Training Communication Partners

Transcription

1 Training Communication Partners Heather L. Emery Lyons, M.S., CCC-SLP June 4, 2013

2 What we know Who are communication partners? What does it mean to be a communication partner? Old model = speaker & listener New model = interactants jointly co-construct meaning Slide 2

3 Problems? Individuals who use AAC face many problems when their communication partners: Take the majority of conversational turns Provide few opportunities for communication Ask only yes/no questions Interrupt Focus on their technology (Kent-Walsh & Binger, 2013) Slide 3

4 Communication Accommodation Theory Interactants shift their communication styles to accommodate or adjust to each other (Giles, 2008) Different registers and different modes depending on communication partner Form versus function Slide 4

5 Types of Communication Partners Communication Facilitators Day-to-day, long term supports Responsible for system maintenance, upkeep, and programming Train communication partners (Beukelman, Ball, & Fager, 2008) Slide 5

6 Types of Communication Partners Communication Partners (Social Networks) Not responsible for system maintenance Not in a caretaker role (Blackstone & Hunt Berg, 2003) Slide 6

7 Types of Communication Partners Caregivers Not responsible for system maintenance Caretaker role Slide 7

8 Social Networks Five circles of support (smallest to largest) Lifelong communication partners Close friends/relatives Acquaintances Paid workers Unfamiliar partners (Blackstone and Hunt Berg, 2003) Slide 8

9 What is communication? A dynamic and transactional process Changes based on the context of the interaction Inherently involves participants (i.e., communication partners) Sender Message Receiver (Binger & Kent-Walsh, 2012) Slide 9

10 Why do we communicate? What is the pay off? Slide 10

11 BICS v. CALPS Basic Interpersonal Communication Skills (BICS) are language skills needed in social situations. Social interactions that are usually context embedded and not very cognitively demanding or specialized. Cognitive Academic Language Proficiency (CALP) includes listening, speaking, reading, and writing skills about subject area content material. Slide 11

12 Obstacles to partner training? What are they? Pair with potential solution Slide 12

13 Obstacles to partner training? In 2011, the Assistive Technology Industry Association (ATIA) conducted a survey of speech language pathologists to measure attitudes about and usage of assistive technology and augmentative alternative communication. Only 10% of respondents believed that there are enough SLPs with AT and AAC knowledge to meet the needs of consumers 74% felt that they did not receive adequate preparation in AT and AAC in school SLPs favored a mix of pre-service curriculum modifications, more continuing education opportunities, and increased mentoring to address gaps in knowledge of AT and AAC Slide 13

14 Where to start? Identify communication facilitators, partners, and caregivers What are the environments? Use the Augmentative Alternative Communication Profile as a tool for determining current and desired skills levels and to write measurable goals for the student using AAC and their communication partner Slide 14

15 The AAC Communication Profile The Augmentative Alternative Communication Profile: A Continuum of Learning, Tracy M. Kovach, Ph.D. (LinguiSystems) Ages 2-21, Grades Toddler-Adult Test Set $69.95 Slide 15

16 AAC Communication Profile Two Functions: 1. An assessment tool that measures subjective, functional skills for developing communicative competence using AAC systems; re-evaluates skill level; and monitors progress 2. A guide to manage students/clients who use any type of speech-generating AAC system Slide 16

17 Group Activity Identify a student Complete the Augmentative & Alternative Communication Profile, noting areas you do not have sufficient information to complete Slide 17

18 Setting goals For current competency level For communication partners Thoughts on separating language versus operational/navigational skills? Discussion on how to incorporate these goals into the IEP Slide 18

19 Characteristics of Effective Communication Partners Take turns Ask questions Share in topic shifts Focus on the conversation partners messages Learn to create shared communication spaces Appropriately support co-construction of messages (Thiessen & Beukelman, 2013) Slide 19

20 Goals of Communication Partner Training Knowledge Abilities of the person using AAC Skill Ability to modify messages Willingness to accommodate Learn new strategies Settle for less than perfect Accept and honor all communication Slide 20

