2000 Conference Proceedings

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Promoting Sentence Building Skills In Dynamic Display AAC Users (Lori Geist)

Presenter: Lori Geist, M.S., CCC-SLP / DynaVox Systems Inc.

Several major transitions in language use occur during the beginning years of learning to communicate. Each transition allows a person to communicate with greater complexity and flexibility. Many of these transitions appear to be facilitated to some degree by natural speech. This session will highlight the transition that takes place in moving from single words to multiword combinations, and the role speech may play in this transition. Using normal language development as the guide, the focus will be on intervention strategies for assisting augmented communicators in learning to combine symbols on an AAC display. Activities which may encourage language development in augmented communicators will be presented and demonstrated.

Communication efficiency is often a great challenge for augmented communicators, so ways to express full messages quickly must be provided. For this reason, many AAC dynamic displays are organized to allow the expression of full phrases with a single selection, rather than the building of phrases by combining single words. Full phrases programmed on a display undeniably increase the speed of communication, but may also limit the flexibility, accuracy, and precision of communication. Light offers the example of a boy who had a sentence indicating his dog's name programmed on his communication device. This sentence was the only method he had for communicating anything about his dog, so when he wanted to share more than the dog's name, he was severely limited (1997). The use of some full phrases on an AAC system makes a great deal of sense, but these should coexist with more flexible single words or symbols that can be combined to create novel utterances. This session will consider how strategies that have benefited speaking children in moving from single to multiword utterances may also encourage the transition for augmented communicators who are beginning to combine symbols on a dynamic display AAC devices.

Language learning is most greatly stimulated by successful communication. The strategies presented throughout this session will aim to increase augmented communicators' language skills without sacrificing efficiency and successful communication. In short, the challenges of altering an augmented communicator's system to encourage the development of language skills, without hindering his/her success in communicating during this period of transition, will be addressed. Several ways to promote successful communication from primarily word based AAC displays will be presented. The principles and ideas discussed will be demonstrated using DynaVox dynamic display technology, and will be applicable to the users of a variety of dynamic display AAC devices. The strategies will be presented as a set of supplemental ideas to compliment the intervention plans currently in place for an individual using a dynamic display AAC device. Participants will be encouraged throughout the session to exchange intervention experiences related to assisting AAC users in making the discussed transitions.

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Three AAC vocabulary organizational strategies, including semantic category based, activity/environmental based, and grammatical category based, will be briefly reviewed (Beukelman and Mirenda, 1998). Participants will be guided to think about how these organizational strategies may promote semantic and syntactic development. Practical applications for promoting semantic and syntactic awareness, using these organization designs and the features of dynamic display technology, will be discussed.

Theories on the ways speaking children make the transition from single words to word combinations will be introduced. Ideas about the ways AAC users learn to combine symbols/words to communicate full phrases will be the emphasis. Participants will identify several characteristics of AAC users with respect to semantic-syntactic development. The intervention challenges of encouraging syntactic language development with AAC users who are effectively communicating from displays that are primarily "phrase based" will be addressed. The term "phrase based" will be used to refer to displays that are programmed to speak a full message with a single input from the augmented communicator.

The strategies presented will be based on two forms that typically assist this transition in normal development. The first form is successive one-word utterances, and involves the sequential production of two words (each with its own intonation pattern) to express a semantic relationship (Paul, 1997). An example would be using "Me. Drink." to mean "I want a drink." The second form is the unanalyzed language chunk idea, which suggests that children learn phrases as one unit and then begin to analyze the parts (i.e., words) later on. This suggests that "see you later alligator" and "happy birthday" may initially be understood and used as a string of sounds that create one "giant word" (Paul, 1997).

One intervention approach for promoting the use of successive one-word utterances is referred to as "vertical structuring" (Schwartz, Chapman, PreLock, Terrell, & Rowan, 1985). A series of pictures or objects that an individual already has some experience indicating on a communication device may be shown. The individual can then be asked, "What's this?" If the child responds accurately, the follow-up question may be "What color is it?" or "What do we do with it?" The interventionist could then follow up with an expanded sentence, and model the sequence on the communication device (e.g., "the sun is yellow" indicated by the selection of sun + yellow on the AAC display). DynaVox Systems Software (DSS) Child User pages will be used to simulate variations of this intervention approach.

