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AAC & Autism: Teaching Communication Through Motor Planning

AAC & Autism: Teaching Communication Through Motor Planning. Thank you… Michigan Integrated Technology Supports. The Mission of LAMP .

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AAC & Autism: Teaching Communication Through Motor Planning

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  1. AAC & Autism: Teaching Communication Through Motor Planning

  2. Thank you… Michigan Integrated Technology Supports

  3. The Mission of LAMP To improve public awareness of the unique qualities of the power of AAC to change the lives of non-verbal individuals with autism and other developmental disabilities by: • Providing specialized clinical training to health care professionals, teachers, and parents • Supporting Clinical Research • Supporting clients and families with education, resources and information

  4. By the end of this session you will be able to: Briefly describe the five key elements of LAMP Identify the relationship between motor planning and communication using AAC Identify the benefits of using core words to teach communication using AAC

  5. What is LAMP? Language Acquisition Through Motor Planning • A therapeutic approach

  6. What is LAMP? Language Acquisition Through Motor Planning • A therapeutic approach • Built on principles of motor-learning

  7. A Case for Motor Consistency

  8. "In the practiced automatic movementsof daily life attention is directed to the sense impression and not to the movement.  So, in piano playing, the beginner may attend to his fingers but the practiced player attends only to the notes or to the melody.  In speaking, writing and reading aloud, and in games and manual work, attention is always directed to the goal, never to the movement. In fact, as soon as attention is directed to the movement, this becomes less automatic and less dependable." Cattell, J.M. 1893

  9. Ming, Brimacombe, Wagner2007 • 154 Children with ASD found that 41% of 2–6 year olds and 27% 7-18 year olds showed clear evidence of oral motor and/or hand muscle apraxia Mirenda, P. (2008) A back door approach to autism and AAC; Augmentative and Alternative Communication, 24, 220-234

  10. Motor Planning Indicatorsand ASD • High prevalence of motor planning difficulties in ASD • Speech requires high degree of motor planning • Automaticity facilitates motor action

  11. We can take advantage of motor planning when: • Each word has its own motor pattern due to consistent icon locations • Motor patterns don’t change • Patterns build upon themselves as language grows

  12. We cannot take advantage of Motor Planning when: • Significant navigation of the system is required • Requires continuous visual refocus and visual reorientation • Large bank of icons to learn • Same motor plan has different language outcome • Too many or inconsistent rules for generating language

  13. What is LAMP? Language Acquisition Through Motor Planning • A therapeutic approach • Built on principles of motor-learning • Emphasizes independent access across environments

  14. Communication Goal • Same as for all AAC users… • S: Spontaneous • N: Novel • U: Utterance • G: Generation • i.e. expressive, generative communication

  15. What is LAMP? Language Acquisition Through Motor Planning • A therapeutic approach • Built on principles of motor-learning • Emphasizes independent access across environments • Multi-sensory

  16. LAMP approach

  17. Zone of Optimal Arousal The Inverted U-Principle Good Performance Poor Low Moderate High Arousal Level (Duffy, 1962)

  18. Considerations for Treatment • Enhance or minimize sensory input • Manipulate sensory input to maintain a “zone of optimal arousal: • Client must be able to orient, discriminate, attend, explore, interact, and learn • Match activity to level of arousal • Incorporate sensory strategies throughout the day to help maintain appropriate arousal level

  19. LAMP approach

  20. Child-Focused

  21. As suggested by Stanley Greenspan, enter the child's activities and follow the child's lead. If the child wants to line up cars in a row or twirl a top, the parents will join the child in his or her preferred activity (with the intent of developing this action into an affective interaction) rather than demanding that the child join them in their preferred activity (a process which, at best, will produce no more than rote action and reaction). From Autism National Committee http://www.autcom.org/behaviorism.html

  22. Follow the child’s lead: Watch for what interests the child and use that interest to create a meaningful language learning experience. • Join in with the child: Shared focus develops through interaction.