21 Training partners Consider Adult versus peer Learning style Environment AAC user preferences Cultural considerations Slide 21

22 Learning Mode Preferences Independent Learning with manuals and other aids Small Group Learning with others Case Study Learning to support a particular user s needs Step by step Detailed instructions (Beukelman, Burke, Ball, & Horn 2002) Slide 22

23 Cultural Considerations Four areas of potential parent-professional dissonance Beliefs about parenting style Intervention goals Family/community concerns Pragmatics of communication (Soto, 2012) Slide 23

24 Don t Program irrelevant vocabulary or culturally insensitive messages Assume all families interact in the same way Impose a foreign communicative task E.g. shared book reading Slide 24

25 Do! Make it explicit to families why you are asking their opinion Use cultural liaisons Model use of AAC in a communication context that is culturally appropriate and increases the child s sense of belonging/harmony to family and community Slide 25

26 Self Anchored Rating Scales A family-based AAC approach Use 10-pt Likert scale to have AAC user and communication partner identify and rate communication behaviors and goals Scale Goals Small changes Assign Follow up Slide 26

27 SARS Steps 1. Describe communication now 2. Describe a long term goal 3. Set a value for communication now 4. Describe a short term goal 5. Search for exceptions and work toward small change (Fox, 2012) Slide 27

28 SARS Benefits Helps clients and families calibrate their expectations Shows how opinions and actions contribute to goal achievement Involves everyone and develops an AAC action plan Recognizes small changes (appreciation) Creates a record that becomes a tool for discussing change Slide 28

29 The ImPAACT Program Improving Partner Application of Augmentative Communication Techniques Developed by Kent-Walsh, Binger, and colleagues based on the instructional program guidelines developed by Kent- Walsh and McNaughton (2005) Designed to teach communication partners to facilitate communication of AAC user Slide 29

30 Common Frustrations Communication partners often: Dominate interactions Ask primarily yes/no questions Take majority of conversational turns Provide few opportunities for initiation or response Interrupt communicative attempts Focus more on technology than message (Kent-Walsh & McNaughton, 2005) Slide 30

31 Common Approaches Intervention with communication partners Talk about need to change behaviors to facilitate communication Offer suggestions to how to change behaviors and/or patterns Ask How s it going? with implementation strategies Slide 31

32 Results Unchanged interactions Clinician feels frustrated Partner feels inadequate Slide 32

33 Communication involves behavior! Behaviors are patterns of action Information without action does not have inherent value Small day-to-day changes lead to bigger long-term changes Relevant motivators and triggers need to be considered (Binger & Kent-Walsh, 2012) Slide 33

34 So ImPAACT approach: Select appropriate targets Use effective instructional techniques Structure the intervention program Slide 34

35 Targeted skills Aided AAC Modeling Expectant Delay WH-Question Asking Verbal Prompts Increased Responsivity Slide 35

36 RAA READ + Model using AAC system (Pause) ASK + Model using AAC system (Pause) ANSWER + Model using AAC system Respond to all communicative turns taken by AAC user at any time Slide 36

37 RAAP READ + Model using AAC system ASK + Model using AAC system ANSWER + Model using AAC system PROMPT using AAC system Slide 37

38 Enhanced Milieu Teaching (EMT) A naturalistic, conversation-based intervention utilizing child interests and initiations as opportunities to model and prompt language in everyday contexts Slide 38

39 Enhanced Milieu Teaching and AAC Match symbols to context Use the system the child uses Pair spoken words with AAC (Kaiser & Wright, 2013) Slide 39

40 Steps in Training Partners Build a partnership Teach strategies Model, practice, and coach Provide feedback Slide 40

41 Other ideas? Resources? Techniques? Slide 41

42 Let s practice! Communication partner goal based on skill area of AAC Profile Technique No tech, low tech, or high tech device Book Group Presentations Slide 42

43 Questions? Answers 43