Take NOTES: Supporting Emergent Writers Who Use AAC

Take NOTES: Supporting Emergent Writers Who Use AAC By Beth Waite-Lafever

literacy

The need for intentional literacy instruction for people us- ing AAC has become a frequent topic of conversation among teachers, therapists, parents and researchers. When we think of literacy, we often first think of reading. However, research shows that intentional writing experiences are critical as intervention strategies to help those with complex communication needs be- come better communicators, readers and writers (Sturm, Janet “Writing in AAC.”The ASHA Leader, September 2003). How do you begin teaching writing with your students who struggle not only with communication but with fine motor skills as well? First, we need to think not about writing as a fine motor activity, but as a composition activity. Handwriting is important to learn, but not at the exclusion of the concept of writing: The act of combining words to tell a story, commenting on a picture, or sharing ideas. For many emergent AAC communicators, writ- ten composition is either watered-down to marking on paper or not taught at all. Just as we can’t confuse not being able to speak as having nothing to say, not being able to form letters with a pencil doesn’t mean there are no ideas to share through writing. Help students write for real purposes and a genuine audi- ence. Teach your students to think of themselves as writers. A simple way to remember how to do this is to take NOTES: No- tice, Opportunity, Talk, Engage, Share They tell budding authors to write what they know. The famil- iarity of a known subject is comfortable and perceived as easier to talk about-so NOTICE your students’ interests. Take photos of favorite activities, people, art projects and hobbies, etc. and be- gin a collection of photo writing prompts. Ask family and class- room staff to take pictures on an iPad or tablet to build a collec- tion. Is your student into the latest movie or video game? Use Google images to find photos of favorite characters to write

about as well. Part of the activity is the act of collecting these photos for writing prompts. Taking photos and talking about them is age-respectful for everyone. There are a lot of communi- cation opportunities built-into just taking or finding photos. It’s a fantastic way to practice verbs (look, get, take, move, save, delete), prepositions (on, in, out, over, about, for), determiners (there, this, these, that), adjectives (good, bad, happy, funny, goofy). Then, find a way to organize these photos: Use folders in the Photos app in tablets/smart phones, social media sites like Pinterest or Instagram or Google Keep. Say goodbye to the same old writing prompt for everyone: mix it up and give your students using AAC familiar and personally-relevant prompts to select from for writing. Once you have several photos, provide daily OPPORTUNITY to write. Expressing ourselves through word is as much about the process as it is the finished product. A great way to begin with an emergent learner is to model writing. Either an adult or peer with adult direction can go through the process of looking at their personal photos-commenting aloud about each as they consider their options. “I like this scene from my backyard, here’s a cute picture of my dog-today I’ll write about my dog, Beau”. By talking through our process we can help build our nonver- bal student’s “inner voice”. We can develop this by using “think- aloud” strategies. According to the website Reading Rockets (www.readingrockets.org), think-alouds have been described as “eavesdropping on someone’s thinking.”This technique is widely used in early elementary education as the teacher verbally de- scribes things she is doing as she reads to show students what to do to improve comprehension. Using this “think-aloud” ap- proach to model illustrates to students how readers get mean- ing from text.

Beth Waite-Lafever Beth is speech-language pathologist with over 30 years of experience in the field of AAC. She has the RESNA ATP credential and LAMP certification from The Center for AAC and Autism. Beth has worked in outpatient rehab, private practice, and public school. Through her private practice, she has provided evaluations/therapy, trainings, and presentations at the state, national and international level. She is the co-creator of The Indiana AAC Summit, the only conference in Indiana dedicated to the practice of AAC. Currently she provides monthly online trainings for PRC as a contracted employee and is a speech/language pathologist and AT Coach for MSD Martinsville, a public school system in Martinsville, Indiana.

