Successful Strategies For Teaching AAC Commu…

Closing The Gap Solutions e-Magazine, August / Sept 2024 Volume 43 - Number 3

augmentative and alternative communication (AAC)

Successful Strategies For Teaching AAC Communication Partners Summary : Today’s world is fast-paced and very much reliant on technology. High tech solutions for communication and accessibility challenges have become more prevalent and affordable and as such are increasingly available to AAC commu- nicators in educational settings On the other hand, financial constraints on school districts often lead to less training for the educational support staff which is so vital to student success. Our AAC training curriculum offers a comprehensive yet afford- able solution to such constraints. Through a well-thought out sequence of activities encompassing lecture, hands-on training with both high and low tech devices, access to materials and manipulatives, and interactive group and online learning, we guide our students towards an awareness of best practice in the field of AAC implementation. Overcoming barriers before they can be encountered, in the form of a solid educational background, allows prospective support staff to enter their cho- sen field without fear of implementing the AAC systems that they will surely see there! In our experience working in a school setting, we have observed that the students who make the most progress with their communication skills are supported by Educational Assistants who are knowledgeable and confident in AAC implementation strategies.

Here are some comments from a survey we conducted at the end of our AAC course to see what the big ‘take homes’ were from our Educational Assistant students.

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JENNIFER WIEGERT, M.A., CCC-R-SLP, is a registered speech-language pathologist and owner of Chickadee AAC Communication Services - a private practice specializing in supporting individuals with complex communica- tion needs along with their team members, including parents and caregivers, school and home teams. She has practiced in the school setting for 25 years and continues to provide support to students and staff as a member of the Surrey School District AAC team. She also co-wrote and teaches an AAC curriculum for educational assistant students. Working directly with complex communicators is Jennifer’s favourite role as a private practitioner. CORINNA DUFFITT, M.Sc., R-SLP, is originally from Wabush, Newfoundland and Labrador and pursued her Master’s Degree at the University of British Columbia in Vancouver, BC. Corinna spent 24 years in the public school system where she specialized in supporting AAC communicators. In 2018, she joined with Jennifer Wiegert to form Chickadee AAC Communication Services, and in 2022 she established AAC in the Grove Communication Services Ltd., and remains committed to supporting AAC users and their families.

Successful strategies for teaching and ongoing training for communication partners are vital components in the effective implementation of Augmentative and Alternative Communication (AAC) systems. It is essential to employ flexible training approaches that cater to diverse learning environments and participant needs. One such strategy involves providing hands-on training opportunities across different contexts, including professional development days, group training sessions, one-on-one consultations, or virtual workshops. This

fosters a dynamic learning environment where participants can engage meaningfully with the resources and AAC devices to develop practical skills. Additionally, incorporating ongoing training ensures that communication partners remain updated on best practices and are able to problem solve unique situations, ultimately enhancing communication outcomes for AAC communicators.

This finding reinforces the need for explicit communication partner training as a means to reduce device abandonment.

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INTRODUCTION In the journey towards effective Augmentative and Alternative Communication (AAC) implementation, a comprehensive plan is essential. This blueprint encompasses various crucial elements, each contributing to the overarching goal of fostering meaningful communication partner skills for individuals supporting students with complex needs. At its core lies the mindset shift, recognizing AAC not merely as a tool but as a comprehensive language system vital for expression and comprehension. Visual supports, whether in the form of pictures, symbols, words, or tangible objects, serve as indispensable aids in facilitating communication. Through modeling, educators and communication partners demonstrate AAC usage, laying the groundwork for language acquisition and fluency. Moreover, strategies like building language complexity and minimizing direct questioning promote natural communication exchanges. This promotes an environment in which the communication partner follows the AAC user’s lead. Every communication attempt is valued and meaning is attributed, providing an environment where all forms of expression are respected and acknowledged. Additionally, roles are clearly defined, and advocacy efforts are prioritized to ensure that individuals with complex communication needs receive the support and opportunities they deserve. Ultimately, the overarching aim is to foster a culture of participation and inclusion, where every individual is empowered to engage meaningfully in their communities. HOW IT BEGAN In 2018, we were called in as last-minute substitute instructors to teach a course on AAC to a cohort of Educational Assistant students at a local college. We realized that this was an ideal opportunity to provide future support workers a strong foundation of AAC implementation strategies and skills, before they even began working in educational settings. We wrote a proposal outlining a comprehensive curriculum in AAC for the college to include in their Educational Assistant program. Our experience as AAC specialists in various educational settings was essential in identifying the skills support staff need to become effective communication partners for non-speaking students. Each time we have implemented this course over the past 6 years, we have further developed and improved it.

