Sunday, August 24, 2014

Core Vocabulary with Booklets

I don't have time to write a big post about this, so here are the main points:

I'm focusing on doing more modeling at home, because modeling is the most important thing that I can do to help Maya become a proficient, active AAC user.

I'm focusing on core words, because core words work across many environments, build many sentences, and make up 80% of what we all say everyday. (80%!)  

I'm focusing on putting phrases and sentences together, because Maya knows the location of a ton of words in her talker, but doesn't often spontaneously make the leap to string them together.

I've decided to create some little booklets, pulling the bulk of the words from core word lists that I've found and dissected online (like here and here). This book is not to teach any concepts, but rather to practice, practice, practice using core words. The more I model them, and the more we use them together, the more likely she will be to use them on her own. Tonight I made the first booklet, about Parker and things that he likes to do. Here are some sample pages:

Core words. Motivating booklet. Done quickly, without getting hung up on graphics or art or perfect margins. 

Here's the booklet file  (as a word doc, which can be totally customized)---if you print and use it, you need to draw a picture for the bugs-under-a-car page. This will print two book pages per sheet of paper (cut and staple to make the book). I put the title & ending pages first so that I could print that sheet on cardstock (for a heavier "cover") and then print the rest on paper.

(If you start making core word booklets, please come share them!)

I'm looking forward to seeing what she thinks tomorrow, and to making more of these. (And I'm selfishly hoping that you guys will create some fun ones and share them here or in the Speak for Yourself Users Group!)


Here's what she thought. So many fun things here :)

1. This is our first time exploring the plural +s.

2. This highlights the need to have interesting, appropriate vocabulary available to the AAC user. Kids like potty words. All children should be able to say whatever they want to say, whenever they want to say it :)

3. She wants to open the book, I want her to communicate something. I use a combination of waiting and prompting. We are working on phrase building (which is why I push for more after she says "open").

Tuesday, August 19, 2014

First Day of School Resources

We still have a few weeks before we return to school in NYC, but I see a lot of folks are returning already. (My apologies if this is too late to make it for your very first day!) Sending a child with complex communication needs (aka a "nonverbal" child) carries a special level of stress . . . will the teachers understand her signals? Will they view negative behaviors simply as acting out, rather than deciphering the communication behind them? Will they move her talker away if there are too many things on her desk?

Here are some of the resources that I send in with Maya (if possible I also email this to teachers/therapists prior to the first day, but I also send hard copies in the backpack), along with a few other tips to help smooth the way into a new classroom.

First, she brings in a packet of information about herself. I try to keep it brief but informative (2-3 pages, well broken up into categories and spaced out). Enough so that the teachers can get a nice synopsis, but not so much that they won't flip through it. It speaks about her personality, her talker, my personal view on speech and academic goals, and pertinent medical and behavioral information. A sample document (with some omitted information) can be viewed here. 

Next, she brings in a folder that contains resources about her talker.

In the folder is information relating to her communication device. I include two copies of each item in the folder, one to remain in the office of the SLP, and one to be available in the classroom.

The contents of the folder are:

  • An information/programming guide about her app for staff. I don't actually want the staff adding or deleting words until I know them and am sure we're on the same page, so I don't provide that information. My guide also includes links to videos of Maya using her app at home, so that they can see what she is capable of. 
  • An app map, care of the Speak for Yourself team. That file can be found in the "files" tab of the Speak for Yourself users group on Facebook. I laminate these so that they can take a beating in the classroom without getting ripped or wet.

The image and text on the front of the folder are the same as the information that I include on the back of her talker:

This is the file for the above image.

Finally, Maya and I make a booklet together that she can bring to share with staff and classmates. Here are a few sample pages from this summer's booklet:

One thing that I can not overemphasize is VIDEO. If you have a child with complex communication needs, get video at home---video of using their device, talking, reading, showing off skills. It's much easier for staff to embrace high expectations and presume competence when they get a glimpse up front of the awesome things that our kids are capable of.

Monday, August 11, 2014

The Merits of AAC Exploration

In recent months, AAC has not been my focus.