Considering the "unanalyzed chunk" form that appears to assist in this semantic-syntactic transition in normal development, it seems logical that many AAC users may also initially view the full phrases programmed on an AAC display as "giant words." As previously mentioned, these phrases may increase the speed and efficiency of the AAC user, but encouraging too much dependence on full phrases programmed for a single selection may decrease overall accuracy, precision, and flexibility for creating novel utterances. These phrases may be gradually broken down into more flexible forms. Considering the "giant word" examples from above, a display with the phrase "See you later alligator" could have the phrases "See me later alligator" and "See you after a while crocodile" added to it (Paul, 1997). The objective would be to show the AAC user that this phrase is made up of separate words, and that each can be broken down and changed slightly to communicate different messages. With the AAC user's demonstrated understanding of the differences, the interventionist may begin introducing the phrase as separate symbols/words to be combined on the AAC display.

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Suggestions will be provided for breaking out the parts of a sentence/phrase in ways that are meaningful to the AAC user. The importance of maintaining consistency with the previous phrase based displays will stressed. Ideas for strategic color-coding and consistent placement of items to increase the AAC user's identification of the parts of a sentence/phrase will be provided. In addition, ways to provide increased visual and auditory feedback will be discussed. For example, a programming option available on many dynamic display devices that will highlight the parts of a message as it is spoken, providing auditory and visual feedback benefits, will be demonstrated.

This session will emphasize the importance of providing the AAC user with access to "new" vocabulary, especially referential and relational words, so that combination and successive one-word utterances are possible. Lloyd, Fuller, and Avidson describe vocabulary that individuals are learning, but are not yet able to consistently recognize or read, as developmental vocabulary. Developmental vocabulary items encourage communication development by adding words such as adjectives and adverbs for modifying nouns and verbs, so that two or more words can be combined (1997).

With respect to the Child User in DynaVox Systems Software, coverage vocabulary is provided to allow the AAC user to begin to explore, understand, and express the relationships of the words in his/her vocabulary, without sacrificing efficiency of communication. Methods of access to new words in DynaVox System Software include: (1) the use of vocabulary search features to access the system's dictionary, (2) the use of the Dictionary pages that are preprogrammed with concept searches, and (3) the "Like This" command button which can be placed on any communication page to function like a thesaurus. These features will be briefly highlighted.

As an individual gains sentence building skills, movement from primarily phrase based communication pages to word based communication pages seems logical and appropriate. Such a move should increase the augmented communicator's freedom to express novel utterances. One example of such a move in DynaVox System Software is from the Child User to the Teen User. The Child User provides both full phrase messages and single words/symbols, allowing the AAC user to begin to compose simple multi-word utterances without requiring complex syntactic structuring skills to communicate a message. The Teen User encourages greater independence with constructing phrases and sentences, while continuing to provide some meaningful single selection phrases to meet the AAC user's needs in certain situations. The Child and Teen Users in DynaVox System Software will be used to highlight the discussed strategies for transitioning an AAC user to communication pages that require greater sentence building skills. The strategies discussed for promoting such a transition without disrupting the augmented communicator's success, and the principles of maintaining consistency with the previous communication pages will be reviewed.

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Beukelman, D. & Mirenda, P. (1998). Augmentative and Alternative Communication: Management of Severe Communication Disorders in Children and Adults. Baltimore, MD: Paul H. Brookes Publishing Co.

Light, J. (1997). "Let's go star fishing": Reflections on the contexts of language learning for children who use aided AAC. Augmentative and Alternative Communication, 13, 158-171.

Paul, R. (1997). Facilitating Transitions in Language Development for Children Using AAC. Augmentative and Alternative Communication, 13, 141-147.

Schwartz, R., Chapman, D., Prelock, P., Terrel, B., & Rowan, L. (1985). Facilitation of early syntax through discourse structure. Journal of Child Language, 12, 13-25.

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