word implementation plan that includes a book and an activity in which they model their core word. Along with a partner, they demonstrate their partner communication skills while presenting for their peers. This curriculum was 24 hours in length delivered across six 4-hour sessions. We have outlined below the various elements of our curriculum along with the activities that the students engage in. MINDSET At the heart of our approach lies the AAC (Augmentative and Alternative Communication) mindset, which is built on key concepts that guide our understanding and practice. Our students need to recognize that an AAC vocabulary is a comprehensive language system, similar to other languages such as ASL, spoken English, and so forth. With this view in mind, we guide our students in understanding that learning to communicate with AAC is similar to learning a new language. To bring these concepts to life, we engage in a variety of interactive and educational activities. We kick off with a fun online Kahoot Quiz game designed to debunk common myths about AAC. Next, we delve into practical application by creating and using low-tech communication boards, which can be invaluable tools for immediate and accessible communication. Our students role play a restaurant scenario wherein they order food using a low-tech communication board that they create, based on directives given by us. (See image 3) The outcome of this activity is often an eye-opening one for students: rather than choosing the type and amount of words needed to be effective communicators, they often choose words that meet the immediate need and for that specific environment. This activity demonstrates that communication is more than just meeting basic needs - it’s also about connecting with others! Creating a communication board leads naturally to a discussion of core and fringe words. We provide a short lesson on core versus personal/fringe words. Prior to playing another Image 2: Here is one cohort’s responses at the beginning of their AAC course in the Educational Assistant College Course about how they felt about implementing AAC.

IMPLEMENTATION APPROACHES AND COMMUNICATION PARTNER SKILLS

(See image 2) We clearly define each element of our training as well as the importance of each in the overall AAC journey for the Educational Assistants and AAC communicators. Within each element of our course we include lectures, hands-on activities, role playing, practice using AAC devices (both low and high tech), small and large group activities, case studies, scenarios, and video models of skills and activities. This leads to a final project in which students are required to create a core

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are instrumental in providing structure and reducing anxiety by making the sequence of daily events clear and predictable. Other visual supports are then introduced in a lecture and video format, after which our students are put into small groups and given student scenarios, where they explore and address various communication challenges and opportunities in real-life contexts. This hands-on approach allows them to understand how broad strategies can be tailored to an individual’s needs and immediately applied in the classroom. (See image 6). Furthermore, we assign an Educational Assistant Toolbox project, wherein our students choose to research and create 5 visual supports to use once they begin their practicums. By collaborating on this project, we ensure that our EA students are well-prepared to meet the diverse needs of our AAC communicators, fostering an environment where everyone can thrive. Through these activities, we reinforce how implementation of basic visual supports impact the student’s ability to successfully participate in the activities of the school day.

