Creating Communication Environments

1
Creating Communication Environments

• An Overview
• Developed by
• Judi Cumley and Mary Wirkus
• Wisconsin Assistive Technology Initiative

2
Learner Outcomes

• Understand the foundations of functional and
  interactive communication
• Identify target activities and strategies for
  eliciting active participation by student(s)
• Select communication opportunities that are
  natural and appropriate
• Arrange the environment to promote communication
• Identify the steps in a least to most prompt
  hierarchy

3
Agenda

• Background of Creating Communication
  Environments (CCE)
• Purposes of Communication
• The Three Main Ingredients of Creating a
  Communication Environment
• Activity
• Environment
• Partner
• The Prompt Hierarchy
• How Can This Be Useful for YOU?

4
Background Information

• CCE is based on ECT (Environmental Communication
  Teaching) - developed by Dr. George Karlan at
  Purdue University
• Developed for a classroom TEAM
• Emphasis on eliciting communication within
  natural environments
• Originally developed as a 5-day training program
  for school-age children who use or need AAC
• Replicated throughout the country for children
  and students of all ages disabilities (CCE in
  Wisconsin since 1999)

5
Everyone Communicates

• Crying
• Eye contact
• Sounds
• Words
• Pointing
• Falling asleep
• Screaming

• Communication boards
• Picture exchange system
• Voice output systems
• Gestures/signing
• Hair-pulling

• Silence

6
Communication Purposes

• Expressing Wants and Needs
• Once desired action or object is achieved,
  communication ends
• Social Interactions including Social Etiquette
• Social vocabulary is difficult to provide, but
  vital for social acceptance
• Greetings, Conclusions, manners, etc
• .
• Exchanging Information
• Starts as joint attention then develops
  into more complex interchanges with
  content or topic specific vocabulary
• Janice Light 1988, 1997, 2005

7
Changing Purposes of Communication
Infancy
Secondary
Elementary
Sharing Information
Sharing Information
WANTS NEEDS
Sharing Information
Social Interactions etiquette
Social Interactions etiquette
WANTS NEEDS
Social Interactions etiquette

WANTS NEEDS
The importance of different communication
purposes changes over our lifetime J. Cumley,
2001 Based on J. Light, 1988, 1997, 2005
8
If we only have to think about encouraging our
students to communicate for three different
purposes, why is it so HARD..what can make it
easier?
9
AAC Augmentative/Alternative Communication

• refers to the ways (other than speech) that are
  used to send a message from one person to another
  (ASHA, 2005)
• Examples
• Communication boards/books/picture symbols
• Speech Generating Devices (SGDs)
• Picture Exchange Communication System (PECS)
• Morse Code
• Eye Gaze
• Picture Schedules

10
AAC can be a vehicle for developingexpressive
languagereceptive languageliteracycontrol
over the environmentcommunication initiation

11
AAC is not.
A last resort Giving up on speech Only for
those of a certain IQ or Age Only the job of the
speech-language pathologist
12
Myths and Misconceptions Young Children with
CCN (Complex Communication Needs)

• Myth and Misconceptions
• AAC hinders or stops further speech development

The Evidence AAC approaches (signs, picture
symbols, VOCAs) do NOT hinder speech
development. In fact, speech often increases
during AAC treatment approaches
VOCA Voice Output Communication Aid
From Augmentative Communication News, Volume
18, Number 2, June, 2006
13
Myths and Misconceptions Young Children with
CCN (Complex Communication Needs)

• Myth and Misconceptions
• There is a representational hierarchy of symbols
  from objects to written words

The Evidence Children can learn to understand and
use a variety of symbols at a very young age
(e.g., sign language) through repeated exposure
to the symbol and its referent in natural
contexts
From Augmentative Communication News, Volume
18, Number 2, June, 2006
14
Myths and Misconceptions Young Children with
CCN (Complex Communication Needs)

• Myth and Misconceptions
• Children must have certain skills to benefit from
  AAC (e.g., be at a certain age, have a particular
  cognitive or linguistic level, etc.)