If you're gasping dramatically, chances are that you're one of our SLP/AAC friends, and if you're thinking "Oh thank goodness I'm not the only one who drops the ball," then chances are that you're living in an AAC family.

We haven't been focused on AAC because . . . well, because life. I've taken two (accelerated summer) classes in the past two months, Maya has started at a new school with a new staff, Dave has been on vacation, and the priority list just shifted all around. The talkers are always around, always accessible, and used a good amount, but I haven't really been teaching or modeling with any real level of commitment.

I've got grand plans (actually, really vague ones that mostly involve just a lot of modeling and some targeted vocabulary selection) at doing some AAC immersion for the next few weeks. Maya's summer school session ended today, Dave went back to work on Friday, and I'm going to be home with both kids until September. Add in the fact that I've got an injured foot (with a boot) and I'll have plenty of parked-at-home time, perfect for aided language input (aka "modeling", or pushing buttons on a device to show the AAC user how to use it conversationally, where to find words you're targeting, etc).

But this post isn't actually about modeling. Or teaching. Or aiding language development. It's about leaving kids alone and letting them explore their devices.

Will, now 22 months old, hasn't gotten a ton of modeling on his talker (for the reasons mentioned above). What he has gotten is (mostly) unlimited access to it. He insists on having it in his crib when he goes to bed for the night, and every morning I know he's awake when I hear the talker through the monitor. I have no idea what he's talking about most days, and a cynic would undoubtedly hear the disjointed words or repetitive again-again-again-again-no-no-no-no and say "he's stimming! he's just hitting random things!" . . . but they would be wrong.

By having unstructured time to explore his talker, without scrutiny or stress or goals, Will has the ability to play with it in whatever way he chooses. He can push the buttons at the top to learn about fucntions of the app. He can linger on favorite screens and study the little pictures. He can pop in and out of secondary pages and learn the location of words. He can find words that he loves the sound of (he really loves again) and "say" them over and over and over again. And his connection to his device grows, because he's enjoying it on his own terms---it's not a tool that he's being forced into using, it's a really interesting and powerful (and FUN) thing that he gets to use however he wants.

Two morning ago I sat with Will (who still looks a little sleepy in his pajamas, is sporting a few good bug bites on his head, and is clutching my cell phone in one hand and intermittently gnawing on the other because he's cutting teeth) and turned on the video camera. My goal was just to see what he would choose to do or say if we were both focused on the talker (the fancy speech therapy term for that is joint attention), but I didn't direct any sort of activity. I wanted him to take the lead, and I just wanted some baseline video . . . but I was actually surprised by what I saw. In his free exploration time, it turns out that Will has taught himself a lot of things about how to work the features of his app (Speak for Yourself). I've highlighted things as they happen in the video, but here's a list of what he does: uses the home key to return to the previous page, opens and closes the keyboard, clears the sentence strip, opens the search feature, types and activates the search feature, scrolls through a list terms. 

I didn't teach him any of this. And that's not to say that he's a baby genius, it's to say that he's a kid who has had a wealth of unstructured time (that's a nice way of saying that he's a second child and sometimes left to his own devices) with a talker . . . which has a lot of merits.

I wanted to share this because I think it really highlights the type of learning (and ownership of a device) that can only happen when kids have time to explore. ( And without sounding too salespitch-y, the babble and search features of Speak for Yourself make this type of learning really easily accessible to users, even users who are really young.) 

PS: For families out there who might be watching this and hoping to get ideas for modeling, this is not the video for that. I'm not doing a good job of modeling, because my goal was to get a baseline video of his AAC use before I really start active modeling over the next few weeks. I join in a few times (because I can't resist, and because it renews his focus when he sees me interact with the talker) but I'm not really focused on anything specific.

PPS: At the end when he says "Oh no See" he's pointing out that I paused his show, "Sid the Science Kid."

Tuesday, August 5, 2014

A small heavy box

Maya got new splints yesterday. Splints? Braces? Orthotics? It doesn't much matter what you call them, they are shiny and new and Maya is Christmas-morning excited about them. They must feel good, the way they stabilize her unsteady ankles, because she is eager to put them on and proud to show them off.