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During the OPPORTUNITY phase, it’s important to use the “think-aloud” strategy to show the emerging writer the process you are going through as you write. Then we simply talk about the picture and model words on a communication device. Basic list poems do not have to rhyme; they are just lists of words that may or may not be connected. It’s a great way to work on vari- ous parts of speech; such as, verbs, adjectives and interjections. I flip through photos on my iPad to find my choice. In order to make the poems visually appealing, I upload them to free graph- ic design apps/websites, as simple as DoodleBuddy, Pic Collage, Canva or Adobe Spark Post with lots of options for font, color and size. After I create my poem I read it and then tell the stu- dent “now it’s your turn.” Make sure that the model is not the same as the student’s photo-we want to model the process but not the exact words. Now it is time for the student to write. After he selects his photo, ask him to TALK about the picture. There are no wrong answers here. We are teaching the concept of writing words and helping our AAC learner see himself as a writer. I usually tell my student we need at least five words to make a poem. I make sure my poem also has at least five words. Then, together we look at the student’s photo. First, I merely say: “tell me what you want to write about your picture.” I pull up the photo in a graphic design website/app and type whatever the student says. Depending on the communication system, you can connect the dedicated de- vice to a computer and let the student type into a document and move the text into a graphic design program. Or, you can use the voice typing feature in Google Docs to transcribe the speech output from a speech generating device. It’s important not to rush the AAC writer. If they are not pro- viding much output, rather than telling him exact words to write, you can give a verbal description of the photo. For exam- ple, looking at a student’s family dinner photo you could say “looks like you guys had fun at dinner. I see your mom smiling and there is a dessert on the table. I wonder if you were celebrat- ing a birthday or special event”. At this time, write whatever the AAC learner says with his device-even if the words don’t appear to make a connection. Verbally comment on the words as you write them and let him see you do this: You said “awesome in name funny face”. I wrote that right here. What else do you want to write about this picture? Part of the writing process is reflecting and revising. If my writer is disinterested, or has difficulty coming up with words during an activity, we will put away the photo and bring it out another day. Once the writer has stopped saying words, or you may have to prompt him “Today’s writing only needs five words, so we are done with that part”, then it’s time to ENGAGE. After composing the text, it’s time to ENGAGE. At this point, the photo prompt is in a graphics program/app and we have added words. Now a lot of choices can be made with the style of the visual aspects of the words; such as font style, text size and color, location on the page, text highlighting or text box color.

We can use words like “top/bottom”, “big/small” and “different”. Making the words visually appealing draws the reader in to the poem and provides more communication opportunities. Once the student is satisfied with the product, read the poem aloud. Depending on the individual’s skill level, he may not be able to recall the words on his system to read the poem exactly and that is OK. You can even take turns reciting the poem by reading all the words but one and asking the student to just read his as- signed word. After this step, we are ready to SHARE. In order to experi- ence being a true writer, our work must be read and appreci- ated by an audience. Keep in mind that it’s also totally fine for some writings to be private, so always get permission to share the writing. Print out copies of the poems and distribute among friends/family, post on social media, text or email to others and let the writer review his work often to see what he’s written for modeling and to monitor growth. Here are some of my authors and how the NOTES strategy has helped them develop writing skills. James is an inquisitive 11 year-old with Down Syndrome. He loves building with Legos and has made some complicat- ed structures. He speaks in two to four word phrases with very poor intelligibility and is learning to use LAMP Words For Life with direct selection to supplement verbalizations. James has significant behavior challenges. He can be difficult to motivate and often prefers to search YouTube for videos than attempt to complete academic-related tasks. When he doesn’t want to participate, he often puts his head down, sits on the floor, or re- sorts to physical aggression. In order to build on his interest but still reduce distractions of live video, James was guided through a process of curating favorite images on Google. We also took photos of some of his block creations. We used NOTES to go through this process with him. NOTICE: James was interested in his photo of the restaurant he made from Legos - he returned to this photo many times. When asked if he wanted to write about this, he shook his head “yes”. OPPORTUNITY: I provided modeling of the writing process by talking through my thought process. “Here is my photo. It is a picture of a sun- set. I like it. I can write words to describe it. Look Pretty Pink Amazing Sky Love”. As I spoke out loud, I found the words on my version of his speech-generating device to model the language, then wrote them into the textbox of Adobe Spark and created my photo. TALK: We talked about his photo. James pointed to it and used sev- eral unintelligible verbalizations. I opened Adobe Spark Post on my iPad, uploaded his photo and opened the edit text window.

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ing process, it was important to take NOTES; Notice her interest. Anna loves looking through photos of favorite items and activ- ities on the Internet. She used her speech generating device to say “block” and we searched through various pictures of differ- ent types of blocks on the iPad. After she made her selection, we went through the additional phases of NOTES to elicit her words and participation in creating the visual. Anna’s words for this picture were “Block, block, play block”. She was also excited to get her printed copy of her poem and eager to return to her class to share it. SEE IMAGE 2 Clare is a 17 year old girl with a funny sense of humor. SEE IMAGE 3 She enjoys reading, horseback riding, creating art projects and jewelry. During the past couple of years, she has added writing to this list and it has become one of her most frequent- ly requested activities. Employing the NOTES strategy, Clare has begun to write poems using her Accent 1400 speech generating device with Unity language through eye gaze. Recalling single words, as well as up to four word phrases, Clare primarily uses her speech generating device to comment, make requests and answer questions. Clare has Rett Syndrome, resulting in mini- mal control of her upper and lower extremities and apraxia. She uses a wheelchair with a tray for seating/positioning and has both a table top mount and a wheelchair mount for her Accent 1400. Her family and school staff take lots of photos of her favor- ite people, places and activities. Using these as writing prompts, we scroll through the photo library on her iPad looking for her choice for writing. Clare offers a long blink for “yes” when she sees what she wants. Then the words begin flowing. Here she