The Evidence There are NO prerequisites for
communication. AAC focuses on all aspects of
communication and communication begins at birth.
AAC is an appropriate intervention approach for
anyone with CCN.
From Augmentative Communication News, Volume
18, Number 2, June, 2006
15
Myths and Misconceptions Young Children with
CCN (Complex Communication Needs)

• Myth and Misconceptions
• AAC is a last resort and means professionals are
  giving up on speech

The Evidence The Wait and See approach is not
an effective way for teams (e.g., speech-language
pathologists, teachers, paraprofessionals,
parents to develop communicative competence)
From Augmentative Communication News, Volume
18, Number 2, June, 2006
16
Using AAC effectively

• Communication partners must model AAC use
• Use of a penlight or finger on paper displays
  (aided language stimulation)
• Sit next to individual with device to facilitate
  modeling
• Use it as both a receptive and expressive tool
• Be natural-focus on communication, not the
  device/board
• AAC must be engineered into the environment
• Displays mounted around the room/school/home
• ACCESS to communication wherever student is
• Pool
• Playground
• Home
• Out shopping
• Bathtub
• School or instructional settings

17
When designing AAC overlays, be sure to
include...

• Vocabulary that reflects all 4 categories
• Wants Needs
• Exchanging Information
• Social Closeness
• Social Etiquette
• Use a communication board to talk to each other.
  Does it contain the 4 purposes of communication?

18
AAC

• Establishes a means of communication
• Provides opportunity for social interaction
• Promotes receptive communication
• Encourages expressive communication
• Decreases frustration
• Provides opportunity for initiation

19
Think about YOUR students who are struggling to
communicate effectively

• What are some characteristics of their
  communication?

20
Common Characteristics of Students Using AAC

• Rarely initiate interactions
• Usual form of communication is NOT using a
  communication device
• Gestural responses (head nods) to yes/no
  questions main form of communicating
• May use challenging behaviors to communicate

21
Common Characteristics of Students Using AAC

• Most vocalizations are unintelligible
• Rarely interact with peers
• Communication system may not be available when
  needed
• Necessary vocabulary is not programmed or correct
  symbol is not available

22
Supporting AAC users.Create a Communication
Environment

• Expect all students to communicate
• Recognize and respond to the students
  communication initiations
• Arrange the environment to increase the
  likelihood for communication
• Identify communication opportunities within
  natural routines and activities

23
Addressing Communication Challenges AND Creating
a Communication Environment

• Requires changes in the
• Activities
• Environment
• Partner

Communication
Activities
Partner
Environment
24
Incidental teaching episodes are brief,
positive, and oriented toward communication
rather than language teaching.
Dr. George Karlan
25
Selecting a Target Activity to Elicit
Communication

• Should be brief in nature, but occur 3-4 times
  per week
• Requires communication (initiations) by the
  student
• Activity should be process - not product oriented
• Activity represents a class of activities
• Art activities, cooking, reading books, snack
• Variation in content from episode to episode,
• but same core vocabulary
• Choices are offered during the activity
• COMMUNICATION
• is the goal of the Target Activity!

26
Selecting Target Activities

• Start by identifying a target activity
• Student must have a reason to perform the
  activity
• Activity must provide opportunities for success
• Must be motivating
• Must be functional and interactive
• Must be age-appropriate
• Must reflect family wishes/team consensus
• Describe your Target Activity on the
• Target Activity Form

27
The Target Activity Form- Sample
Students come to table at snack time. Snack
materials are on counter. Materials food,
placemats, napkins, straws, milk (white
chocolate), communication overlays for requesting
snack items standard vocabulary-more, all done,
uh oh, help, etc.
How is vocabulary represented Activity
Vocabulary Wants/Needs Social Interactions
Etiquette Sharing Information
28
Does your Target Activity have at least THREE
opportunities for the student to initiate?

• What does the student have to say to BEGIN the
  activity?
• What does the student to have to say to CONTINUE
  the activity?
• What does the student have to say to END the
  activity?
• If you cant think of 3 statements the student
  needs to say to be engaged in the activity.
• pick a different activity!

