2001 Conference Proceedings

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AUGMENTED COMMUNICATORS AND THEIR COMMUNICATION PARTNERS: A PARADIGM FOR SUCCESSFUL OUTCOMES

Sarah W. Blackstone, Ph.D.
Pat Dowden, Ph.D.
Mary Hunt Berg, Ph.D.
Gloria Soto, Ph.D.
Elisa Kingsbury
Mary Wrenn
Nicole Liborin

Abstract

The importance of communication partner training is widley recognized in AAC. However, we have limited research to guide our interventions and assess the interaction among the myriad of variables that affect successful outcomes in AAC. This session presents an approach to intervention based on the Circles of Communication Partners (CCP)paradigm. Profiles of augmented communicators will be described and practical strategies suggested.

Interaction, like a dance, reflects characteristics of the communication partners involved. Communicative interactions are governed by rules of social communication and discourse and reflect each interactants' ages, social roles and modes of communication, as well as the context and the skills and abilities of each partner. While the need for communication partner training has long been recognized in the field of AAC, research regarding characteristics of communication partners and partner training has not been a recent focus in the field (Culp. & Carlisle, 1988; Kraat, 1985; Light, Collier, & Parnes, 1985; McNaughton, & Light, 1989).

This session will present a paradigm using the Circles of Communication Partners (CCP) (Blackstone, 2000). We will also present data collected using a survey that employed the CCP in an effort to better describe groups of augmented communicators (e.g., (1) emerging communicators, (2) context-dependent communicators and (3) independent communicators (Dowden, 1999). and the AAC approaches that use to communicate successfully. We will discuss characteristics of modes employed with different circles of partners and issues related to partner training, AAC device/strategy selection and intervention approaches.

The initial survey was conducted in 2000 and presented at the International Society for Augmentative and Alternative Communication. Additional information is being collected by members of the Berkeley Study Group (see list of authors above). Those surveyed included speech-language pathologists, teachers, augmented communicators and family members. Survey questions asked participants to consider an AAC user who was either an emerging communicator, context-dependent communicator or independent communicator (Dowden, 1999).
Our results confirm that many individuals who use AAC have a restricted number of communication partners and have a disproportionate type of communication partner (e.g., friends) as compared to their able-bodied peers. Discussion will include information about the role of expressive capabilities in determining potential communication circles, as well as the amount and type of training communication partners may require. Implications for intervention will be considered.

Circles of Communication Partners Profile

The Circles of Communication Partners (CCP) is a paradigm adapted from Marsha Forest's Circle of Friends (Forest & Snow). It is being used in the survey to collect information about the communication partners of individuals who use AAC. The CCP profile for augmented communicators is useful clinically because it identifies the configuration of partners for individuals who use AAC across communication contexts (Blackstone, 1999). The augmented communicator is at the center. Emanating outward are five circles, which represent different types of partners (and relationships) as described below:

Preliminary data show that it is common for augmented communicators to have many people in their first and fourth circles and few people in other circles. Obviously, having limited access to language makes interaction more difficult and hinders the development and maintenance of friendships. Another problem for some augmented communicators is limited mobility and/or limited expressive language, which decreases opportunities for interaction, participation and independence.

Our study uses the CCP to: (1) identify communication partners in each circle, (2) Determine which partners are most familiar with the individual's communication methods, spend the most time with the user, are most available, are willing to facilitate interactions, have the knowledge, skill and opportunities to train others and are in the best position to assist the user to develop new relationships? (3) identify preferred modes of communication with partners in each circle and (4) determine the augmented communicator's role in partner training intervention.

Groups of augmented communicators

Thinking about how to address issues related to communication partner training may seem overwhelming to a clinician, teacher and family member. The initial study considered three groups of AAC users. The groups were defined solely on the individual's current expressive communication skills, not on their receptive language, cognitive abilities or "potential" as described below (Dowden, 1999). This particular way of describing AAC users helps in planning communication partner training. Other ways of describing groups of AAC users will be considered and discussed during the session.