Through our discussion, James began to recall words on his speech generating device and watched as I wrote what he said. Words continued to poor from his fingers, as he kept recalling words and watching me type them in the iPad. This was the first time I’d seen James get excited about any type of writing. He paused after several words. When asked if he was finished, he shook his head “no” and added three more words. ENGAGE: During the Engage phase, we talk about the visual elements of the picture and text. James used his words to say “big” and “down” to show where he wanted his name to be placed. He also said “green” to tell what color he wanted the background for the text of his writing. SHARE: It is important that our writers see their words published and appreciated by an audience. This is what makes writing pur- poseful and authentic. James, who often refused any activity that looked academic, could not wait to get to the printer and then hand-deliver this to his teacher! SEE IMAGE 1 Writing has been another way that one of my beginning com- municators has learned to express herself. Anna, an eight year- old girl with Down Syndrome loves music, blocks and puzzles. Her speech is improving, but at this time she uses approximately just five verbal words that are intelligible to familiar people. She has been using an Accent 800 with LAMP Words For Life for a year with direct selection, and is combining two words to make comments, ask questions, and make requests. To begin the writ-

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writes about riding her horse, Rascal. SEE IMAGE 4 During the 2018-19 school year, Clare has written many po- ems using the NOTES strategy. Her words are beautiful and typ- ically have a direct connection to the subject. She often amazes us with her insight. SEE IMAGE 5 During the school year, we have incorporated the PrAACtical AAC Year of Core Words (https://praacticalaac.org) throughout our district. This has served to introduce words in different cat- egories (adjectives, determiners, adverbs) that we may not have considered. We see these words reflected in her poems as well as her daily conversation. Clare’s writing is shared with her family and friends. During a recent meeting to discuss her goals, some of her writings were shared with the team. Because writing is personal, we ask Clare’s permission before sharing her writing. A new goal was added to her Individual Education Plan so that we can improve her language through writing: When provided with a self-selected photo, Clare will write a list poem of five to seven words consisting of at least three different word forms (nouns, verbs, adjectives, prepositions, etc.) using her SGD in 3/5 oppor-

tunities across three data collection days. Some days she has less control of her eyes and as a result more difficulty selecting words on her Accent. On these days, we talk about the writing process and the concept of editing and revising- assuring her that it’s OK to put away her writing and return to it another day. Another fun way to encourage interaction is to incorporate apps with selfies. Using Hair Salon Me, from Toca Boca, we up- loaded Clare’s photo and she was able to give herself various hairstyles and hair colors. This led to another writing prompt for Clare to describe - SEE IMAGE 6. By inserting the photo in Adobe Spark Post, Clare then di- rected us which font, background color and sizes to use for her words. JibJab, a free app for making e-cards that allows you to upload photos and find holiday-related backgrounds, is also a favorite. This app lets you add multiple faces, so it’s always excit- ing to see who Clare chooses to be in her pictures and what she will say about them. Using Adobe Spark Video, we’ve made short videos including her poems, and have contemplated opening an Instagram ac-

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devices to express their ideas and make a creation for others to enjoy as well. This changed the perception others held of stu- dents with significant disabilities as well as helped our students to see themselves as “writers”. Helping our AAC communicators experience the writing process is much less intimidating and more successful if you take NOTES: Notice Opportunity Talk En- gage Share. Ready to learn more about teaching writing to students who use AAC? Join us at CTG on October 1st, 8:00 - 4:00 for “Scrib- bling to Learn: Moving Students with Significant Disabilities from Emergent to Conventional Writers #CTG19 https://www. closingthegap.com/preconf-workshop/pc-14/ Resouces: Adobe Spark Post and Video https://spark.adobe.com/home/ Bertram, Mary-Louise, Musselwhite, Caroline, (March 24, 2016) Journaling with AAC and the Alphabet (Webinar) Angel- man Communication Training Series, Angelman Foundation Hanser, Gretchen, “Emergent Literacy For Children with Dis- abilities (December 2015) AOTA.org https://www.aota.org/~/ media/Corporate/Files/Practice/Children/emergent-litera- cy-for-children-with-disabilities.pdf PrAACtical AAC (www.praacticalaac.org) Sturm, Janet “Writing in AAC.” The ASHA Leader (September 2003).

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count for her to publish her work on social media. The look on her face when she hears her words read aloud by others tells it all: Clare is thrilled to be a writer! All of these students have used their speech generating de- vices to experience emergent writing. We’ve seen growth in vo- cabulary, word type and frequency of use in regard to authentic communication. For some, we saw reduced behaviors. All our students expanded their leisure activities by discovering a new hobby. Those who read the poems have a newfound appreci- ation for these young authors, as well as insight into their un- derstanding and views. Students who were not able to write in the traditional sense used words from their speech generating

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