Kahoot quiz - Core or Fringe Word?, the students often require a quick lesson on parts of speech including nouns, verbs, adjectives, and prepositions. To further expand their knowledge of core and fringe vocabulary and its importance to each individual AAC communicator, we have our students engage in a case study. Each small group is given a student profile along with a personalisation form. From the profile they decide what personal vocabulary their student will need programmed onto their AAC device. Personalizing vocabulary ensures that the communication tools we develop are tailored to the unique needs and interests of each individual. Finally, the students compare a variety of commercially available high-tech vocabulary options. They are provided with a list of messages that they need to generate using each of the vocabularies. This demonstrates the advantages and potential challenges they may encounter based on the size and complexity of the vocabulary. As they use these boards themselves, they become aware of the necessity of providing non-speaking individuals with a robust vocabulary. See image 4 and 5. VISUALS Visual supports are useful tools for enhancing both expression and comprehension for AAC communicators, and as such are included as an important section of our curriculum. When implemented correctly, a visual support can significantly improve a student’s ability to communicate effectively and understand the world around them. Our EA students learn that ample time is needed for processing, acknowledging that every individual has unique needs when it comes to communication and comprehension. In our visual support section, our EA students engage in a series of thoughtful and practical activities. One key activity involves setting up visual schedules, which help AAC communicators to navigate their day with clarity and confidence. Schedules Image 3: The EA students’ communication boards typically have vocabulary to make requests for immediate needs and vocabulary to interact socially is often not considered.

MODELLING We recognize the profound importance of modeling in the context of teaching AAC, understanding that children learn language most effectively by seeing it used in real-life situations. Just as typically developing children acquire language skills by observing and imitating the speech around them, children who use AAC benefit immensely from seeing their communication tools in action. This observational learning is crucial for grasping how to use AAC devices or systems to express themselves and comprehend others. To integrate this approach into our teaching, we engage in a variety of purposeful activities. We begin with an overview of vocabulary organization. We show the EA students that the vocabulary templates are arranged in a manner that is rule-based, sequential, and categorical to make them easily accessible and intuitive. This organized system not only facilitates quicker word Image 6: The student working in partners to determine what visual supports would be beneficial based on the student scenario they have.

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Image 4: Example of case study and the form that EA students need to fill in to determine the fringe words they need to personalize their student’s AAC vocabulary.

Image 5: The students experience how the size and content of an AAC vocabulary impacts the navigation and availability of words by communicating the same messages on 3 different AAC vocabularies.

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retrieval but also helps students see that sentence structure, grammatical forms, and language concepts are all related to overall language development. We have the students participate in two different hands- on activities, both core word-first and activity-first, to practice aided language input using both core boards and high-tech AAC devices. We provide a number of core-word language kits, which include a book that has a predominant core word along with an activity that also provides opportunities to model the same core word. Working in pairs, the students practice reading and modelling the core word using the book and the activity. See Video 1.

combine words, we help them move beyond basic expressions to convey richer and more detailed thoughts and feelings. This progression is essential for their overall language development and for fostering more meaningful interactions with others. To help our EA students understand how to do this, we engage in targeted activities designed to build and expand on existing language skills. One of the key strategies involves modelling one word above an AAC communicator’s current level. We provide our EA students with a single core word, and as small groups they generate a list of both 2- and 3-word phrases built upon that single word. Our students are encouraged to explore words from various parts of speech, such verbs, adjectives, prepositions, and so forth - this helps them see how words can be put together to form more complex and specific messages: “happy dog” or “want pink juice”. This exercise is structured to be both engaging and educational, providing a collaborative environment where students can learn from each other and from the models we provide. Once students have generated their lists, they are encouraged to practice them on an AAC device. In this way, they see how they can gradually become more comfortable and proficient in using an AAC system to model communication! See image 7. MINIMIZING QUESTIONS We understand the critical importance of making communication through AAC feel natural and engaging, rather than like a test. When communication feels like an assessment, it can create pressure and anxiety, which can hinder the learning process and discourage students from using their AAC devices. To foster a more relaxed and positive communication environment, we strive to integrate language use seamlessly into everyday interactions rather than a testing environment. Unless they are explicitly taught otherwise, it’s a natural Video 2: After watching a video of a play-based activity, the students are required to generate a list of words that they could model on the student’s AAC system while engaging in the activity. They enter their word lists into Mentimeter to share with the entire group. - https://vimeo.com/974280761

