AT/AAC Session 5

1. AT/AAC Session 5

2. Upcoming Assignments • Date Change…July 16th- Ecological Inventories Assignment • Remember this is with a group • July 16th… Critique of Research Article is due • This is an individual assignment • July 18th… Technology Selection/Design Assignment is due

3. IPAD Applications • IPAD applications for communication and other low-cost apps • Talk to Me 100-Sydspeak, Inc. (Free, but $5.99 to upgrade) • Tap to Talk- Free, customizable (photos) • Talk 4 Me- Free, customizable (English, Spanish, Chinese • iCommunicate- $39.99, can upload pics to make storyboards for activities • getsatisfaction.com/grembe • Verbally, Free, For readers, word prediction • My Talk (lite version is free)- customizable via web “workspace” • Alexicom AAC- free- pre-made boards, customizable • First Then- $9.99, • Story kit- Free, You can record reading of a book and play back • Sounding board-$49.99, create custom boards with symbols or photos, • Proloquo2Go-$199

4. How to establish baseline skills student already has? • Significant other interviews • Ecological Assessment • Direct observation in natural environments • Interrupted chain procedures • Interrupt a routine that student has to complete and see how student communicates • Assess student in interactions with other students • Provide direct assessments to determine if student understands words, pictures, symbols, etc.

5. Take Typical Language Samples • As we talked about last class, take an inventory of the vocabulary used in the settings student’s are in or will be going to. • Conversation inventories with same age peers • Could use audio recorder if allowed.

6. Research on Comm. Assessment • Standardized Tests may provide age-equivalencies in receptive & expressive language, but often fail to recognize the unique characteristics of students with severe disabilities (Cress, 2002; Ross & Cress, 2006; Snell, 2002). • Recommendation is interviewing significant others (Bailey, Stoner, Parrette, & Angelo, 2006) • Analyze Communication Environment (Blackstone & Hunt Bert, 2003; Downing, 2005); Use of Video recordings (Suarez & Daniels, 2009)

7. Reference for Gathering Info/Assessing Communication • Blackstone & Hunt-Berg (2003). Social Networks: A Communication Inventory for Individuals with Complex Communication Needs and Their Communication Partners • Guides team in efforts to collect info on student’s skills & abilities, various modes of expression used by the student, and who the typical communication partners are for the student. • Targets info concerning how the student selects a message, typical topics of conversation, supportive strategies

8. Resistant student and/or Refusal to learn to use his device • This may mean that the device/system is not meaningful or does not meet a communicative need (OR BOTH) • Re-evaluate student’s opportunities to communicate. • May need to manipulate the environment in such a way that necessitates the student use the device/system (Reichle, 1997; Snell, 2002) • May be too difficult in comparison to other communicative means…think of some unaided means of communication (facial expressions, gestures, etc.) OR different symbols, colors, etc.

9. How to select communication devices? • Conduct person-centered ecological assessment on communication • Team approach- teacher, SLP, parents • Consider contextual-fit • Consider: durability, ease of use, transportability, flexibility, cultural sensitivity, cost of device, & quality of speech (McCord & Soto, 2004; Mirenda, 1999). • Ability of student to access an AAC system need to be assessed prior to purchasing system

10. Funding for AAC? • http://www.aacfundinghelp.com/ • Low-incidence funding • (property of school) • Health Insurance (property of student) • Medicare (property of student) • Department of Rehabilitation • Dependent on potential for employability w/ device • In Oregon, Educational Service District (ESD) may have guidelines for this.

11. Collaborating with SLPs? • Developing a communication system for a student is a team effort. • Speech/Language Pathologists will be your “go-to” person to collaborate with when selecting system, designing instruction, implementing communication instruction • Work closely with them. • Make sure you emphasize the ecological assessments and preference assessments conducted with student.

12. Working with Parents? • Consider their home-language, culture, and long-term vision for the student’s communication. • Want to build system so that you can bridge home and school vocabulary, language, etc. • May be an issue when device is not allowed to go home. • Try to work with school to allow device to go home. Parents may need to sign responsibility for device.

13. Research on Intervention Strategies • Comm. Skills are best taught throughout the day where they typically occur or are expected to occur (Beukelman & Mirenda, 2002; Fox, 1989; Haring et al., 1985) • Students without disabilities play a critical role in the development of communication for students with severe disabilities (Carter & Hughes, 2005; Kamps et al., 2002; Von Tetzchner et al., 2005;

14. Communication Skills Across Classes & Subjects • Greetings & Farewells • Age-appropriate vocabulary, mannerisms • May not necessarily need a Speech Generated Device (SGD) • Asking for Attention/Help • Comments of Approval & Rejection • Social Closeness • Observe what typical students do to achieve this • E.g., admiring another’s hairstyle, telling secrets • Communicative Skills specific to a class or an activity

15. Review for Quiz #4

16. Direct Observation is most reliable method for assessing preferences • From list, directly manipulate potentially preferred items and observe to identify which items are actually preferred. • Free Access or Forced Choice of reinforcing items

17. Free Access Steps (Ortiz & Carr, 2000) • Identify several potentially preferred items (checklist or interview of others) • Position items so that the learner has access to all items • Spread around the room in the learner’s reach/view • Observe the learner on several occasions • Document the first item (& successive items) the learner approaches and note the total duration of time the learner engages with each item.

