A Middle School Classroom's Comprehensive Approach to Gaini…

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

Instruction, Literacy, and Inclusion

Summary: This article will discuss a classroom team’s approach to addressing self-advocacy competency for augmentative and al- ternative communication (AAC) users with complex communication needs. Discussion will include the definitions of self advocacy and self determination and corresponding skills AAC users need to reach competency in this skill area followed by components of a comprehensive curriculum looking to teach content, develop skills, and provide training to paraeducators. A Middle School Classroom’s Comprehensive Approach to Gaining Competence in Self-Advocacy Skills

Students with complex communication needs (CCN), face significant challenges in expressing their thoughts, desires, and needs, often relying on augmentative and alternative commu- nication (AAC) tools to facilitate interaction. We typically look at four main areas of communication to consider the way an AAC user currently uses their system to communicate and to iden- tify next skills to target; these areas are operational, linguistic, social, and strategic. As a practicing school based speech-lan- guage pathologist with a caseload of students who require AAC as a primary means to communicate, these areas are criti- cal considerations in my therapeutic intervention planning and often drive how I am setting my goals; however, there were still observable barriers to participation, engagement with peers, building relationships, and engaging in larger environments. In addition, progress and generalization of skills were falling short due to ineffective training and coaching of communica- tion partners. As I worked with my multidisciplinary teams to address these challenges, it became evident that self advocacy was an area we wanted to hone in on. In our research we found curriculums, like IEP participation, to be too narrow focused or are limited; however we know students with CCN require a comprehensive approach that combines explicit teaching with in the moment coaching. Additionally, our AAC users require

communication partners who can interpret intentions and messages as they learn effective and efficient communication strategies. With high turnover and limited time for training, our paraeducators were undersupported in this area. As a team we were familiar with the National Joint Committee’s Communica- tion Bill of Rights; we had posters up in the classroom, used it when training new staff members, and referenced it in meet- ings with parents and school districts. We started to consider this not just as a reference tool but as a teaching foundation, to support giving our students and staff the knowledge around their rights as we supported self advocacy skill development. Using what we knew about working with AAC users and stu- dents with CCN, we identified that an effective intervention would involve changes to both the individual’s skills and the environment (Walker 2011, Light, 2015). We chose to look at the Communication Bill of Rights combined with environmen- tal observations to identify access and participation barriers to lay the content foundation for teaching. Selection of necessary skills such as effectively communicating preference, rejection or protest, opinions or feelings, desires, and needs, we created units to comprehensively develop self-advocacy skills, to sup- port our students with CCN. Our goal was to build competency in order to navigate their educational and social environments

AMANDA SCHERIFF HOBSON, M.S., CCC-SLP is a school based speech-language pathologist and department head at a collaborative school in Massachusetts for students ages 3-22. She directly supports students in acquiring and using AAC with a focus in alternative access.

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more effectively, foster independence and enhance their qual- ity of life. This article will further define self advocacy as an area of communication competence for AAC users and outline how our middle school classroom is developing a comprehensive curriculum to teach knowledge, build skills, and train commu- nication partners concurrently. SELF ADVOCACY AS A COMPETENCY AREA When we consider communication competencies, we are stating that a person should have a set of skills or strategies to use to engage in various communication opportunities effi- ciently and effectively; ideally we are striving for independence achieved through development of mini milestones or acquisi- tion of stepping stone skills Self-advocacy can, and should be, considered an area of communication competency used to consider and set goals to move towards a person’s ability to communicate efficiently and effectively in a variety of commu- nication settings with a variety of communication partners. Self advocacy can be defined as a set of skills and subskills used to engage in the complex process of speaking on your own behalf to share needs, beliefs, opinions, interests, and desires (Singer & Morgenson, 2021). For students with complex communication needs (CCN), self-advocacy is essential as it empowers them to navigate their environments, communicate effectively, and as- sert their rights and preferences. When considering a definition for self-advocacy, we want to think about self-determination as a driving force. Self-determination refers to an individual’s ability to make choices and take control over their actions and decisions such as setting goals, solving problems, and pursuing opportunities that reflect their desires and needs. Without self determination, we can’t advocate for what we want. Therefore, we want our students to develop comprehension of “self” be- fore, or while simultaneously, teaching skills on how to act on desires, motivators and preferences. Using the above to lay the foundation, there are two broad areas to target: knowledge of self and individual needs and skills needed to self advocate that move towards self advocacy. While the ultimate goal is to develop competency in these two areas, the following knowledge and skills areas can be consid- ered markers towards achieving independence. For knowledge of self and individual needs, we are looking to build awareness of:

