Assistive Technology & Augmentative and Alternative Communication SPED 510-183, CRN:82583

1. Assistive Technology & Augmentative and Alternative Communication SPED 510-183, CRN:82583 Sheldon Loman, PhD. Summer 2011 Contact: sheldon.loman@pdx.edu

3. This Morning’s Agenda • Course Syllabus & Assignments • Student Information Sheet • Break • Activity • Dismissal

4. Course Structure • This class will be taught using an adapted interteaching method (Boyce & Hineline, 2002; Saville et al., 2005). • Interteaching methods are based on common research-based practices in college teaching, including reciprocal peer tutoring, problem based learning, and cooperative learning (Saville, Zinn, Neef, Van Norman, & Ferrari, 2006). Review: Based on feedback Quiz: Short quiz after review Self-evaluation & Feedback: Evaluate quality of interactions & topics requiring further clarification Discussion: Use discussion guide with partner(s)

5. Walk-through Course Structure

6. Mock Review (for “Quiz”):

7. Define Assistive Technology: • Assistive technology (AT) is defined as any item, piece of equipment, or product, whether acquired commercially, off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. (P.L. 101-407, The Technology Related Assistance Act of 1988).

8. Define Augmentative & Alternative Communication: • Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. -American Speech-Language-Hearing Association (asha.org)

9. Who are students that require Assistive Technology (AT) and/or Augmentative and Alternative Communication?

10. Quiz • Complete the student information sheet/ quiz (not graded!)

11. Correct Quiz • Self-grade quiz

12. Define Assistive Technology: • Assistive technology (AT) is defined as any item, piece of equipment, or product, whether acquired commercially, off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. (P.L. 101-407, The Technology Related Assistance Act of 1988).

13. Define Augmentative & Alternative Communication: • Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. -American Speech-Language-Hearing Association (asha.org)

14. Functional Communication Training (FCT) • FCT involves teaching specific communication skills that are functionally equivalent to problem behavior, based on a functional behavior assessment (FBA) • Behavior may serve a number of functions: • -obtaining desired items, activities, attention, or environments • -escaping a nonpreferred or nondesired activity • -regulating levels of sensory arousal

15. Functions That Behaviors Serve

16. 4terms of Hypothesis/Summary Statement Setting Events/ “Set ups” Antecedent/ Trigger Problem Behavior Consequence/ Outcome Infrequent events that affect value of outcome Following events that maintain behaviors of concern Preceding events that trigger Observable behaviors of concern

17. SerenaCompeting Behavior Summary Turn off computer & transition Do another assigned activity Setting Event: No computer for several days Continues to work on computer (preferred activity ) Asked to turn off computer in a firm tone Yells at teacher Use picture symbol or sign to Ask for “1 more minute”, then go to schedule

18. Dyadic Discussion Practice 1. Class will break into three groups • Group 1: Read Chapter 1(pgs. 3-22) of Soto & Zangari text • Group 2: Read Chapter 13 (289-309) of Soto & Zangari text • Group 3: Horner et al., 2005 article posted on the wiki. • (30 minutes) 2. Complete discussion guides as if you were bringing it to class (5 minutes) 3. Get together with two partners from the other two groups to discuss readings (20minutes)

19. Brief Lecture

20. “If I could not express myself, I would become like the tree in the forest—the one for which it does not matter if it makes a sound when it comes crashing down, because there is no one around to hear it. Unfortunately, there are still many silent fallen trees all around us if we stop and look.” Bob Williams, AAC user with complex communication needs (Williams, 2000, p. 250)

21. Loman et al., 2010

22. Communication Bill of RightsEach person has a right to: • Request desired objects, actions, events, & people • Refuse undesired objects, etc. • Express personal preferences & feelings. • Be offered choices & alternatives. • Reject offered choices & alternatives. • Request & receive another person’s attention/interaction • Ask for & receive info about changes in routine & environment. • Receive intervention to improve communication skills From the National Joint Committee for the Communicative Needs of Persons with Severe Disabilities. (1992). Guidelines for meeting the communication needs of persons with severe disabilities. ASHA, 34(Suppl. 7), 2–3.