18. Forced Choice Steps (Piazza, Fisher, Hagopian, Bowman, & Toole, 1996) • Identify several potentially preferred items • Present items in pairs. • Randomize the presentation of items in pairs and order of pairs (to prevent the same item from being presented too many times in a row) • Randomize the position of the items • Observe the item in each pair the learner selects.

19. Functional Analysis • Experimental methodology in which (ANTECEDENTS) and potential reinforcers (CONSEQUENCES) of a problem behavior are carefully arranged in a controlled manner to isolate the effects of potential sources of reinforcement that are often confounded through other observational methods • (Iwata, Kahng, Wallace, & Lindberg, 2000; Mace, Lalli, & Lalli, 1991). • Can lead to causal rather than correlational outcome data with respect to the relationships between environmental events and behavior (Cooper, Heron, & Heward, 2007)

20. Design of Functional Analysis Conditions • Individualized according to the functional hypotheses. • The functional analyses for all students consist of at least three conditions: control, attention, and escape. • Control Condition: baseline condition in which student has consistently exhibited little or no problem behavior. Reinforcement should be freely available and no demands placed on student • Attention Condition: will involve the contingent provision of attention following occurrence of the problem behavior. • Escape Condition: will examine the function of student behavior through the contingent removal of aversive tasks (e.g., difficult, long, or physically taxing tasks)

21. Control Condition • Baseline condition in which student has consistently exhibited little or no problem behavior. Procedure: 1. Introduction: “I’ll help you while you do __________ task” 2. Student presented with the _____________task. 3. The researcher provides 1:1 attention with ongoing prompts every 3-5 seconds. 4. Any occurrences of the problem behavior will be ignored and the student will continue to receive attention every 3-5 seconds.

22. Attention Condition • Involves the contingent provision of attention following occurrence of the problem behavior 1. Introduction: “I want you to do this activity.” 2. Researcher will present the activity and then move 10 ft away from student 3. If student engages in target behavior, the researcher will approach the student and provide the student with 5 seconds of adult attention 4. Following the 5-second interval the student will be directed to return to the activity, the researcher will walk away, and the next trial will begin.

23. Escape Condition • Examine the function of student behavior through the contingent removal of aversive tasks 1. Introduction: “I want you to work on this activity, if I think you are having trouble, we’ll take a 10-second break. During that break you need to sit quietly and count to 10 seconds. 2. The researcher will provide 1:1 attention with ongoing prompts related to completion of the assignment every 3-5 seconds throughout the condition. 3. Any time the student engages in the target behavior , the researcher will say, “Let’s have a 10 second break” and remove the worksheet for 10 seconds without providing the student any further attention. 4. The next trial will start following the 10-second break after the student is directed to get back to work.

24. Gain Object Condition

25. Sensory Condition (similar to control condition)

26. Example: • The student is a 5th grade student in a general education classroom with 29 students. • His strengths are: likes computers, great gross motor skills Routine: Reading (9:00) OR Math (10:00-10:30)

27. Activities for Conditions:

28. What would you use for the conditions to test this hypothesis? If Problem behavior occurs: Preferred Activity during read aloud Ignore Provide him w/ attention Alone during read aloud (peers & adult 10 ft away) Stop read aloud and give him “easy activity” Adult close to him during read aloud or waiting period.

29. What would you use for the conditions to test this hypothesis? If Problem behavior occurs: Preferred Activity Ignore Provide him w/ attention Alone with Easy “writing/typing” task (e.g., coloring) Take away writing/typing task/sheet Adult close to him with “regular writing task”

30. Quiz #4

31. Discussion • Pragmatic Organization Dynamic Display Communication Books (Porter & Burkhart) • http://www.youtube.com/watch?v=S5Yrmm5mKzw • http://www.youtube.com/watch?v=XSvY4jdKMxk&feature=related

32. 3 steps to FCT • Functional Communication Training (FCT) is based on….. • Based on notion that problem behavior may function as a means of communication • Conduct a Functional Behavioral Assessment (FBA) to determine when, where, what, and why problem behaviors occur for a student. • Complete a competing behavior pathway to outline alternative/replacement behavior (way of communicating) • Design interventions to teach student new communication mode while not allowing problem behaviors to pay off for student.