29
Communication Turns-example

• Snack
• Beginning Student asks for snack items.(e.g.,
  milk, cracker, napkin, straw, placemat)
• I want. Can I have . milk, etc.
• Middle Student asks for more, help, makes
  social, informational or etiquette comments to
  peers and adults
• I want more ., more ., good .. I like
  You want
• End Student indicates when finished
• (asks to be excused, says all done, asks for
  clean-up materials, asks to go to transitional
  activity)
• all done, clean up, no more, bye-bye

30
The Target Activity Form- Sample
Students come to table at snack time. Snack
materials are on counter. Materials food,
placemats, napkins, straws, milk (white
chocolate), communication overlays for
requesting snack items standard
vocabulary-more, all done, uh oh, help, etc.
How is vocabulary represented Activity
Vocabulary Wants/Needs Social Interactions
Etiquette Sharing Information
Student asks for snack items (e.g., Milk,
cracker, napkin, straw, placemat) I want
Can I have. milk
Student asks for help Student asks for
more Makes comments to peers and adults I
want more I like . good You want ..?
Student says all done when finished clean-up
go play bye-bye
31
Communication Considerations

• How will the vocabulary be represented (e.g.,
  objects, tangible symbols, photos, symbols, etc.)
  
• List the vocabulary that must be available. Try
  to have vocabulary that represents
• Wants/Needs
• Social Interactions Social Etiquette
• Sharing Information

32
The Target Activity Form - Sample
Students come to table at snack time. Snack
materials are on counter. Materials food,
placemats, napkins, straws, milk (white
chocolate), communication overlays for
requesting snack items standard
vocabulary-more, all done, uh oh, help, etc.
How is vocabulary represented? Communication
board with PCS symbols. Vocabulary for expansion
labeling. Student points w/some vocalizations.
Teacher models expands Activity Vocabulary
milk, straw, napkin, cracker, placemat Wants/Nee
dsI, want, more, help, specific snack items
Social Interaction Etiquettesit here, want
some?, please, thank you Sharing
Informationgood, yucky, uh oh, all done
Student asks for snack items (e.g., Milk,
cracker, napkin, straw, placemat) I want
Can I have. milk
Student asks for help Student asks for
more Makes comments to peers and adults I
want more I like . good You want ..?
Student says all done when finished clean-up
go play bye-bye
33
Video..
34
Addressing Communication Challenges AND Creating
a Communication Environment

• Requires changes in the
• Activities
• Environment
• Partner

Communication
Partner
Activities
Environment
35
Arrange the Environment to Increase the
Likelihood of Communication

• Common Strategies.
• Use motivating materials and activities
• Materials should be in view but not accessible
• Student should need assistance with some
  materials
• Provide small or inadequate amounts of materials
• Sabotage
• Provide something the student doesnt like/want
• Use communication boards/devices visual tools

36
Your Environment

• Are there any environmental changes you could
  make to increase communication?
• Activity-based environmental changes
• Material location, amount, type
• Communication-based environmental changes
• Picture symbols, communication boards, device
  placement

37
Video- Note Environmental Arrangements
38
The Target Activity Form - Sample
Students come to table at snack time. Snack
materials are on counter. Materials food,
placemats, napkins, straws, milk (white
chocolate), communication overlays for
requesting snack items standard
vocabulary-more, all done, uh oh, help, etc.
How is vocabulary represented? Communication
board with PCS symbols. Vocabulary for expansion
labeling. Student points w/some vocalizations.
Teacher models expands Activity Vocabulary
milk, straw, napkin, cracker, placemat ,
Wants/Needs I want, more, help, specific snack
items Social Interaction Etiquette sit here,
want some?, please, thank you Sharing
Information good, yucky, uh oh, all done
Student asks for snack items (e.g., Milk,
cracker, napkin, straw, placemat) I want
Can I have. milk
Student asks for help Student asks for
more Makes comments to peers and adults I
want more I like . good You want ..?
All students have snack placemat with specific
snack vocabulary velcroed on top core vocab.
permanently on sides. Single small pieces of
snack Straw on table, but out of reach Milk
carton not open Wrong flavor of milk (sabotage)
Student says all done when finished clean-up
go play bye-bye
39
Addressing Communication Challenges AND Creating
a Communication Environment

• Requires changes in the
• Activities
• Environment
• Partner
• (And that means YOU!)

