Joint Engagement refers to participating in an activity or event with another person. We know that social interaction is a challenge for many of the individuals that we support, and is a core deficit of individuals on the autism spectrum, so the goal is to provide motivating, child-directed activities that improve the capacity for joint attention and engagement. We are looking for a “moment of joy” (and hopefully a lot of them!). The use of Consistent and Unique Motor Plans means that the motor plan that an AAC user uses to access vocabulary does not change once it is learned. While each of the LAMP principles are impovrtant, this particular aspect of the LAMP approach is sometimes referred to as “LAMP Law”; the consistent and unique locations of every word allows for us to teach vocabulary based on location and allows for an automaticity to develop that is im- possible if an AAC user has to cognitively attend to the icons, categories, or shifting locations of vocabulary items. We know that our brains develop motor plans for movements that are re- peated frequently. Some examples of this include: typing, hand- writing, driving a car, playing the piano, etc. Over time, as we be- come proficient in a specific task or skill, we don’t have to “think” about the actions required to perform it. Likewise, with spoken language, once we are a proficient speaker of a language, we are able to devote cognitive resources to thinking about what we will say with little regard to how we will coordinate our articula- tors to form the words in our message. Auditory Signals are provided to AAC users as they access individual words. In individuals who are developing spoken language along a typical course, these auditory signals are pro- vided as sounds and words are expressed using the vocal folds and the articulators (e.g., lips, tongue, teeth), whereas AAC users are using their hand as an articulator and the auditory output is provided by the speech-generating device. When consistent au- ditory feedback is paired with each unique motor plan, an AAC user is able to learn the meaning of words. Natural Consequences are also incredibly important for language learning. Communication partners should provide animated reactions to the utterances of the AAC users, provide the item or activity that has been requested, or offer an appro- priate response that lets the AAC user know that their message has been received. All attempts at communication should be honored. The goal of incorporating each of these LAMP principles is to help the AAC user develop language. As clinicians, we take what we know about language therapy and intervention with users of spoken language and apply it to our work with AAC users. In fact, it’s vitally important that we don’t lose sight of the fact that we are in fact teaching language. We view teaching language to AAC users through the same lens we use to approach teaching language to non-AAC users, we want to help you to be able to say whatever you want, whenever you want, to whomever you want. Ultimately, it was coming back to this fundamental belief
about how we approach language learning that made us realize that perhaps teletherapy wasn’t going to be quite so different than what we had already been doing in our in-person service delivery models. LONG DISTANCE LAMP BEGINS So just as we began to see some of our own clients via tele- therapy, we decided we should start a conversation within our community of like-minded LAMP-focused interventionists. We developed a 90-minute webinar with the idea of sharing our experience as we learned to navigate these unfamiliar waters, hopeful that we would be able to confirm our hypothesis that these trusted principles would indeed guide the way even as our service-delivery model had changed. Our intention was to create a space for connection and community, to cultivate a safe space to ask questions, an opportunity to share challenges and successes, and to offer reminders of the things we already knew in the context of learning so many new things. What we thought might be a one-off, web-based session, turned into several more, and Amy also developed a LAMP at Home webinar focused on parents. We found that despite our initial concerns and hesitations, that all of our clients were in fact good candidates for teletherapy provided we kept focus on the principles of the LAMP approach and maintained some flexibili- ty for what each individual session looked like. That is not to say that this transition to telepractice was easy. We had moments of anxiety and overwhelm, and as we all know technology can be both friend and foe. As we began meeting with our colleagues to share our experiences, we asked them to provide their one-word reaction to being faced with the prospect of AAC intervention via teletherapy. During each of these sessions, we compiled a word cloud using the interactive presentation software program Mentimer (mentimeter.com) where word frequency was indicated by the size of the word in the cloud. After several sessions, we created a composite word cloud, realizing we were seeing many of the same words, offer- ing a continual reminder that while we were maybe not all in the same boat, we were certainly all in the same storm. (See image 2: Clinician Response to Teletherapy- Mentimeter) APPLYING THE PRINCIPLES VIA TELETHERAPY Before really discussing what application of the LAMP princi- ples would look like in a virtual AAC session, we needed to talk about changes in service delivery and platform. Prior to the pre- cautions put in place related to COVID-19, we had both been seeing our students and clients for in-person, direct therapy. Suddenly, we were showing up in client and student homes on a screen and relying heavily on parents to support us and their AAC users during therapy sessions. We likened this in some ways to the experience of supervising a graduate student, in that we found we needed to wear (at least) two hats, that of clinician/in- terventionist and that of mentor/coach. We found that sessions
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