To support competency in self-advocacy, we need to build skills such as: • Comprehension of language; (content vocabulary as well as words to use) • Effective protesting • Expressing preferences, choices, and needs • IEP participation • Active participation in decision making • Conversation strategies; (different strategies for familiar and unfamiliar partners) • Problem solving With our content and skills identified, we need to look at the opportunities needed to build, facilitate, and practice while as- suring that the environments assure meaningful, and authentic opportunities. We need to consider if the environments our stu- dents are using these skills in are ready to respond. Will peers know what to do when a student says “Give me time to make my message”? Will a general education teacher be prepared to provide an accommodation requested at the start of class? Will a communication partner be ready to accept a protest even if it goes against the classroom agenda? Asking these tough ques- tions as we as we develop our lessons and activities will ensure that teaching and coaching of communication partners is of equal consideration. Taking into consideration the individual level as well as the immediate and larger contexts contributes to a comprehensive approach to teaching and building skills in an effective manner. OUR CLASSROOM CURRICULUM In a busy middle school classroom, time is tricky. Balancing therapies, inclusion classes, individual work time, and social op- portunities is a challenge. Throw in a 6-day waterfall schedule and it’s next to impossible. As a team we started by identifying the “must haves” and unanimously, self advocacy made the list. We dedicated a once per week, 50 minute block to this topic to tackle the explicit teaching as a group; students and parapro- fessionals attendance required. Integrating both the classroom teacher and speech pathologist’s perspectives, units of study were, and continue to be, created by a) identifying the knowl- edge to teach (i.e., content) 2) identifying how to expressively use the gained knowledge (i.e., skills), 3) identifying commu- nication partner skills to respond to student skills (i.e., partner training and coaching), and 4) tools needs to engage in the learning process (i.e., permanent products). With a structured approach, we can create a comprehensive plan to teach and skill build in a holistic manner. Units are additionally driven by an environmental need. New team members or teaching staff drove the unit for choice making and protesting. Challenges with building peer connections set in motion a unit targeting respect and acceptance. Repetition of units has and will con-

• Individual communication strategies • Disability awareness and disclosure • Accommodations to access education • Low and high stakes choices • Role of communication partners/ allies • Personal preferences and motivators • Public and private information

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tinue to occur to further build knowledge and skills.

lying on the mat in PT, in the sun) • Word relationships: Provide students with fill in the blank of a sentences with an appropriate word from a set (e.g., My classmates ______ me when they answer my ques- tions, I must be ______ in my community, You can sit next to me to protect my physical ______; targeting words ac- knowledge, include, and boundary in a unit about teach- ing respect) • Sentence generation: use AAC systems or a closed set of choices to complete a sentence starter (e.g., My IEP tells someone about…; People can respect me by…) In addition to explicit vocabulary routines, customized so- cial narratives (Sam & AFIRM Team, 2015) provide examples of new vocabulary (words and phrases) in a narrative format to help hear and learn information (e.g., Let’s go to an IEP meet- ing; My Accessible School). Customizations include using real pictures of places and people, targeted pre-stored phrases that may be added into devices, contexts that are relevant to the student or staff, and use of skills that are accessible to the stu- dent. See the video below of a customized social story teaching the phrase “ask me first”.

VOCABULARY As referenced above, the Communication Bill of Rights serves as a foundation for knowledge. To begin, a communica- tion bill of rights dictionary was created to support consistent reference to the vocabulary we were using for students and paraeducators. We took the lengthy, complex right and paired it with a symbol. We identified tier 1, or high frequency words / core words, to use when descriptively teaching the right. See the video here to see our communication bill of rights diction- ary below.

Explicit vocabulary instruction routines (Geis & Erickson, 2021) provide structured and consistent introduction and teaching for new vocabulary. Through use of tier 1 words (high frequency/ core words) to define tier 2 and tier 3 words we en- gage in a process called descriptive teaching. For example, a right is something we all + get and it tells us what we can +do . We can break down “the right to be addressed directly and not be spoken for or talked about as if not there” by using tier 1 words (e.g., talk to me) to descriptively teach this right. To more deeply understand content vocabulary, we engage students in activities to develop comprehension, such as: • Examples and non-examples: Look at pictures represent- ing the word ACCESSIBLE and determine if the picture matches the definition of accessible (e.g., picture of a ramp going up stairs or an automated door button com- pared to stairs to enter the building and tight aisles of the library with books on the top shelf). • Generating Situations: when considering times when LOW-TECH tools are used, students consider parts of their schedule where they might need to use a LOW-TECH or ALTERNATIVE communication tool (e.g., swimming pool, Example of communication bill of rights dictionary YouTube Video - https://www.youtube.com/watch?v=_ tm8SkYOcIU

Example of ask me first YouTube Video - https://www.youtube.com/ watch?v=OsebiCkTybQ