The activity-first task requires the students to watch a silent video of play with specific toys. While watching the video, they generate a list of words from their AAC vocabulary that they could model during that activity. We use the website www. menti.com which allows the students to enter their word lists online, thus creating a word cloud so they can see the variety of words that they could model. Once they understand how to model words across literacy, games, and play activities, they are given the opportunity to watch the videos a second time and model using their AAC vocabulary while watching. The instructors model as well to demonstrate the variety of language functions that should be included in language instruction for AAC communicators. These activities allow the students to explore the systems, understand motor planning, and how to plan for device implementation. See Video 2. INCREASING LANGUAGE COMPLEXITY Increasing language complexity for AAC communicators is crucial, as it empowers them to form more complete and nuanced messages. By progressively enhancing their ability to Video 1: Here are a variety of core word book/activity kits that the Educational Students use to practice modelling on the devices and the students practicing with them in their small groups - https://vimeo.com/974280084

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validated, not just the use of AAC devices. Communication is multifaceted, encompassing gestures, facial expressions, body language, and vocalizations, alongside AAC. By valuing these diverse modes of expression, we respect and respond to each AAC communicators’ unique way of communicating. To reinforce this inclusive approach, we have our EA students watch role play video models, which are particularly effective for demonstrating how to recognize and respond to various forms of communication. Through videos we have made ourselves, we showcase scenarios wherein different communicative behaviors are interpreted and appropriately responded to, providing clear and relatable examples for both students and educators. For instance, a video might depict a student pointing to an object, and the model response could be acknowledging the point and expanding on it, such as saying, "You’re pointing to the book. Would you like to read it together?" This activity serves multiple purposes. It teaches prospective EAs that all attempts to communicate, regardless of the form, are valid and meaningful. It also equips them with the skills to notice and respond to these cues effectively, fostering a more responsive and empathetic communication environment. By regularly incorporating video modeling into our practice, we ensure that everyone involved in the learning process can recognize and celebrate the full spectrum of communicative behaviors. ATTRIBUTING MEANING We recognize the critical importance of responding to all communication attempts as intentional. This perspective is foundational in supporting individuals who use AAC, as it teaches EA students that they should not judge a student’s output as being intentional (clear communicative intent) or unintentional (hitting random buttons). By attributing intention to every communicative act, we help the AAC communicator understand that their words have meaning and their AAC device is a tool that they can use to connect with those individuals in their environment. We also use video modelling for this concept to provide concrete examples that demonstrate how to attribute meaning to every communicative behavior. It equips EA students with the skills to observe and interpret these behaviors accurately and how they should respond to their students' attempts to communicate - intentional or not. ROLES AND ADVOCACY We understand the critical importance of clearly defining roles within the AAC support team. When everyone knows their responsibilities and works collaboratively, it enhances the effectiveness of our efforts to support individuals using AAC. A well-defined team structure ensures that each member can contribute their expertise and that there is a coordinated approach to meeting the communication needs of our students. By advocating for these roles, we also highlight the value of each

Image 7: The students work in small groups to generate increasingly complex utterances that they then practice modelling on high-tech AAC devices.

inclination for communication partners to slip into questioning AAC communicators to demonstrate their understanding of their device. The EA students have a list of questions that they turn into statements. Instead of constantly asking direct questions, which can feel demanding, we make statements that invite responses in a more open-ended and conversational manner. For instance, rather than asking, "What do you want to play with?" we might say, "I see you have the toy car, that looks like fun." This approach reduces the pressure on the student to provide a specific answer and encourages spontaneous communication. This method promotes a more organic learning experience where students can observe and then practice using language without the fear of being tested. It allows them to explore their AAC devices and express themselves in ways that feel genuine and self-directed. Through this lesson, we aim to encourage our EA students to provide supportive and encouraging communication environments for their AAC communicators. RESPONDING TO ALL FORMS OF COMMUNICATION It is important that future Educational Assistants recognize that all forms of communication should be acknowledged and

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Image 8: We have generated interpersonal scenarios based on experiences we have had or seen in our roles as school-based SLPs. Here is an example of one that students discuss in their small group followed by a discussion with the whole group.

