Integrating AAC into a Center-Based Preschool Classroom: Co…

Feb/March Closing The Gap Resource Directory 2025 Volume 43 - #6

augmentative and alternative communication (AAC)

Summary: In this article we will share our journey as an SLP and early childhood special education teacher in a center-based class- room with autistic preschoolers where we successfully embedded AAC best practices. We will take you through our previous teaching methods, our shift to neurodiversity affirming practices, and successful implementation of AAC within our class- room. We will discuss our lesson planning and the collaboratively designed curriculum. Integrating AAC into a Center-Based Preschool Classroom: Collaboration is Possible!

SARA CARRIGAN, BA, M.Ed. Sara Carrigan has been an Early Childhood Special Education teacher since 2004, dedicating most of her career to supporting autistic children aged 2-5 in center-based preschool classrooms within public schools. Since July, Sara has expanded her impact by working with children and families and is currently working as an Early Interventionist. She is deeply passionate about empowering families to advocate for their child’s success in every setting, fostering meaningful growth and connections along the way. LEAH CARPENTER, MS, CCC-SLP. Leah has been working as a speech-language pathologist since 2017. She holds an educational and health license for the state of Minnesota and her ASHA CCCs. Most of her career has been spent in schools; specifically, early childhood special education. She is now a clinical instructor at Minnesota State University - Mankato. Leah is passionate about making communication more accessible to non speaking individuals and creating an environment to facilitate neurodiversity-affirming practices.

INTRODUCTION : Any SLP will tell you that establishing buy-in with adults is one of the most significant barriers to successful implementa- tion and use of AAC. How will the child ever learn their AAC if no one is willing to teach them? How do we get more adults on board that AAC should be used more often than 2x/week for 20 minutes? It is not an easy feat, but Sara Carrigan (special education teacher) and Leah Carpenter (speech-language pa- thologist) accomplished such a high level of collaboration that AAC was eventually embedded within curriculum planning for an early childhood special education (ECSE) classroom. But let’s start at the beginning, where most of us start - traditional instruction and service provision during specific “work station” times.

Our ECSE journey began together in 2020. We had two centerbased classes of autistic 4-year olds, 4 days a week. Our classroom ran as many did, a traditional early childhood special education classroom. We had a schedule that included play, work time, circle time, snack, and gross motor time. Students were supported through visuals for communication, most of- ten through low tech AAC such as activity boards, teacher cre- ated visuals or customized snack mats. Work stations were structured times for teacher, speech-language pathologist, occupational therapist and paraprofessionals to target identi- fied goals and objectives and teach “preschool academics.” Play was often one of those stations. Each child had a schedule of color coded tables to rotate through 4 different stations. We

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used first-then and token boards to “motivate” kids to complete activities and earn their preferred snack item toy/activity. We used timers to indicate when that station was over and time to move on to the next activity. At the beginning of the year we often started out with play based stations to get kids used to being in an area and transitioning when there was that au- ditory cue to change. The intent was that as kids learned the routine of stations we would transition to the “more academic” tasks to get their stamina built up for longer and more struc- tured work time in kindergarten. Does this sound familiar? AAC COLLABORATION - LEAH’S TAKE AND RECOMMENDATIONS: Before Sara and I met, the ECSE teams I worked with tended to assume that young children can only do so much with visu- als and AAC. It seemed people believed the simpler, the better. But we know that typical children need exposure to a lot of dif- ferent words in order to learn language. In fact, if we withhold language or only model “ready, set…” until they can say GO, they usually fall behind in their language development. So why doesn’t the same principle apply to non speaking children who just need language to be in a different modality? If we only provide PECS or simple low tech pictures, we are not promoting the use of a robust system or autonomous com- munication, which is what language truly is. This is how I ex- plained the importance of a robust system to Sara - and she got it. While we had some bumps along the way, we were support- ive of each other and respected each other’s expertise. While I was working with Sara and we were slowly changing our approach, I was on other teams in other buildings who also had complex communicators. It was tricky navigating differing team dynamics and staff buy-in. Admittedly, I fumbled quite a few times with collaborative efforts. But those experiences taught me a lot about how to navigate conflict and successfully gain staff buy-in so we can all work towards building a commu- nication system for the child. First and foremost, we have to start where the staff are. If they have never even seen a high tech device, it is an unreal- istic expectation that they will be modeling on it consistently throughout the school day immediately. Perhaps a more real- istic expectation would be to get the device out of the back- pack, make sure it is available throughout their day at school, and charge it when it needs to be charged. One team I was on needed to start here - take the device out of the backpack and have it out for the school day for the first month of school. I put up “don’t forget my voice!” posters on the student’s lockers with a picture of the app and brief technical instructions. Prior to hanging these posters up, I gathered staff feedback on them. I left it open ended - “do you think something like this would be helpful? Do you think I need to add or change anything?” This seemed to increase staff buy-in because they had input and an