LEARNING ACTIVITIES There are endless activities that can target skill develop- ment in a structured setting. To move from knowledge to ac- tion, we want to create structured opportunities to practice real skills that can easily be used in a larger setting. The intent of this section is to provide some examples that have worked in our classroom because they have been engaging, have yielded skill development, and have clearly facilitated movement from content knowledge to skill use. We want to focus on skill build- ing in age appropriate, authentic, and applicable opportuni-

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ties; ultimately, we want to be intentional. Activities should en- gage and challenge students to use what they know to prepare for real world scenarios. They should be able to practice with support from those who planned the activities as well as those who will be supporting them in the naturally occurring envi- ronment (i.e., communication partners). When we consider bridging the gap of activity specific vo- cabulary and use in natural environments, we look for oppor- tunities to have vocabulary learning exist within functional, hands on activities with AAC user input. We involve students in locating vocabulary and planning for device programming ( a perfect time for meaningful choice making!) to merge content knowledge into expression of knowledge. For example: • Go on a scavenger hunt within communication systems and communication environments to check off what words we can use and what words we should add • Take phrases to support quick self advocacy and have stu- dents decide where to program into devices. This can be open-ended or modified by providing choices of where to program • Use same aged peers to get vocabulary that is age ap- propriate to include into relevant content (e.g., opinion words, leisure choices, conversation starters or interjec- tions, etc.). Have students decide which words or phrases to program With vocabulary provided, we want to plan for opportuni- ties to use it. Communication planning tools are essential to this process to plan for opportunities that arise in fast paced, naturally occurring environments. Examples include: • Create “When I do… It means…” dictionaries for uncon- ventional communication strategies can help others ef- fectively interpret the message while building awareness of self. • Guided communication passports to be created and shared with all those in the immediate and larger envi- ronments. Rather than being written by an SLP or teacher, using sentence prompts or starters or other guides to co- create a written document to be shared that highlights communication strategies and important to’s (things that are important to the communicator). • Co-constructed narratives to summarize learning or share as a presentation • Providing realistic scenarios to collaboratively plan and co-create a script before acting it out for the group (Bur- khart & Musselwhite, 2001) To build meaningful participation in a variety of decision making tasks, talking mats (Hayden et.al, 2023) have become a frequently used tool. Talking mats are a low-tech and digital tool used to guide a conversation. Using three categories (like it, don’t like it, whatever/ I don’t care) students can sort pre-

A guided communication form to inform preferences for customized adapted video games created by peers.

A co-constructed narrative to wrap up a unit on acceptance.

Example of sorting mat for personal high and low tech communication tools.

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sented information related to a topic. You can see, in the pic- ture example, completed talking mats that can be referenced in conversations. It creates the opportunity to pre-plan, rather than producing answers in the moment, so that students have had the opportunity to meaningful and successfully partici- pate. This has been a helpful tool for participating in decision making processes for field trips, allied arts/ elective classes sign ups, device programming, and sharing school preferences at an IEP meeting.

• Diversify response strategies (verbal referencing, act on, acknowledge, relate to context, prompt symbolically)

In our groups, staff participate alongside the students. Ac- tivities include: • Brainstorming and sharing challenges to support self ad- vocacy during the week • Engaging in role plays • Co-constructing scripts with students • Asking for observation times from the teacher or SLP dur- ing challenging moments in the day

Example of a talking mat for the topic “what I think about my school schedule”.

PARTNER TRAINING AND COACHING : Thinking back to the self-advocacy definition and reason for needing to teach these skills, we can recall that we need ex- trinsic factors to be considered as we teach students the skills to self-advocate. We know that for complex communicators, there is a substantial need for communication partners to be interpreting communication which leaves students vulnerable. We look at our partners as communication allies, or the people who are there to support communication problem solving. We emphasize that communication partners should not act as the voice but instead, the microphone. We coach our teachers to make sure that they have the skills to ensure student’s rights are being validated and followed through on by giving them practice in a structured setting to: • Utilize a least to most prompting hierarchy to be respon- sive while leaving space for independence • Understand presentation and access methods • Getting comfortable with wait time • Respond to both students and those who might (acciden- tally) violate student rights • Provide meaningful choices/ choice diversity across the day (Brown, et.al., 1993)

Posters creating for the environment to remind people to ask students first before engaging in routine activities.