23. Communication Bill of RightsEach person has a right to: • Receive a response to any communication, whether or not the responder can fill the request. • Have access to augmentative and alternative communication and other assistive technology services & devices at all times. • Be in environments that promote one’s communication as a full partner with other people, including peers. • Be spoken to with respect & courtesy. • Be spoken to directly and not spoken for or talked about in 3rd person while present. • Have clear, meaningful, and culturally & linguistically appropriate communication.

24. Think-pair-share • How you can ensure these occur for students within your current and future teaching situations?

25. Think of a student that is diagnosed as requiring AT or AAC: • What supports does/will this student receive? • How are these supports determined? • Who is involved in this determination?

27. Left unchecked interfering behaviors negatively affect one’s quality of life: • Unsuccessful social relationships, • Social isolation, • Restrictive educational settings, • Limited independent work opportunities • (Dunlap & Carr, 2007)

28. Need for “One Voice”…. • Fragmented supports that are not linked across systems… • Not based on function of behaviors… • Lack breadth and depth to effectively change behavior… • Implemented with low intensity, low fidelity = poor outcome… • Cynicism by student/family towards interventions… • Apathy by support providers…

29. External Community Supports Academic Support System: Response to Intervention Social/Behavior Support System: School-wide PBS Context for: Functional Assessment, Person Centered Planning, & Wraparound

30. Strength-based shared understanding of : Values, Long-term Goals, Current Programs, Possible variables influencing behaviors FBA Identifying: Routines, Setting Events, Antecedents, & Functions of Interfering Behaviors Collaboratively Outline Behavior Supports Plan that speaks with “One Voice” Consistently Implement, Monitor, Evaluate, COMMUNICATE

31. Add effective & & remove ineffective reinforcers Neutralize/ eliminate setting events Add relevant & remove irrelevant triggers Teach alternative that is more efficient

32. Single Subject Research • Systematic analysis using individual subjects as their own experimental control. • Main message: • Single subject research is an approach to rigorous experimentation that involves small numbers of subjects, repeated observations of subjects over time, and employs research designs that allow each subject to provide his/her own experimental control. • Within-subject analysis • Fine-grained analysis across time and conditions

33. Types of research • Basic – gain knowledge for knowledge’s sake • May be no immediate or foreseeable application or implications for “real world” life • Applied – research to gain knowledge or address issues/problems that have immediate application to “real world” life • Educational research is applied research • Single subject research methods are used in basic and applied research – we’ll focus on applied research in the course

34. Reasons for using single subject methodology • Focus on an individual rather than group means • Interest is in the behavior of a single individual or on within-subject variability • A “group” may be treated as an “individual” • Group descriptive statistics may not "describe" any actual individual • Generalizations from a group to an individual are problematic in many instances • Predicting the behavior of a specific individual is different from predicting that of a “typical” individual

35. Reasons for Using Single Subject Methodology (continued) • Many populations of interest are low incidence populations • Practically, large numbers of subjects may not be available • Assumptions of normal distribution and homogeneity of variance may not be valid • Can be used in clinical practice contexts • Single subject research studies may develop out of and be conducted on a specific problem or need of an individual(s) in a practical context • Scientist-practitioner model

36. Dependent and independent variables • Dependent variable (DV) – the behavior (measure) that you are analyzing • You want to produce change (variability) in the dependent variable • Studies may have multiple DVs • Independent variable (IV) – the variable (event, intervention, condition) that is of experimental interest and that the researcher manipulates in an experimental research design • May be discrete or continuous • May be a single element or multi-component compound • Studies may have multiple IVs

37. Internal Validity • The degree to which observed differences/changes in the dependent variable are a direct result of manipulation of the independent variable, and not some other extraneous variable • Extent to which a functional relation can be documented. Control of extraneous variables that provide alternative explanations for results. • It is okay to try to maximize internal validity, especially in initial documentation of a functional relationship • Doing this may come with a cost, however