Emerging communicators. Individuals with emerging expressive communication skills have no reliable method of symbolic communication. They communicate using gestures, facial expressions, vocalizations, etc. These non-linguistic and often idiosyncratic forms significantly limit the range of messages they can convey. These individuals may be very young, older with significant developmental delays, or adults with severe acquired speech and language impairments. Some emerging communicators fall within this category because they do not yet have access to appropriate AAC strategies and technologies (Dowden & Cook, in press).

Emerging communicators need maximal support from a skilled AAC facilitator. The communication support person (facilitator) must be able to encourage interaction, understand and interpret idiosyncratic behaviors and support both partners during an interaction. In addition, a facilitator must encourage the augmented communicator to use more conventional expressive forms. Even familiar partners have difficulty interacting with an emerging communicator. Emerging communicators rarely interact with people they don't know. When they do, both partners require considerable support.

Context-dependent communicators. Individuals with context-dependent expressive skills communicate reliably using both symbolic and nonsymbolic modes. While they can express a range of communicative functions, they often remain dependent on familiar partners because others do not easily understand the modes of communication they use, e.g., partner-assisted scanning, eye-coding system or severely dysarthric speech. Individuals may also be dependent communicators because they have had limited AAC intervention, have inadequate or inappropriate vocabularies in their existing AAC systems and/or have no way to produce novel messages. Facilitator's may or may not be involved with familiar partners; however, when context-dependent communicators interact with unfamiliar partners, communication support is often required.

Independent communicators. Individuals with independent expressive communication skills can interact with both familiar and unfamiliar partners about any topic. These individuals may or may not use equipment, and may or may not have receptive and cognitive skills that are considered normal or age-appropriate. Under some situations, independent communicators may choose to depend on a familiar partner or facilitator to provide some support; however, they are independent in most contexts.

Intervention strategies

Training a family member, paraprofessional, teacher, community helper, etc. to facilitate interactions between individuals who use AAC and their communication partners is "not a one shot deal" (Blackstone, 1999; Cumley, 1989; Fried-Oken et.al., 1999) Giving someone "off the cuff" suggestions, conducting a workshop, providing a check list, a training package, a chapter on communication partners, or a written report with suggestions does not and can not change communication behaviors. "Telling" someone to "pause for ten seconds" and "look expectant" won't work either. The session will suggest materials that take into account basic learning principles and address the needs of three groups of AAC users and their primary communication partners.

References

Blackstone, S. (1991). Interaction with the partner's of AAC consumers: Part I - Interaction. Augmentative Communication News. 4:2, 1-3.

Culp, D. & Carlisle, M. (1988). Partners in augmentative communication training. Tucson, AZ: Communication Skill Builders.

Cumley, G., & Beukelman, D. (1992). Roles and responsibilities of facilitators in augmentative and alternative communication. Seminars in Speech and Language. 13: 111-118.

Dowden, P.A. (1999). Augmentative & Alternative Communication for Children with Motor Speech Disorders. In Caruso, A., and Strand, E. A. Eds.) Clinical Management of Motor Speech Disorders of Children. New York: Thieme Publishing Co.

Dowden, P.A. and Cook, A. M. (in press) Selection Techniques for Individuals with Motor Impairments. In J. Reichle, D. Beukelman & J. Light (Eds.). Implementing an augmentative communication system: Exemplary strategies for beginning communicators. Baltimore, MD: Brookes.

Forest, M. & Snow, J. May's map. With a little help from my friends. A videotape. Expectations Unlimited. POB 655, Niwot, CO 80544

Fried-Oken, M., Sharp, J., Remmer, L. & Staehely, J. (1999). Handout on Competency Rules) as cited in Blackstone, S. (1999). Communication Partners. Augmentative Communication News. 12:1&2, -6).

Kraat, A. (1985). Communication interaction between aided and natural speakers: A state of the art report. Toronto, Ontario, Canda: Canadian Rehabilitation Council for the Disabled.

Light, J., Collier, B., & Parnes, P. (1985). Communication interaction between young nonspeaking physically disabled children and their primary caregivers: Parts I, Discourse patterns; Part II, Communicative functions; Part III, Modes of communication. Augmentative and Alternative Communication (AAC), 1, 74-133

McNaughton, D. & Light, J. (1989). Teaching facilitators to support the communication skills of an adult with severe cognitive disabilities: A case study. AAC, 5: 35-41.


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