Part 4 of 5 Children with Complex Communication Needs

their vision to see the chair, the photograph of a chair, and sub- sequent drawings or symbols representing chair. At the same time, they must learn to understand the concept of chair and its use in language. While a visual hierarchy may help a child learn to use her vi- sion to see what a chair is (e.g. first a real chair, then a different real chair, then perhaps a doll chair, a picture of a chair, a line drawing of a chair, and so on), the symbol hierarchy is not nec- essary and is likely counterproductive when we are talking about language development and expressive communica- tion using AAC. As stated by Burkhart and Costello (2008), chil- dren with CVI require consistent and predictable opportunities to experience and manipulate language. Their language expo- sure and success should be built upon, but not dependent on, engaging vision. HIGH CONTRAST SYMBOLS ARE BEST A commonly held belief in the field of AAC is that children with CCN and CVI should be provided with so called “high con- trast” symbols. Typically, these picture communication symbols are intentionally less complex in terms of detail in the image, highly saturated with bright color and placed against a black background. However, there is little evidence that these “high contrast” symbols are the best ones to use for children with CCN and CVI. It depends on the individual child. AAC professionals must depend on their TVI colleagues to help them provide chil- dren with CCN and CVI what all children need: symbols that rep- resent language in a way that they can not only understand but use (Tomasello, 2003). GATHERING OUR INFORMATION: COMMUNICATION AND LANGUAGE In the article Setting the Stage for Augmentative Communi- cation , Wanger, Hanser, and Musselwhite (2020) provide some guidance in terms of documenting how children with CCN and CVI are presently communicating. The form they present can be used to document what a child is doing as a communicative behavior, what that behavior/actions means (or what partners believe it to mean), what actions the partner(s) should take to re- spond to that behavior/act to support the child understanding its communicative power, and how the partner should respond both verbally (what to SAY) and in aided/augmented form (what to MODEL in their AAC modality). While this is indeed a useful form, it is sometimes difficult for partners to identify exactly how they know what a child is com- municating through their behavior(s) and to see how the child might be communicating for various functions. Three additional tools that may be helpful in identifying the child’s present com- municative behaviors:

COMMUNICATION, LANGUAGE, AAC AND CVI Blackstone and Roman- Lantzy (2019) state that children with CVI who need AAC have limited opportunities to explore robust AAC systems that contain vocabulary for commenting, protest- ing, questioning and communicating about their world. In addi- tion, they quite importantly point out that vision is a key com- ponent of visual joint attention , and therefore children with CVI may fail to see a partner’s pointing cues or any supplementary cues such as where a partner is looking. The consequence of this is that the child may clearly fail to see or even notice that their communication partner is modeling language on an AAC sys- tem where symbols are pictographic or visual (sign). However, there are other means of establishing joint attention, and not all AAC systems must be accessed visually. These and other issues may be impeding access to robust AAC for many children with CCN and CVI. MYTHS AND MISCONCEPTIONS ABOUT CCN & CVI Increasing access to AAC for children with CCN and CVI re- quires careful attention to a number of myths and misconcep- tions that professionals must grapple with across areas of exper- tise and interest. SYMBOL HIERACHIES The first misconception is an age old one for the field of AAC, but one that has thankfully been refuted. That is the idea that children must start with real objects, then progress to photo- graphs before we introduce graphic symbols. In AAC this is called the “symbol hierarchy.” It has been shown that it is unnecessary to follow the hierarchy (Romski & Sevcik, 2005), and it has also been asserted that it limits children’s learning of language (von Tetzchner, 2015). While parents, teachers and therapists may at- tribute meaning to a graphic symbol because it is iconic (looks to us like what it is supposed to represent), youth with devel- opmental disabilities and CCN can establish iconic and arbitrary symbol-referent relationships for symbols when given expe- rience with them, regardless of the iconicity of the symbol (Romski & Sevcik, 1996; Sevcik, Barton-Hulsey, Romski & Hyatt Fonseca, 2018). In other words, children don’t recognize symbols, they LEARN them through repeated opportunity for understanding and use! For children with CCN and CVI, this must mean that the sym- bols are perceptible and distinguishable from one another. They must also contribute to learning over time. For example, learn- ing that a photograph of a chair references an actual chair is only helpful if you want to reference the specific chair. Yet, we typical- ly want children to understand that the symbol represents any chair – it is a symbol for chair or, potentially, sit. The concrete reference for the original, specific chair is relatively easy to teach to a child who can see both the chair and the photograph of the chair. However, children with CVI may need to learn to use

• The Communication Matrix (Rowland, 2020) • Pragmatics Profile (Dewart & Summers, 1995) • Communication Signal Inventory (Cress, 2018)

BACK TO CONTENTS

Made with FlippingBook Ebook Creator