While self-sufficiency is always important for students as we prepare them for life as independent adults, there is another side of this we want to explore.  In my mind, self-sufficiency does not refer only to carrying out a task on our own.  It also includes the skill of knowing when to ask for assistance.  This is particularly true for students with physical disabilities.  

There is a tendency for those around these students to get in the habit of doing tasks automatically…without being asked.  This is certainly understandable but it is not always in the best interest of the students in becoming independent adults.  

Adults with physical disabilities need to have the skill of not only asking for assistance but directing others in the process.  One woman I knew would ask me to write her appointments in her schedule book for her.  She was able to remind me to do it, tell me where her schedule book was located and what she wanted me to write.  Another person I knew would ask cashiers to take his wallet out of his bag, remove a specified amount of money, show him the cash and place the receipt in the wallet before returning it to his bag.  The ability to ask for this assistance and to provide specific directions politely enhanced the independence of these individuals and their ability to participate in activities of their choosing. 

Teaching these skills begins early.  We can begin by teaching young students to request assistance with physical tasks as needed.  We can then enhance this skill by encouraging them to provide specific instructions.  Tasks might include: 

• Opening doors, lockers and cabinets
• Collecting and positioning materials
• Moving to various places within the environment
• Eating and drinking
• Completing school work

Students could produce these requests by formulating a message word-by-word or letter-by-letter using core word strategy or keyboards.  This is certainly an appropriate skill to accommodate unusual situations.  However, many of these requests will occur consistently.  Let’s increase the student’s efficiency by programming in these frequently occurring requests in “My Phrases” in the Series 5 software under the “Wants and Needs” tab on the DynaVox Maestro, V+ or Vmax+, or the “Needs and Wants” tab in “Quickfires” on the DynaVox Xpress.  You might also consider programming them within the topic where they will be used (e.g., classroom, cafeteria, bus).

Sharing opinions and, in particular, comparing one thing to another is a regular part of our everyday interaction. It is not just related to food but is done when discussing movies and clothing as well as feelings about an event (e.g., party, therapy).  Television shows in general can be rated for how good the plot was, how well the new cast member fits in, etc.  The singing, dancing and cooking contest shows that fill the program schedule offer many opportunities to compare performances.  How can the individual with a severe communication impairment share “ratings?” 

We might immediately think of using facial expression (e.g., smile, frown) or a thumbs up/down as possible techniques.  We often ask yes/no questions – “Did you like it?”  While these are good for indicating overall positive or negative feelings, how can we get to the idea of comparison – of saying that one was better than the other? 

Incremental thumbs up – The thumbs up/down technique could be modified to show level of like/dislike.  In this case, the thumb in the 6:00 position indicates bad, 9:00 (from the communicator’s perspective) means OK and 12:00 means great.  Given this schema, 10:00 would mean pretty good. 

This technique is used naturally by some people but will need to be taught to others.  The advantage is that it requires no equipment and is understandable to many people.  The disadvantage is that it is fairly abstract and may not be easily understood by the communicator who has language and/or cognitive issues.  

Indicating number ranking with fingers – This technique requires the communication partner to establish a rating scale with the communicator.  “1 finger means bad.  3 fingers mean OK.  5 fingers mean great.”  This technique has the advantage of requiring no equipment.  The challenge is that it requires the communicator to understand the rating scale delivered verbally and, if the communicator ever uses it spontaneously, it would not be understood by unfamiliar people. 

Rating Scale – Rating scales can be drawn on pieces of paper, kept in a communication book and can be found or customized in speech generating devices.  The picture (at right/left) is an example of a rating scale written on a piece of paper.  As you can see, it isn’t pretty but it is functional.  You still describe it verbally but it provides visual cues at the same time providing additional support for the communicator.  If used spontaneously, this scale would be understood by someone unfamiliar.  A number-based scale is available in the “Doctor’s Office” scene in the Series 5 software found on the DynaVox Maestro, V+ and Vmax+.   

Next week, I am going to my favorite (thus far) Mexican restaurant.  I will see if they can maintain their current rating – thumb at 12:00, five fingers, close to “great” on the written scale and 9 of 10 on the number-based scale on my Series 5 device.