  23. Surprising and Novel Purposeful and Intentional Use Movement

  24. LAMP approach

  25. LAMP LAW…

  26. LAMP LAW… • Initiating a unique motor plan • Hearing the word produced by that movement • Experiencing another’s reaction to the word

  27. Things to remember: • Device Position

  28. And… • Random Selection and Perseveration

  29. When using AAC, teach location, NOT metaphor Why?? Stable key location enables the development of automaticity

  30. Each consistent pattern of one, two or three hits on the AAC device must always result in production of a unique word.

  31. Automaticity

  32. Automaticity • EMG brain : new vs. automatic tasks • Repeated movements become subcortical • Cortical areas can then be put to “better use”

  33. Avoid temptation to “check comprehension” by shifting locations of pictures because …?

  34. LAMP approach

  35. The auditory output stimulates the child’s auditory system, providing auditory feedback with the motor response, …

  36. … which may later stimulate the child’s natural attempts to imitate the auditory output he/she gets from the AAC device and the auditory feedback from his/her communication partner.

  37. Auditory Signals • “Input from the vestibular, proprioceptive, and auditory systems is critical for the development of speech and language (1989, Windeck & Laurel) • Children need to experience words, not just repeat them • In LAMP each unique motor pattern = specific auditory signal……a specific word • SGD provides critical auditory information

  38. LAMP approach

  39. Any attempts to communicate should have natural auditory/verbal, visual, and social consequences.

  40. Social Exchange

  41. No Mistakes: No matter what the child selects on the AAC device, the rule for the communication partner is RESPOND RESPOND RESPOND

  42. SPECIFIC S

  43. LAMP Language Consideration: Single Words “Communication is based on the use of the individual words of our language. True communication is spontaneous and novel. Therefore, communication systems cannot be based significantly on pre-stored sentences. Communication requires access to a vocabulary of individual words suitable to our needs that are multiple and subject to change. These words must be selected to form the sentences that we wish to say.”ASHA’s AAC Glossary

  44. Focus on “core” vocabulary

  45. Words Percentage I 9.5 No 8.5 Yes/yea 7.6 my 5.8 the 5.2 want 5.0 is 4.9 it 4.9 that 4.9 a 4.6 go 4.4 mine 3.8 you 3.2 what 3.1 on 2.8 in 2.7 here 2.7 more 2.6 out 2.4 off 2.3 some 2.3 help 2.1 all done/finished 1.0 96.3% Toddler Vocabulary Arranged by Frequency These 26 core words comprise 96.3 percent of the total words used by toddlers in this study Banajee,M., DiCarlo, C, & Buras-Stricklin, S. (2003). Core Vocabulary Determination for Toddlers, Augmentative and Alternative Communication, 2, 67-73.

  46. 1. again 2. all done 3. all gone 4. away 5. big 6. go 7. help 8. here 9. I 10. it 11. like 12. mine 13. more 14. not/don’t 15. stop 16. that 17. want 18. what 19. you 20. my 21. do 22. down 23. get 24. in 25. little 26. off 27. on 28. put 29. some 30. out First 30 Words ©Van Tatenhove, 2005, Revised October 2007

  47. Michael Brian Reed (2009) • Is “campaigning for people with communication impairments to be given a way to say the same 100-400 words that speaking people say most each day…” • Questions for, teachers, SLPs, decision makers and makers of communication aids: 1. What is your plan to introduce core vocabulary to students with communication disabilities? 2. Can teachers and SLPs be sure that during preschool years specific core vocabulary and all language functions be introduced. 3. Can teachers and SLPs be sure that students have access to core vocabulary in education?

  48. The “Core” of Language Representation • Picture producing words RARELY provide communication power • Early vocabulary samples have very few, if any, picture producing words • Any representation method requires learning • DO NOT create the AAC displays based upon what can be easily represented

  49. Word List I Stop Go Not Eat Drink More

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