38. Threats to Internal Validity • History – everything happening outside of the research study • Maturation • Testing - repeated measurement • Instrumentation • with human observers, observer bias and drift • Attrition - loss of participants • Multiple treatment interference • Diffusion of treatment - intervention is inadvertently provided when not intended

39. Threats to Internal Validity (continued) • Loss of baseline through generalization or spread of effects (across settings, behaviors, or participants) • Instability and/or high variability of behavior • cyclical variability • Statistical regression toward mean • Selection biases with participants • Inconsistent or inaccurate implementation of the IV (Treatment Drift/Treatment Integrity)

40. External Validity • Defined: The extent to which results can be applied to settings, activities, people, etc. other than those involved in the study. • Given that you have found an effect for this intervention with this participant under one set of conditions, will it work with other participants, in other settings, when implemented by other interventionists, and when implemented with minor variations in the basic procedures? • What can we generalize from this single study? • Importance of systematic and direct replication.

41. Threats to External Validity • Reactive experimental arrangements - Hawthorne effect • Reactive assessment - reactivity to observers • Pretest sensitization • Experimenter bias • Interaction between selection bias and treatment effects - i.e., intervention only works if the "right" participants are selected • Specificity of effects

42. The Research Question • In single subject designs the research question typically examines a causal, or “functional” relation, between the independent and dependent variable. As such the research question should have three features • Identify the dependent variable(s) • Identify the independent variable(s) • Proclaim intention to determine if change in the IV is functionally related to change in the DV.

43. Research Question Features • Dependent variable is socially important • Independent variable(s) can be controlled (e.g. manipulated) across time. • Both the dependent and independent variable(s) can be operationally described and measured. • For “experimental” research, the question must ask if change in the DV is caused by (or functionally related to) change in the IV.

44. Research Question Examples • Is there a functional relation between development of reading fluency and scores on comprehensive reading assessments? • Will walking in water facilitate development of appropriate gait by individuals with “gait imbalance hypertension.” • Is there a functional relation between use of escape-extinction and reduction of escape-motivated food refusal? • Does Jason act out because he has ADHD?

45. Phase A Phase B Phase A Phase B Immediacy of Effect Variability Level Trend Overlap Research Question???

46. Defining Features of Multiple Baseline Designs • A multiple baseline design involves three or more AB interventions (series) with phase changes staggered across at least three points in time. • Key Features • Series are independent of each other • People, places, materials, behaviors/skills • The same IV is applied in each series • Staggered implementation of IV

47. Interpreting MBL Designs • Identify Research Question(s) • Assess Baselines for each series • Do the Baselines document a predictable pattern? • Do Baselines allow opportunity to document IV effect? • Are Baselines similar? • Horizontal Analysis of Effect (per series) • Level, trend, variability, overlap, immediacy of effect • Vertical Analysis • DV change in one series is associated with NO change in other series? • Similar effect (consistent effect) across series? • Functional Relationship? • At least three demonstrations of effect at three points in time

48. Lollipop for R+ BL Treatment 6 100 80 60 40 20 Vivian 0 Lollipop for R+ 100 80 60 Percentage of Correct Responding 40 20 Tammy 0 Lollipop for R+ 100 80 60 40 20 Dr. Cathy 0 10 20 30 40 50 60 70 Sessions

49. Defining features of withdrawal and reversal designs • Sequential phases of data collection involving the implementation and withdrawal of an independent variable(s) • within each phase, multiple data points are collected to establish a representative pattern of behavior • phase change should occur only after stability of behavior within the phase is established • traditionally, the first phase is Baseline, followed by implementation of the IV (Intervention) • this is not required, however, as you may begin a study with an intervention phase

50. When are reversal and withdrawal designs appropriate? • Behavior measured as DV is “reversible” • Learning will not occur • Limited carryover effects between phases • Ethical concerns • Can do a reversal • DV is not a dangerous behavior, or you can protect participant • Staff cooperation • Can compare multiple conditions • Comparison of too many conditions makes design cumbersome