One of my favorite examples of this came from a friend of mine.  Her father was pumping gas while the rest of the family waited inside the car.  He looked at his wife, held up both hands and showed her five fingers on both hands followed by two fingers on each hand then four fingers on each hand.  His three children were in the back seat complaining, “What does he mean – 10, 4, 8?”, “How does he expect us to understand that?”, “He does this all the time!”  My friend’s mother calmly turned to her children and said, “He means that the five (5) of us are going to (2) a restaurant for (4) dinner.”  Inexplicable, yes, but not unusual! 

There are times when these types of communication attempts fail.  I recall my own father standing at the corner of our house making some kind of odd salute followed by a turning motion.  This was supposed to mean, “Go down to the end of the house, turn the corner and turn on the water.”  I didn’t get it either! 

The problem with this type of idiosyncratic (personal) communication is that is it easily misunderstood by less familiar people or even by familiar people if the context is unknown.  It is for this reason that multi-modal communication is so important.  

Multi-modal communication is the use of many forms of communication for expression.  This might include any combination of speech, vocalizations, gestures, pointing to objects, pictures or general location, facial expression, body language, etc.  When I didn’t understand my father’s gestures, he held up the hose and repeated his gesture resulting in my understanding of his message.  This isn’t confined to people who can speak.  I’ve had AAC users use photographs, brochures, business cards, tickets and other memorabilia to communicate in addition to their devices, voice and gestures.  

Think about the modes of communication already at the augmented communicator’s disposal.  Consider what additional modes you might teach.  Use our Multiple Communication Methods resources in the Implementation Toolkit to assist you.  Go to our Search Resources page at http://www.dynavoxtech.com/implementation-toolkit/search-resources/ and type in “Multiple Communication Methods” in the search box to see a handout and worksheet as well as worksheet and video examples.

• V, V+, Vmax, Vmax+, Maestro – Young Adult, Adult and Navigator users under the “Talk” button in the upper right hand corner
• Xpress – Young Adult user under “Quickfires” in the upper right hand corner 
• Young Child, Child and Teen users may have “wait” or “hang on” in the Quickfires depending on the age of the user. 

Why is “wait” so powerful? 

Production of the word, “wait”, can be used to get others attention.  For example, I was in the airport the other day and saw a group of seniors who were clearly part of a tour group.  One person was struggling with her luggage and called out for the others to wait so that she would not be left behind. 

“Wait” can be used to provide time to process information.  This is very important for individuals who have experienced stroke or brain injury.  Sometimes, they need additional time to understand what is being said to them.  Sometimes, we all need that.  I was explaining something about the computer to a friend and she had to stop me to give herself to time understand the new information I was providing. 

We can use the word “wait” to give ourselves time to think about then produce what we are going to say.  I am sure that there are times when you ask someone to wait while you decide how to respond to a request or statement.  If you have children, you have probably done this today!  In situations that are touchy, you may also think about HOW to say what you want to say so that it is received as you intend.  Both of these reasons for asking others to “wait” are important for augmented communicators who may need extra time because of their language issues. 

Finally, we might ask others to “wait” when we want to interject into a conversation.  This may occur with a person who talks very quickly or in group interactions.  Sometimes, we have to just jump in!  Because it does take longer to communicate with AAC, augmented communicators often need a way to halt conversation so that they can participate before the topic moves on.  “Wait” gives them a way to do that! 

Big impact!  Little word!

It seems to me that this question may have arisen from hearing about a technique known as Partner Augmented Input (PAI) or Aided Language Stimulation.  In this technique, the communication partner uses the student’s AAC system to produce his or her (the partner’s) own message while also talking.  In other words, the partner is demonstrating use of the device in everyday situations as a means of communicating. The partner does not elicit imitation back from the student.  This technique focuses on building the student’s acceptance, understanding and skills with AAC through demonstration.  Research has shown this to be a powerful and natural method for teaching use of AAC.  Check out these resources for instructions and a summary of results: – Partner Augmented Input Instructions, and Partner Augmented Input References. 