opportunity to connect with me. I have found that establishing relationships with staff mem- bers is key to the success of AAC implementation. AAC, no mat- ter the program or device, is a learning curve. We need to es- tablish a relationship with staff so they feel comfortable with us teaching them a brand new skill set. One way to do this is being a holistic team member. Think of ways you can ease their work- load while you are in the classroom - can you help by wash- ing tables? Taking students to the bathroom? Helping a child regulate so staff can take a breath? All of these little things add up to you showing that you care. We also need to recognize that there can be so much going on in the classroom that AAC might not be the priority every minute of everyday. By taking on a few tasks here and there, you could be freeing up time and cognitive energy for the staff to continue learning new skills with AAC. Like anything new we come across or introduce, there may be initial hesitation. And that is to be expected! Lean into the discomfort and be willing to have big picture, vulnerable con- versations once you have a well-established relationship. The staff need to be on the same page with how they envision chil- dren gaining skills and the overall priorities of the classroom. Communication is so important to other aspects of develop- ment that it can be embedded within most activities. This is where joint planning and problem solving is going to increase AAC use. It’s important that we reflect and re-evaluate how things are going and if our approach is supporting the child and the classroom dynamic. Doing this with another profes- sional to get their perspective is imperative to the student’s holistic success. We absolutely can and should be supporting other areas of development because it is about the child as a whole, not just our goals and objectives. Lastly, being open to problem-solving and setting aside time to co-plan helps create a sense of a team. This shows you are in it with all of the classroom staff and want to not only be supportive, but a part of helping the child be successful in the classroom. Sara and I have been told we are good at “getting curious” about children - we don’t just see the behavior, we try to look past it to underlying reasons which then lead to proac- tive solutions. Sometimes, the solution is modeling on the AAC device or programming in regulation strategies so the child has access to those all of the time. For one child, we found that teaching her programmed phrases in her AAC while she was regulated led to her using those strategies when she was be- coming dysregulated, then coming out of that dysregulation faster. This then supported not just her communication devel- opment, but also her social/emotional development, meeting both mine and Sara’s goals.

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When we take a team-based approach with AAC, meet staff where they are, and view the child as a whole, that is where we can see the most change and progress for both staff and students. AAC COLLABORATION - SARA’S TAKE: As a teacher, I have always relied on my fellow educators, speech, occupational therapy, and paraprofessionals as equal team members in supporting the kids in our classroom. We all bring a different skill set and expertise to the table. Everyone has something to contribute. I trusted Leah as a professional, when she suggested higher tech AAC as communication sup- port, and was on board to give it a chance. New is hard but when I saw how AAC opened up our kids’ world, I knew I was excited for the possibilities and ready to learn a new skill. Leah showed me she was “all-in” by problem-solving with me, taking on extra tasks, and supporting my goals within her sessions. She and I had vulnerable conversations about our visions for the classroom and how we would get there. It helped us align our values and center our priorities. I wish every special educa- tion teacher would give AAC a chance to experience the magic like I have. NEURODIVERSITY-AFFIRMING JOURNEY AND CURRICULUM CREATION: During that 2020 school year, we had a student join the class who made us question our entire approach and was our true catalyst for change. At the beginning of the year, we began by implementing a rotational “work station” time. We remember dreading the beginning of the year when we felt like the entire workstation time was spent on the transition itself. Once we finally got kids regulated enough to engage in something… ding! It was time to transition again. One of our students showed intense dysregulation through self-injurious behavior, biting and scratching others. This was very evident during our work station times. We realized we were asking too much, hav- ing him transition to a new adult and new activity every 8-10 minutes. He felt safe in the wagon, LOVED bubbles and tactile sensory activities. When the timer went off, staff began coming to him and engaging in whatever activity he was interested in. We quickly realized how many concepts and communication opportunities we could embed in blowing bubbles and sen- sory bins. If we had success following his lead to be able to feel safe to connect and engage with us, why couldn’t we take this approach with all of our kids? We came to the realization it isn’t the kids’ responsibility to comply with our teaching methods, it was our responsibility to create a learning environment to meet each one of them where they are. Starting in 2021, we invested in neurodiversity affirming professional development, sought out various neurodiversity affirming accounts, and other resources from autistic voices. As