team member's contributions, fostering a sense of ownership and accountability. To facilitate this, we created interpersonal scenarios that we have seen or encountered ourselves within our roles as school- based AAC SLPs. By exploring various scenarios, we show our EA students potential challenges they may encounter and help develop appropriate strategies for addressing them. For example, we might role-play situations where team members have differing opinions on communication strategies and we discuss how to navigate these conflicts constructively. Through these discussions, we not only clarify each person's role but also strengthen our future EAs ability to work within their defined roles and develop an understanding that there are some decisions that they should not be making. For example, reinforcing that EAs cannot decide that a student does not need to use an AAC device. Our intent is to decrease the chance that EA’s will take actions that negatively impact the students we support. See image 8. PARTICIPATION AND INCLUSION We want our EA students to understand the importance of fostering a sense of belonging and contribution for our AAC communicators. When students feel that they are valued members of their community and that they can actively contribute, their confidence and willingness to communicate

flourishes. This sense of inclusion is essential for their emotional well-being and social development. To help our EA students understand this and to give them the means to foster inclusion, we have them engage in activities like planning vocabulary models for inclusion and practicing with task boxes that represent activities and events that could occur during a regular school day. The first activity for participation and inclusion - planning vocabulary models specifically tailored for inclusive classroom activities - has our EA students rotating through various scenarios taken directly from classrooms at both the elementary and high school levels. EA students are put into small groups and provided with a planning tool to fill in. They then go through several school subjects, such as math, cooking, arts and crafts, or coffee cart. They are tasked with observing the materials, watching videos of how such activities would look in a classroom/school setting, and then selecting appropriate targets to model so that AAC communicators are exposed to the vocabulary models they need in order to build success in those areas. Our EA students are encouraged to brainstorm across a variety of language functions, such as asking questions, making comments, giving directions, and parts of speech, such as verbs, nouns, pronouns, and prepositions. Again, we are building familiarity with how an AAC system is organized while ensuring that our future support workers understand that they need to

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teach a variety of communicative functions. Another activity involves the use of task boxes - a set of materials put together for a specific activity typically found in mainstream classrooms. These may include books, manipulatives, craft supplies, or a work assignment and are complete with a description of the activity, a single message voice output device, visual supports, as well as instructions for students to follow. In small groups, our students rotate through tasks such as circle time, literacy center, school-wide announcement, ordering at a restaurant, and so forth. Once the task is completed each group shares their example and demonstrates how the communication tool is used in their situation. By exposing EA students to these communication opportunities, they become increasingly aware that they have the ability to build a strong sense of identity and community, essential for their AAC communicators’ overall development and well-being. See image 9.

in the activity modelling the core word, while their partner is the student. During the role play they are required to demonstrate some of the communication partner strategies that they have learned during the course. It is a great opportunity for the EA students to observe one another, to see creative ideas for implementing AAC, and to gain confidence in their ability to generate their own contexts for facilitating their future student’s communication skills.

Video 3: The best day of our AAC course is final presentation day. It’s exciting to see the creative activities that each group presents to their peers! Although the presentation day is stressful for the Educational Assistant students, they benefit by gaining confidence and a toolbox of ideas that they can draw from. - https://vimeo.com/974282721

BRINGING IT ALL TOGETHER The EA students’ final project is a culmination of all of the skills and knowledge that they have gained during the course. For the final assignment they create a lesson plan to teach core vocabulary using their AAC communicator’s device They are required to teach the same word(s) using a book and an extension activity. Once they determine their book and core word, they need to identify another context to practice the target core word chosen. The extension activity could be: a game, a craft, writing activity, matching activity, song, or gross motor activity. The activity should target the same core word(s) that they focus on in the book. The activity should provide repeated opportunities for them to model the core word. On the final day of class, each group presents their book and extension activity to their peers. They take turns role playing as the EA and then as the student. The first EA student reads the book while modelling the core word on the AAC device for the second EA (their student). Then the second EA student engages Image 9: Educational Assistant students practice planning and modelling vocabulary using Inclusion Task Boxes. They include work that their students might do in their classroom setting.

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