This technique does not provide license for any peer (or adult for that matter) to use the individual’s communication device whenever they wish.  Rather in cooperation with the student (if possible), peers and adults are identified and trained to provide PAI.  There isn’t a lot of training necessary and, in fact, DynaVox has training plans to help you with this technique and a few others – Training Plans for Communication Partner Techniques.

I’m guessing that you might have a few questions. 

• How many peers and adults should be trained?  At least two in each environment so that PAI can be done consistently.  The more people who know the technique the more likelihood that the technique will be used and the student will receive the benefit.
• How can I provide training?  Use the training plans noted above and teach how the AAC device’s vocabulary is organized so that partners can find vocabulary more easily.
• What if the student doesn’t want someone touching their device?  That person should not be a PAI partner.  If they are a necessary partner, you might need to work on building a relationship between the student and the potential partner over time. 

For more information, the Implementation Toolkit has a resource regarding PAI with peers – Partner Augmented Input – Tips for Training Peers.

• “I’m just staying in until spring.”
• “Can you believe this weather?”
• “I am so ready for spring.”
• “This is the worst winter in a long time.”
• “Why do we live here?” 

It is as if this were the first time we’d ever been through a winter!  Those of you who live on the East Coast or Midwest understand this.  Some of the same phrases above are, I am sure, uttered in milder climates as well though you probably hear the speaker better because their mouth is not covered by a scarf. 

This is a topic of conversation among everyone!  We share stories of how weather has affected our plans from getting stuck in our own driveway to the four inches of ice that covered our car to that time we stepped in the puddle in our new shoes.  We complain about what is happening and look forward to the next season.  Though repetitious, these conversations are equalizing and bonding.  They are safe subjects. 

My last blog talked about where to find weather vocabulary in DynaVox devices.  This week, I want to talk about how to use your device to engage less familiar people on a safe subject like weather.  

• Begin with an opener to make sure you have the person’s attention.
  • Use a Quickfire like “Hello”, “Hey” or “Excuse me”
  • Make a comment about the weather
    • Prestore this in your weather pages or in My Phrases
    • Be prepared to comment on what the individual says back to you
      • Quickfires can be great for this – “good”, “no good”, “really”
      • Ask a question about another subject to continue the conversation or close the conversation
        • Quickfires and My Phrases are great for this

This is a short conversation and not deep but it is a start!  It is something that is common to everyone; it is inclusive.  

Help the augmented communicator use subjects like the weather and others (e.g., sports, happenings in the news) to take a step toward engaging with less familiar people.  In the long run, this will be a benefit to them (possibly establishing new relationships).  It may also positively impact the perceptions of the general populous toward those who use AAC. 

“We build too many walls and not enough bridges.”  Isaac Newton

Whether you have already done some preparation or would like to accommodate for the unexpected, let us provide you with some resources from our Implementation Toolkit to help you improve communication and consistency from year-to-year.

• Multiple Communication Methods Worksheet – This worksheet facilitates sharing of ALL the ways the augmented communicator expresses him or herself.  Use it to share the facial expressions, body language and gestures/signs produced as well as communication using speech/vocalizations and AAC.  Fill out one worksheet or fill it out for various activities (e.g., mealtime, music).  It will help classroom staff more accurately understand the messages the student is trying to produce.  http://www.dynavoxtech.com/implementation-toolkit/details.aspx?id=77

• Selection Method Checklists – We have one of these for individuals who use direct selection (e.g., touching the device, eye gaze) and one for those who use scanning.  These checklists help classroom staff understand how the student physically uses the device – where switches need to be setup, software settings in the device, etc.
  • Selection Methods – Direct Selection Checklist http://www.dynavoxtech.com/implementation-toolkit/details.aspx?id=213
  • Selection Methods – Scanning Checklist – http://www.dynavoxtech.com/implementation-toolkit/details.aspx?id=219
  • Positioning Worksheet – This worksheet provides a way to clearly describe where the device is positioned best for the student’s use. http://www.dynavoxtech.com/implementation-toolkit/details.aspx?id=143
• Transportation Worksheet – Use this worksheet to share how the student takes the device from place-to-place.  http://www.dynavoxtech.com/implementation-toolkit/details.aspx?id=169

This set of resources can provide foundational information to current and new classroom staff members to encourage proper setup and use of the student’s AAC device.