we dove deeper into our understanding of neurodiversity af- firming practices we learned about strengths based approaches as well as masking and autistic suicide. During our team meet- ings, we had open conversations about how the neurotypical approaches to therapy and teaching weren’t working with our learners. We realized that our well-intended teaching strategies were actually trying to change them to be more like their neu- rotypical peers… and it was an awful feeling. We decided to move forward as a team with our new neurodiversity-affirming principles where every staff member commits to helping the child holistically and as they were. Everyone understood the value in modeling on the child’s AAC as often as they could to teach the child a communication system. As we implemented this new approach, children began to learn. They began to show us what they knew - and turns out, they had a lot to say! As a team, we began to understand the pivotal role communi- cation played in regulation, cognition, and social connection for our students. Not only was this helpful in addressing their immediate communication, it was teaching foundational skills for learning, and most importantly, skills that would inevitably enhance their overall quality of life. Why did this go so well? At that time, we were fortunate to work with a group of women who knew we could do better for our kids. We were in agreement that the traditional teaching strategies I learned in graduate school and were common in many early childhood special education classrooms just didn’t feel right for our kids. We were willing to learn, stumble, and get outside of our comfort zone to find a better way. As the 2021-2022 school year progressed, we established our classroom philosophy to understand the purpose, values, and goals that drive our students’ learning environment. This streamlined our instruction and purpose as well as informed new adults entering the classroom about the expectations. Our philosophy was: Connection, Regulation, and Communication. First and foremost, we put connection as a foundation for all students. Trust and connection is a critical piece of our job. If a child doesn’t feel safe and connected to an adult, they are not in a space for learning. We honored every child’s manner, pace, and willingness to connect. We joined in their joy no mat- ter how silly we looked or felt, let go of what was coming next on the schedule, and didn’t mind how loud or messy we were. It was a matter of striking a delicate but intentional balance between needed predictability/structure while still joining kids where they are, presuming competence, and holding high expectations. We honored each child’s emotional state and sat with them when they were having big feelings. We wanted kids to be able to connect with us while still being their authentic, perfect selves. We prioritized connection and our kids’ emo- tional well being over anything else and it felt really good. Not only did it feel good, we discovered all of the incredible things our kids knew and had fun doing it! They trusted us to let us in

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and eventually stretch them to learn and try new things. Regulation before expectation. We can’t expect kids to be ready to communicate, play, and interact with others until their bodies and brains are regulated. Quickly we realized our kids were showing us what they needed. That student we were con- stantly helping down from the top of a toy shelf or table, he needed to climb. That student who was constantly jumping off of things, he needed to jump and crash! We realized their bod- ies needed access to sensory input all of the time. We trusted kids to access sensory equipment when they needed it, not only during designated sensory times or earning it after a “non- preferred”task. The result was more regulated, more connected kids. From then on out, we got curious, let the kids show us what they needed and gave it to them. We did circle time on the trampoline, coloring activities under the table, and speech activities on the swing. A final pillar to our classroom philosophy was communica- tion. All students would have access to a voice even if speak- ing isn’t accessible. We were all in agreement that low tech AAC absolutely has a place in our classroom but at the same time, it was limiting. Communication is not only a right but a key to connecting with others. We needed to honor and acknowl- edge all forms of communication equally. AAC in our class- room would be accessible without constraints or gatekeeping. Kids were given many models and opportunities to use their devices. They were free to explore their devices and talk about what they were interested in. We presumed competence, ac- knowledging any and all communication as intentional. We

shifted our communication from questioning and prompting to modeling natural, declarative language, commenting, nar- rating and even giving brief moments of silence to allow kids opportunities for spontaneous language. We learned to model language on devices and we even got to model mistakes as we were learning too. Above all we understood and honored refus- als are self-advocacy. Every student, no matter how young, has the right to advocate for themselves and be heard. Now that the baseline was established for the classroom, it was time to address the details of implementation. We wanted to highlight AAC and create a curriculum that was not only ac- cessible for the students, but supported staff and families in learning these programs in a functional and intentional way. This is our classroom set-up, with a variety of ways for our students to meet their sensory needs. We switched out equipment as our students showed us they were ready for something different.

