmentative systems far earlier than 20 years ago. More attention is being given to the communicative functions associated with challenging behavior. We are increasingly considering the importance of using a combination of augmentative communicative modes. With increasing opportunities for software and hardware to meet the communicative needs of AAC users, researchers are beginning to scrutinize the skills required to use navigational strategies such as scrolling. The role that context may play in configuring graphic symbol arrays is also beginning to receive increased attention (e.g. visual scene displays vs. traditional grid-like displays). Evidence is also accumulating to suggest collateral gains in speech production and comprehension as a result of the implementation of augmentative communication systems. Q: What sort of collateral gains? A: A collateral acquisition occurs when behavior that was not the intended focus of intervention is acquired and related to the intervention implemented. Collateral communicative behavior is a particularly important topic given the common fear among parents that AAC may impede spoken communicative development. Although the data are limited, there is good reason to believe that this is not the case. For instance, whenever a child selects a graphic symbol on a speech generating device, a spoken word is produced. Among children who are imitative, this produces a spoken model that can be imitated. Over time, the models produced by the device that are imitated by the child likely lead to the acquisition of spoken language. We also have discovered that the pairing of spoken words with graphic symbols can facilitate comprehension of spoken language in some learners. The spoken word is paired with an item or event that is present. We believe that this pairing across opportunities results in spoken words being matched with objects and events for a number of beginning AAC users. Q: It's been said that, if you know one child with autism, you know one child with autism. The same holds true for a learner with limited communication. What are some considerations an interventionist must look at in creating an individualized communication system? A: Interventionists must consider any alternative to speech in terms of its efficiency from a learner's standpoint. How quickly will use of the system get the desired outcome? How much physical and cognitive effort must be expended to use the system? For individuals using graphic symbols, selecting the type of symbol is a critically important decision. Often interventionists select symbol type (e.g., line drawings or photos) based on interventionist convenience vs. learner need. There are systematic methods that can be used to make these decisions, which are outlined in the book in detail. Much the same is true for how symbols are displayed (e.g., traditional grid vs. visual scene). Other considerations include the size of symbols used. Interestingly, visual acuity is often overlooked during assessment. Once intervention begins, interventionists rarely consider using communication conditionally. Q: What do you mean by "using communication conditionally"? A: If I teach a learner to request assistance, for instance, it is important that they learn to issue a request only when they are not capable of acting independently. This means that in some contexts the request should be used and in others it shouldn't. If this fails to be taught, the learner runs the risk of engaging in learned helplessness as a result of their new communicative skill (failing to become more independent because they can request assistance). For example, a child can be taught to ask or signal for someone to pass the ketchup bottle if it is too far. If it is within reach, we want to provide a more powerful reinforcer to encourage the child to get the bottle him- or herself. Although teaching conditional use of newly acquired behavior appears to be effective, this strategy seems to be being applied sparingly in practical settings—for reasons we are still studying. Q: . How can low-dose intervention help generalize a newly established behavior? A: Applying only a portion of the original, higher-intensity intervention may be sufficient for establishing a newly acquired behavior in a second setting. Suppose that a new skill is established in one context (e.g., appropriately requesting a toy in a classroom) but fails to generalize to a different context (child continues habit of squealing for a toy at home). Sometimes the skill fails to generalize because an old, less socially acceptable behavior continues to work in the context where intervention has not occurred. In such a situation, low-dose intervention may involve discontinuing reinforcement for the old behavior (family members cease passing the toy when the child squeals). For some learners that modest intervention may be sufficient for the new behavior to begin to be used. Q: How crucial is it for practitioners to assess and monitor the effectiveness of interventions? A: If you went to a doctor with a lump on your arm, you would want the physician to conduct tests to identify the issue and determine the best course of treatment. With some chronic health conditions such as high blood pressure, you would want your blood pressure regularly monitored to make sure treatments continue to be effective. Some educators don't do this. They simply estimate whether the intervention is working. In the absence of data, it is difficult to isolate why a program is floundering, which contributes to difficulty troubleshooting the program. Q: What support would you like to see practitioners receive to successfully implement evidence-based interventions? A: In many classrooms that I spend time in, educators don't systematically monitor their implementation of instructional programs. This suggests that many don't recognize the value of making data-based decisions. Care needs to be taken to make new information more accessible to busy educators. Online training with video examples is a great way to expose practitioners to evidence-based strategies in a way that makes learning more interesting.
Often problems encountered in implementing interventions involve teaching methodology. We know that the accuracy and consistency of instruction often is insufficient. We've found, for instance, that interventionists can be quick to abandon one strategy for another when the research demonstrates that it may take hundreds of teaching opportunities to establish functional communication with many learners. Persistence pays off. I'd like to see onsite assistance for interventionists to help them troubleshoot difficulties they encounter. Educators can be guided in how to best select and match a type of prompt to a learner's needs and then be able to fade the prompt systematically. With respect to graphic mode instruction, there are errorless instructional strategies that rely on stimulus shaping and fading. We know that these strategies are extremely viable with individuals who have difficulty learning, yet they often are not part of the interventionist's repertoire of teaching strategies. Innovative training of proven instructional methods and onsite assistance will lead interventionists to greater success. In our book, they will find step-by-step guidance on determining, implementing, and monitoring effective interventions for individual learners.
|
|
|
|
|
|
|