What does this have to do with AAC?  In this blog we discuss topics related to AAC and individuals who have experienced stroke or brain injury.  Many of those who have experienced a stroke are in the senior set.  Given the results of my unscientific poll, I thought it appropriate to discuss the weather. 

Where would we find weather-oriented vocabulary in the Adult User in InterAACt?  

• To ask family and friends about the weather in general and remark on it yourself, add this question and comment to “My Phrases” in the “Talking to Friends” section. 
• To ask a family member about the weather in their area, customize the “My Family” page.   You will certainly make different comments to a child who lives in Arizona than the one who lives in Minnesota! 
• To discuss the weather, share stories about past weather experiences and plan for weather events, customize vocabulary in the “winter” scene that is already available in InterAACt or use the “weather” category in “My Words”. 
  • Adult 60 – Select “Weather” on the Master popup
  • Adult 40 – Select “Seasons” on the Master Page then “Winter”
  • Adult 12 & 20– Select “Leisure” on the Master Page then select “Seasons” and “Winter”
  • Adult 6 – Select “Things I Like To Do” on the Master Page then “Seasons” and “Winter”
  • Adult 12, 20, 40 – Select “My Words” then “Weather”

Uh oh!  It winter is right around the corner again!  Better grab my phone!

Questions are an important part of learning.  They help us determine what person understands and in what they are interested.  Nancy Willard said, “Sometimes questions are more important than the answers.”  While an old African provide asserts, “The one who asks questions doesn’t lose his way.” 

Asking questions can be accomplished a number of ways in InterAACt.  The most simple is by using Quickfires (under the “Talk” button on the Series 5 devices and under “Quickfires” on the Xpress).   The number of question words available in Quickfires depends on the age and communication ability level of the user.  They are quick and easy ways of asking questions useful for all communicators. 

Questions can also be found in various topics and in My Phrases (“My Phrases” in the Series 5, 2^nd through 5th tabs in Quickfires in the Xpress).  These questions are related to a particular topic or communicative situation.  

Finally, a student can create his or her own questions using the core words strategy (e.g., Gateway, Xpress Core) or keyboards.  

During classroom activities, encourage students who use AAC to ask questions by using their device to ask questions yourself, have other students use the augmented communicators device (or printed out copies of pages) to ask questions and give them opportunities to ask questions.  As Bishop Creighton said, “The one real object of education is to have a man in the condition of continually asking questions.”

• Drivers who don’t use a turn signal
• People who drink directly out of the milk/orange juice container
• Made up car names that are not even real words
• Couples who sit on the same side of the booth when there is no one on the other side
• People who sit next to you on public transportation even when there are other seats available
• Noisy eaters

“Mouth noises” drove my mother crazy.  You know what I mean, those funny noises that kids make when they are bored using their mouths.  Those noises were like fingernails on a chalkboard to her.  

What are your pet peeves?  What are the pet peeves of the person who has had a stroke or experienced a brain injury?  What is this topic doing on a blog about AAC? 

Well, pet peeves can be something we share to interact with someone else and to express aspects of who we are.  Pet peeves may also need to be expressed to avoid anxiety or frustration on the part of the augmented communicator.  On DynaVox devices, address this by: 

• Adding a list of pet peeves in the About Me topic and don’t forget to include a question for the communication partner, “What are your pet peeves?” or “What drives you crazy?”
• Including comments or requests regarding pet peeves in the appropriate topic in which they might be used (“He didn’t even use his turn signal!” – car, “They are sitting on the same side of the table.  Why do people do that?” – restaurant, “Will you try to eat more quietly?” – mealtime, “Please use a glass next time!” – kitchen).  Of course, the level of politeness will depend on who the augmented communicator is talking with and their typical style of interaction.

Now, will you stop snapping your gum?  It’s driving me crazy!