Planning Grid: This is an example of our planning grid demonstrating how we embed opportunities to practice our core words of Look/See in all of our activities. These activities were included in our newsletter to parents.

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YouTube Video: This is a video of Sara and a student on a nature walk. You will notice this student asks for a “blue” leaf, and instead of correcting him, Sara presumes competence and actively searches for a blue leaf. When they didn’t find one, he labeled the leaf the correct color. https://www.youtube.com/shorts/WrEtCFh9bHA

This is a visual we had available for students when we went on our class nature walk to reinforce our core words of Look/See.

unit’s core words in as many activities as possible. This planning happened at team meetings and lived in shared docs online so everyone was able to contribute even if they weren’t on-site full time. Not only were our activities rich in the chosen core words, we would find areas of the classroom where we could have the symbol in print, in books, on motor equipment, in the sensory table or on the way to the bus. A silver lining of COVID was in- tentionally planning an activity in each of our units for families to make AAC accessible at home. Some units it was a video of a song we were doing at circle time, other units it was practicing “go” with a visual on the door to talk about where they were YouTube Video: This is a video of a paraprofessional and a student engaged in a child-selected sensory activity. The paraprofessional models on his device without expectation that he responds. https://www.youtube.com/watch?v=z5rSL0PX5SY

This is a visual support we had for students to follow along during one of our movement activities at circle time during our Look/See unit.

Not only was this new for our students, we wanted staff and par- ents to feel confident navigating to be able to model through- out classroom activities and with their child at home. It made the most sense to start with core words. After abandoning work stations (never looking back) and embracing play based, child led learning activities, we started with each two-week unit fo- cusing on one to two core words. We went through each activ- ity of the day and brainstormed ways we could incorporate that

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going each time they left the house. Keeping it simple and al- lowing for repetition not only gave our kids opportunities to practice but also built confidence and competence in staff and parents to be able to get to know their child’s communication program and provide models. Having a core word focus really seemed to be going well. Staff were feeling more confident modeling and we were see- ing more communication from students as well. That first year, averaging 2 words per unit, we covered 4- 6 words per month, for a total of 30+ words for the entire school year! What we were finding the next school year was we had students coming in day one with their own devices and had already had familiar- ity with many of the core words we had focused on as well as staff who were much more confident and efficient in modeling on their devices. As our knowledge about their programs and about our kids as communicators grew, we learned what voices felt right for kids to be motivated to communicate. While we

YouTube Video: This is a video example of a book reading that was sent home to families to watch and practice modeling on the AAC. https://www.youtube.com/watch?v=3M57Eqv9F0E

AAC IN ACTION: THINGS OUR STUDENTS HAD TO SAY

This is a student who is hoping for more Cheetos at snack time.

This student is expressing his opinion on Oreos.

This is from a student letting us know he didn’t want to be outside any longer.

This student is requesting to swing.

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still used a core word focus, we were able to start expanding into kids’ interest areas during play, emotions, and diving into those more custom, specific pages to give our kids an opportu- nity to talk about what they wanted to say. What we were also finding out is our kids knew a lot of things! We continued to model and our students continued to gain more language and make great progress. CONCLUSION: We went our separate ways in 2024; Leah now works at Min- nesota State University - Mankato as a clinical instructor and Sara works as an Early Interventionist in a Birth-to-Three pro- gram. While it was a hard decision to part ways, we both need- ed something a little different… but we still remain friends and professional collaborators. This experience taught us to ground our practice in what is best for kids and families. It taught us to be vulnerable and that progress isn’t always linear. Collabora- tion to implement AAC and best practice is no easy feat. But it’s worth it.

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