33. FBA: Summary of Behavior Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION FUNCTION is where student behavior intersects with the environment Function = Learning Student learns…. When (A), if I (B), then (C)… Function = how I benefit so I keep doing B

34. Competing Behavior Summary Desired Behavior Typical Consequence Summary of Behavior Setting Event Antecedent Problem Behavior Maintaining Consequence Alternate Behavior

35. Function Based Interventions When generating interventions we use Function to develop ideas to change A, B & C Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION Function should guide selection of consequences: (+) and (-) Function should guide selection of prevention strategies Function should guide selection of alternative/ replacement behaviors

36. Function Based Interventions When generating interventions we use Function to develop ideas to change A, B & C Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION Function should guide selection of alternative/ replacement behaviors

37. Understanding Alternate/ Replacement Behaviors Alternate Behaviors are: an immediate attempt to reduce disruption & potentially dangerous behavior in the classroom designed to actively begin breaking the student’s habit of using problem behavior to meet their needs, by replacing it with a more acceptable alternate behavior AAC device can be means for a student to use replacement behaviors

38. Essential Characteristics of a Replacement / Alternate Behavior An appropriate Replacement Behavior: Serves the same function as the problem behavior Is easier to do and more efficient than the problem behavior Alternate Behaviors require less physical effort & provide quicker, more reliable access to desired outcome/response than problem behavior Is socially acceptable

39. Which of the Following are Appropriate Replacement Behaviors? Leslie is 12, has severe intellectual disabilities, does not use words, and hits her head. Head hitting is maintained by adult attention during work periods. Which is the best Replacement Behavior hide under her desk and be ignored sign for “more” to another student take completed work up to show the teacher move to sit by another student Use picture communication system to request teacher help Start w/ the Function 1. Serve same Function? Does it provide adult attn? 2. Is Behavior easier to do than problem behavior? 3. Is Behavior socially acceptable?

40. Which of the Following are Appropriate Replacement Behaviors? Jason is nine and cries when asked to do difficult tasks. The crying is maintained by avoiding or escaping difficult tasks. Possible Replacement Behaviors: More rewards for doing tasks Asking for an easier task/ worksheet Asking to play w/ his Gameboy Requesting adult attention Asking to have soda after tasks are done Start w/ the Function 2. Is behavior easier to do than problem behavior? 1. Serve same Function? Does it provide adult attn? 3. Is Behavior socially acceptable?

41. Competing Behavior Pathway: Alternative Behavior Example: Jason (from previous example) Antecedent Problem Behavior Consequence Asked to do difficult tasks Avoid/Escape Difficult Task Crying Asking for an easier task/ worksheet NOTE: This antecedent is not specific enough

42. Communication Replacements for Problem Behavior

43. Function Based Interventions When generating interventions we use Function to develop ideas to change A, B & C Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION Function should guide selection of consequences: (+) and (-) Function should guide selection of prevention strategies Function should guide selection of alternative/ replacement behaviors

44. Consequence InterventionsReinforcing Behavior • Reinforcement should focus on 2 different sets of behaviors  Alternative Behavior & Desired Behavior • Reinforcing the Alternative Behavior • When the student engages in the alternative behavior, quickly provide the student with an outcome that matches the outcome/ function of the problem behavior • E.g. if student raises hand to request an easier, substitute assignment; in order to escape difficult tasks  then quickly provide the student with the easier assignment

45. Consequence InterventionsReinforcing Behavior • Considerations for Reinforcing Desired Behavior • The reinforcer must be valued by the student • The function of behavior is a good place to start when identifying valued reinforcers • e.g. If the function of behavior is to Gain Peer Attention, the reinforcer should give access to Peer Attention • e.g. if the function of behavior is to Avoid Difficult Task the reinforcer could be a “Free Homework Pass”

46. Consequence InterventionsResponding to Problem Behavior • Responding to Problem Behavior should focus on 2 things: • Redirecting to the Alternative Behavior • Active Extinction of the Problem Behavior • Do NOT let the problem behavior be effective in giving the student what they want • Redirecting to the Alternative Behavior • When the student engages in the alternative behavior, quickly provide the student with an outcome that matches the function of the problem behavior • This should also help to prevent escalation • E.g. if student raises hand to request an easier, substitute assignment; in order to escape difficult tasks then quickly provide the student with the easier assignment

47. Consequence InterventionsResponding to Problem Behavior • Active Extinction of the Problem Behavior • Make sure the problem behavior no longer works for the student… If using a consequence as a response to negative behavior, make sure the consequence is not providing the desired function for the student

48. Function Based Interventions When generating interventions we use Function to develop ideas to change A, B & C Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION AVOIDING DIFFICULT TASK Consequence (+) Reinforce (a)alternate behavior w/ oppt’y to avoid task & (b) desired behavior (effort on task) (-) problem behavior should not result in avoiding task; redirect to Alt. behavior Prevent Make task less difficult to avoid difficult task Alternatebehavior Must allow student to avoid difficult task

49. Function Based Interventions When generating interventions we use Function to develop ideas to change A, B & C Targeted Routine Maintaining Consequence & Function Antecedent Problem Behavior FUNCTION GETTING ADULT ATTENTION Consequence (+) Reinforce both alternate behavior & desired behavior w/ adult attention (-) problem behavior should not result in adult attention; redirect to Alt. behavior Prevent Provide adult Attention in advance & often Alternatebehavior Must give student access to adult attention

50. General Case Design— Why?Determine what to teach and features need to varyto increase generalization. 1. Define the Instructional Universe 2. Define the Range of Relevant Stimulus and Response Variation 3. Select Examples for Teaching & Testing 4. Sequencing Teaching Examples 5. Teaching the Examples 6. Testing with Non-trained Probe Examples