One of the most effective ways we found to empower com- munication partners to engage in the structured activities and try to use skills in the larger environment has been through our self advocacy shout outs. Each week we start our group by pull- ing notes from a bucket that share a self advocacy victory, for students and staff. It fosters a culture of encouragement, shar-

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Sheldon, E., & Hartmann, A. How to be an AAC supporter - Assis- tiveWare . https://www.assistiveware.com/learn-aac/how-can-i- help-be-an-aac-supporter Karimi, L. (2024, February 9). Erika Fundelius - Department of Educational and Counselling Psychology, and Special Educa- tion. Department of Educational and Counselling Psychology, and Special Education. https://ecps.educ.ubc.ca/erika-funde- lius/ Light, J., & Mcnaughton, D. (2015). Designing AAC research and intervention to improve outcomes for individuals with complex communication needs. Augmentative and Alternative Commu- nication, 31(2), 85-96. Hayden, N. K., Bradshaw, J., Hayward, S., Murphy, J., Boa, S., Eden, V., Mischo, S., Pampoulo, E., Macrae, A.-M., Reid, J., Darvell, C., Lauer, N., Mundt, I., Clark, L., Nagawa, M., Duner, A., and Talk- ing Mats Research Network (2023). Summary of Talking Mats Studies. Sam, A., & AFIRM Team. (2015). Social narratives. Chapel Hill, NC: National Professional Development Center on Autism Spec- trum Disorder, FPG Child Development Center, University of North Carolina. Samuelsson, J., Holmer, E., Johnels, J. Å., Palmqvist, L., Heimann, M., Reichenberg, M., & Thunberg, G. (2024). My point of view: Students with intellectual and communicative disabilities ex- press their views on speech and reading using Talking Mats. British Journal of Learning Disabilities , 52, 23–35. https://doi. org/10.1111/bld.12543 Singer, B.D., & Morgensen Jennifer. (2021). Getting students to Self-Advocacy—Step by step. In ASHA LeaderLive. https://doi. org/10.1044/leader.ftr1.26082021.32 Taub, D., Wakeman, S., Saunders, A., Thurlow, M. L., & Lazarus, S. S. (2019). Using the least dangerous assumption in educational decisions (TIPS Series: Tip #6). Minneapolis, MN: University of Minnesota, TIES Center. Walker, H. M., Calkins, C., Wehmeyer, M. L., Walker, L., Bacon, A., Palmer, S. B., ... & Johnson, D. R. (2011). A social-ecological ap- proach to promote self-determination. Exceptionality, 19(1), 6-18. Wehmeyer, M. L. (2005). Self-determination and individuals with severe disabilities: Re-examining meanings and misinter- pretations. Research and Practice for Persons with Severe Dis- abilities, 30(3), 113-120.

ing big and small moments of the week, and lets us focus on positive changes and actions as opposed to supporting strug- gles. With emphasis on encouragement, staff are more open to receiving feedback, asking questions, and seeking advice when we do use in the moment coaching. It has easily become my favorite time of the week to see how proud someone is of the work they are doing. CONCLUSION: While the above outlines what we are doing to address the need for a comprehensive approach to self advocacy compe- tence, we still experience barriers and find ourselves thinking about where to go from here. We may have found the ticket to empowering our classroom staff to try to use skills in the natural environment but we haven’t yet unlocked that for all communication partners in our students’ broader communica- tion circles. We continue to develop a flexible curriculum that allows us to move with the challenges that present themselves so that we place value on providing meaningful and impact- ful learning opportunities. For our future goals, we look to seek out opportunities to work towards peer to peer interactions, strengthen the message of presumed potential, and create more meaningful opportunities for our students to practice their self advocacy skills. REFERENCES: Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogle- tree, B. T., Paul, D., Romski, M., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. American Journal on Intellectual and Developmental Disabilities, 121 (2), 121–138. Burkhart, L., Mussel White, C. (2001). Can We Chat? Co-Planned Sequenced Social Scripts. Litchfield Park: Special Communica- tions. Finke, E. H., Davis, J. M., Benedict, M., Goga, L., Kelly, J., Palumbo, L., . . . Waters, S. (2017). Effects of a Least-to-Most Prompting Pro- cedure on Multisymbol Message Production in Children With Autism Spectrum Disorder Who Use Augmentative and Alter- native Communication. American Journal of Speech-Language Pathology, 26(1), 81-98. doi:10.1044/2016_ajslp-14-0187 Geist, L., & Erickson, K. (2022). Robust Receptive Vocabulary Instruction for Students With Significant Cognitive Disabilities Who Use AAC. TEACHING Exceptional Children, 54(4), 296–304.

Hartmann, A & Sheldon, E. (2019). Just Ask: What we can learn from AAC users. [Blog post]

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Van Tatenhove G. (2009). Building language competence with students using AAC devices: Six challenges. Perspectives on Augmentative and Alternative Communication, 18, 38–47.

Witkowski D., Baker B. (2012). Addressing the content vocabu- lary with core: Theory and practice for non-literate or emerging literate students. Perspectives on Augmentative and Alterna- tive Communication, 21, 74–81. Wood, W. M., Fowler, C. H., Uphold, N., & Test, D. W. (2005). A re- view of self-determination interventions with individuals with severe disabilities. Research and Practice for Persons with Se- vere Disabilities, 30(3), 121-146.

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