Communication
Partner
Activities
Environment
40
What are some common characteristics of
communication partners?
41
As a Communication Partner
What Can DISCOURAGE a student from
communicating --test, bombard, or demand
responses (e.g., what is this called what do
we use a knife for? what do we call this?)
--use rhetorical questions (e.g., you dont want
milk, do you?) --use YES/NO questions
--anticipate their needs so they dont have to
ask
42
As a Communication Partner
What else Can DISCOURAGE a student from
communicating --dont give them regular
access to their communication system(s) --when
they make a choice, ask them again --use only
teacher-directed activities so the student
doesnt HAVE to communicate --GOOD TALKING!
as a reinforcer --use figurative language
(take your seat vs. sit) --rush the
students communication
43
Strategies to Promote CommunicationAdapted from
Original ECT, Hodgdon, 1999

• Engage (get at their level, eye contact)
• Establish attention
• Proximity to child
• Be in their line of vision
• Watch for student to orient to you (attention
  shift)
• Use visuals (present visual first)
• Use meaningful gestures
• Exaggerate movements to attract attention
• Hold gestures (point long enough to mutual
  referent)
• Less may be better!
• Match students verbal output?
• Expand by one

44
Strategies to Promote CommunicationAdapted from
Original ECT, Hodgdon, 1999

• Wait for responses
• Count to 5, 10 after a command/question
• Stay engaged
• Increase opportunities for initiation
• Be consistent with labels (why?)
• Modify the environment to create active
  participation, communication
• Make sure the student has access to communication
  at ALL TIMES!

45
The most language learning will occur when your
response is related to the students focus of
interest or to what he has communicated.
46
YOU are part of the environment

• When you use a prompt hierarchy you can
• Provide consistency across partners because of
  framework
• Give students processing time
• Be individualized
• Provide only as much prompting as is needed

47
Prompt Hierarchy

• Environmental Cue
• PAUSE
• Open Question
• PAUSE
• Prompt OR Request for Communication
• PAUSE
• Full Model
• PAUSE
• Incorporate descriptive feedback into each step

48
Descriptive Feedback

• Use after the student has produced a
  communicative response (at any point within the
  hierarchy)
• Descriptive feedback is specific to the students
  communication
• Oh, you asked for more juice, heres your
  juice.
• You want paint. Heres some blue paint.
• You asked to be all done. We need to do just
  one
• more, then were all done.
• You looked at the cheese, heres some cheese for
  your sandwich.

49
Descriptive Feedback

• Serves Three Functions
• Acknowledges
• Immediately acknowledges that the partner heard
  the students communication attempt
• Confirms
• Confirms that the message sent by the student is
  the same as the message understood by the
  partner.
• Models
• Can be used to model an expanded version of the
  communication message.

50
Prompt Hierarchy Step 1 Environmental Cue

• Set up the environment to signal to the student
  that an activity is about to begin.
• Lining up at the door
• Getting everything ready for an activity then
  waiting..
• Art materials prepared but out of reach
• Desired items visible but inaccessible
• Cutting the pizza up and waiting
• If student responds, provide...
  Descriptive Feedback

51
Prompt Hierarchy--Pausing Pause after every step
to give the student time to respond to the
cue.

• Focus your attention on the student (expect
  communication!)
• A
• N
• PAUSE D
• If the student responds, provide...
  Descriptive Feedback

52
Prompt Hierarchy Step 2 Open Question

• If the student does not respond to the pause by
  making a response
• Ask a WHAT, WHY, WHO, WHEN, WHERE, OR HOW
  Question ONE time
• What do you want?
• Whose turn is it?
• Where does that go?
• AND then...PAUSE
• If student responds now, provide...
  Descriptive Feedback

53
Prompt Hierarchy Step 3 Prompt or Request
Communication

• If the student does not respond to the open
  question pause
• Provide a prompt to students (ONE time)
• Choices, carrier phrase, initial sound, visual
  cue OR
• Request Communication (ONE time)
• Tell me what you need.
• Tell me what goes next.
• AND thenPAUSE
• If student responds now, provide...
  Descriptive Feedback

54
Prompt Hierarchy Step 4 Full Model

• If the student does not respond to the partial
  prompt and pause..
• Provide a full model for student
• Use students AAC device
• Use developmentally appropriate model
• AND then...PAUSE
• If student responds now, provide...
  Descriptive Feedback

55
PAUSE
Pause Pause Pause Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause Pause Pause Pause
Pause Pause Pause Pause Pause Pause Pause Pause
Pause Pause Pause!
In other wordsPAUSE!
56
Prompt Hierarchy