Yesterday was a rush of a day . . . I picked her up early at school (which is where the splints had been delivered) to take her over to her first day of AAC camp (where I stayed and observed). After camp I rushed her home, where my pit crew (Dave and Will) were waiting on the sidewalk to make a trade: I released Maya to them, they gave me a sandwich and new vat of iced coffee, and then I hopped back in the car to drive to my night class. I didn't get to really look at the new splints until I arrived home after class, and as I opened the door and came into the apartment they were waiting to greet me on the countertop.

I picked them up and admired the straps, clean and white and new, though likely not for long. Soon the threads on the sides of the velcro will start to fray. The little white cushiony thing that prevents the strap from overtightening on her skin will become more progressively dull, then it will loosen, and then it will be lost (spoiler alert: they always get lost). The suede-y soft inner white cushion pads will stay soft, but lose some of the supple squishiness that they have this week. Newness aside, what struck me the most was the length: cut to extend a bit past her toes in the front, these seem huge! Are her feet really this big? Do these really fit Maya?

Maya's feet had been abnormally small for years, which we were told was a typical side effect of not being able to bear weight and stand and walk (which typically causes feet to spread and grow more rapidly). The sheer size of these splints seemed to say "look how far my feet have come, look how far I've come."

This morning I crept into Will's room, to the high shelf in his closet, and pulled down a small shoebox. If I could hand it to you, the shoebox would feel light enough that you would wonder if there was actually a pair of shoes in there . . . but in my hands, it is a heavy box. Small enough to hold with one hand, big enough to hold years of progress. Light enough to balance on a loaf of bread, heavy with the weight of our worries and wonders and yes-my-baby-wears-splints and she's-almost-three-and-no-not-walking-yet.

Made of light cardboard, strong enough to hold our past.

I remember every pair of splints in that box.

I remember the first pair. She was fitted for the first pair in a clinic, wiggling and unhappy and not at all interested . . . and I was hopeful and eager and thinking "maybe this will be the magic ticket!" Picking the bold pink straps . . . trying them on her at home, watching anxiously to notice a change. Not noticing a change. Keeping the faith. When she outgrew them, we took a little break, because it didn't seem like they mattered much anyway.

I remember the second pair. She was fitted at home and we poured over the choices in patterns. For my cow-obsessed girl, finding a pattern with barns and farm animals was perfect. These were a different type of splint, and I recognized cautious hope as it bubbled up in me . . . these might be the ones, after all. I popped most of those bubbles, but a few remained. They popped themselves as weeks turned to months.

I remember the third pair, which we were fitted for at her preschool. The orthotists were so friendly and her physical therapist was excited about a new pair. I was happy that Maya was happy. Again, we searched through pattern swatches and she squealed upon seeing a green rainforest pattern that had alligators (a big love at the time). I remember how quickly she learned to take these off in the car, and I remember countless white pads being lost during those undressings. I remember her love of the splints, the way she wanted them on in the morning, how I knew that they must actually feel good . . . maybe like the way my knee brace eases the pull and pain on my weak knee when I walk? I'm not sure. I wish I knew what it felt like to have her feet, what the splints feel like around her ankles. I wish she could tell me.

And now, again, we begin with the fourth pair. She is blissfully excited about the blue butterfly pattern and didn't want to take them off yesterday. Part of getting new splints is evaluating the fit, and I'm supposed to check if any parts of her feet look raw or red, but she wouldn't let me take them off to check. "Maya, how do they feel? Are they good or tight?" I asked. "Doh" (good) she replied, with wrinkled brow, the subtext being don't-try-to-take-them-off-I-said-they're-good. I love them because she loves them, and I hope that they make her more comfortable. She is delighted, and I am happy for her.

We need to pick up a bigger pair of sneakers, and then she'll be in them more or less full time until they become too small, at which time they'll go to the small heavy shoebox. And I wonder, years from now, when I pull out pair #4 with the butterflies, what memories they'll bring with them.