• Gives student the necessary time to process
  information and to formulate a message to
  communicate
• Provides a structure for adults that encourages
  communication
• Can be customized for individual students
• Organized as least to most

57
Prompt Hierarchy
58
The Target Activity Form - Sample
Students come to table at snack time. Snack
materials are on counter. Materials food,
placemats, napkins, straws, milk (white
chocolate), communication overlays for
requesting snack items standard
vocabulary-more, all done, uh oh, help, etc.
How is vocabulary represented? Communication
board with PCS symbols. Vocabulary for expansion
labeling. Student points w/some vocalizations.
Teacher models expands Activity Vocabulary
milk, straw, napkin, cracker, placemat ,
Wants/Needs I want, more, help, specific snack
items Social Interaction Etiquette sit here,
want some?, please, thank you Sharing
Information good, yucky, uh oh, all done
Snack materials set out, but out of reach of
students. Adult waits expectantly.
Student asks for snack items (e.g., Milk,
cracker, napkin, straw, placemat) I want
Can I have. milk
What do you want? What do you need now? Who do
you want to pass that to?
Student asks for help Student asks for
more Makes comments to peers and adults I
want more I like . good You want ..?
Do you want apple or crackers? I want
.. Mmmmmmm (for milk)
All students have snack placemat with specific
snack vocabulary velcroed on top core vocab.
permanently on sides. Single small pieces of
snack Straw on table, but out of reach Milk
carton not open Wrong flavor of milk (sabotage)
I want milk. Apples please I want more crackers
please
Student says all done when finished clean-up
go play bye-bye
You asked for milkheres more milk. Crackers..he
res 3 more crackers. Milk is good! Are crackers
good too?
59
CCE is a paradigm shift

• From sole focus on the students AAC device to
  communication
• From focusing on the students communication
  limitations to creating a communication
  environment
• From a single player to team ownership
• for communication opportunities
• From product-oriented activities to consciously
  designed communication-based activities

60
Where do I go from here?
61
Some Possibilities

• Identify one specific student (do not select
• your most challenging student!)
• Encourage other teams in the district to join you
  form a study group where you.
• Use videotaping to help you analyze your
  activities, partner behaviors environment
• Critically analyze the activities for student
  communication opportunities (minimum of 3)
• Set up your environment to maximize communication
  (one activity a day)
• Post prompt hierarchy start to use
• Provide feedback to team members ask for same
• Others?

62
References

• American Speech-Language-Hearing Association
  website www.asha.org
• Burkhart, L. 1993, Total Augmentative
  Communication in the Early Childhood Classroom,
  p.38
• Binger, C. Kent-Walsh, J. (2005).
  Evidence-Based Language Supports for Children
  Using AAC Increasing Expressive Communication.
  Closing the Gap conference, Oct. 2005,
  Minneapolis, MN.
• Blackstone, S. (2006). Young children. False
  beliefs, widely held. ACNAugmentative
  Communication News, June 2006, 18 (2).
• Casey, K. Kornfeld S. (2004). Developing
  language-rich light tech AAC systems for young
  children. Closing the Gap, October/November 2004,
  23 (4).
• Hodgdon, L.A. (1999). Solving behavior problems
  in Autism improving communication with visual
  strategies. Troy, Michigan QuirkRoberts
  Publishing.

63
Karlan, George. Environmental Communication
Teaching Training. Field-Initiated Research Grant
Award No. H023C9005 from the Office of Special
Education, U.S. Department of Education.
Lafayette, Indiana Purdue University. Light, J.
(1996) Communication is the essence of human
life Reflections on communicative competence.
AAC Augmentative and Alternative Communication,
June 1997 (13), 61-70. Light, J.C. (2005, May).
AAC interventions to maximize language
development for young children. State College,
PA AAC-RERC. Retrieved June 10, 2008 from
http//aac-rerc.psu.edu/index-16147.php.html Skot
ko, B., Koppenhaver, D., Erickson, K. (2004).
Parent Reading Behaviors and Communication
Outcomes in Girls with Rett Syndrome.
Exceptional Children, 70 (2), 145-166. Quill, K.
(2000) Do-Watch-Listen-Say Social and
communication intervention for children with
autism. Baltimore Brookes Publishing. WATI
(2009). Assessing students Needs for assistive
technology. www.wati.org
64
Thank you for coming.