AAC and RTI: Building Classroom Strategies for Every Child

1
AAC and RTIBuilding Classroom Strategies for
Every Child

• Sandra M. Grether, Ph.D., CCC-SLP
• Adjunct Associate Professor, University of
  Cincinnati
• Coordinator of Speech Pathology,
• Developmental and Behavioral PediatricsCincinnati
  Children's Hospital Medical CenterCincinnati,
  Ohio
• Linda Sue Sickman, Ph.D., CCC-SLPAssistant
  Professor, Towson University
• Towson, Maryland

2
Agenda/Purpose for Todays Session

• The purpose of this professional education
  session is to provide SLPs with evidence-based
  information on how to support children who use
  AAC in the classroom using a Response to
  Intervention (RTI) approach (Grether Sickman,
  2008).
• This session will focus on
• the levels of support provided by RTI,
• the speech-language pathologists role in RTI
• strategies for achieving academic success for
  children who use AAC.

3
Response to Intervention (RTI)

• Educators previously used IQ-achievement
  discrepancy to identify children with learning
  disabilities.
• IDEA (2004) promoted RTI, to identify and provide
  early intervention to all children at risk for
  school failure.
• Children with complex communication needs, who
  use AAC, are at risk for succeeding in the
  classroom and can benefit from the educational
  supports provided through RTI.

4
Supports Provided Through RTI

• The concept of RTI was included in the recent
  federal law due in part to the traditional
  special education identification model, where
  students tend to fail before receiving services
  (NRCLD, 2007).
• Three tiered intervention approach

5
RTI Tiers

• Tier 1 - Classroom screening, monitoring and
  identifying individual students who are
  struggling
• Tier 2 - Identified students are provided general
  classroom instructions as well as sound
  instructional design principles in the classroom
  and monitored for their responsiveness to the
  instruction and further assessed if needed.
• Tier 3 - If identified students do not respond to
  the classroom instruction and/or have additional
  areas of risk identified, further testing is
  completed to determine if the student qualifies
  for special educational services

6

• Students may be identified as at-risk for
  academic failure, yet may not meet the
  eligibility requirements for special education
  services. Through RTI, they will be provided
  support through structured intervention.
• The nature of the academic intervention changes
  at each tier, becoming more intensive as a
  student moves across the tiers (Fuchs, D.
  Fuchs, L. 2006).
• The hallmark of the RTI approach is to use high
  quality instruction and evidence-based
  intervention as well as monitor and maintain data
  on the individual students progress.

7
Tier 1 Services

• Delivered in the classroom, initially by
  screening the students, to determine who is at
  risk for not developing requisite skills at an
  acceptable rate.
• Instructional team is charged with improving the
  instructional environments prior to further
  student referral
• Improve the overall quality of the classroom
• Rule out whether lack of instruction is
  instrumental in producing the students
  deficiency (Kovaleski Prasse 2004).

8
Transition

• If identified as at-risk, student is provided
  with Tier 2 instructional intervention with
  continued monitoring for progress, with more
  thorough screenings (NCLD, 2007).

9
Tier 2 Services

• Typically provided in the classroom with the SLP
  collaboratively problem solving with the
  classroom teacher to design a supplementary,
  diagnostic instructional trial tailored to the
  needs of the student (Fuchs, D. Fuchs, L.
  2006).
• At this level, the classroom teacher can also
  receive additional support ranging from
  professional development to support from other
  educational professionals to provide intervention
  and/or monitor progress.

10
Transition

• If the student is not progressing with Tier 2
  support, then additional support can be provided
  within Tier 3.

11
Tier 3 Services

• Provide services to those students who meet
  eligibility requirements under RTI.
• These services include formalizing the
  intervention plan (IEP).
• Services may reflect collaboration in the
  classroom, traditional pull-out therapy, and a
  combination thereof.

12
SLPs Role in RTI

• SLPs have increasing role in school based
  practice.
• Important for SLPs to become familiar with their
  districts RTI approach, as the components of a
  RTI model can vary from district to district.
• Imperative that SLPs become familiar with the
  classroom curriculum, as the basis for movement
  through the tiers of RTI are based upon the
  response to the needs of the student in
  relationship to the curriculum.

13
SLPs Role in RTI

• Assisting with Tier 1 screenings,
• Assisting with at-risk students in Tier 2 by
  being a resource and assisting in the development
  of interventions, focusing on the language and
  literacy skills related to the classroom
  curriculum,
• Assisting with progress monitoring data
  interpretation (ASHA, 2006).

14
SLPs Role in RTI

• Assist with the development of the referral
  process for eligibility determination.
• SLPs retain the roles of using best practices
  regarding assessment of individual students for
  eligibility determination and of determining the
  type of intervention for those students who
  qualify for special education services for
  communication disorders.
• SLPs knowledge of evidenced-based practices
  regarding language and literacy curriculum can be
  used in any tier of RTI (ASHA, 2006).

15
Classroom Collaboration

• Collaboration with classroom teachers setting up
  AAC based interventions can benefit every student
  in the classroom, since many students are also
  visual learners and may benefit from the symbol
  based support for instruction.
• SLPs can and should advocate for more time to
  support teachers in their classrooms, especially
  when they have students with AAC needs.

16
SLPs Role in RTI

• Collaborative efforts in the classroom for
  individuals using an AAC system include
• Modeling interactions
• Training instructional aides and peers
• Advocating for increased opportunities to respond
  and participate
• Team teaching the curriculum

17
Integrating RTI

• Intensive supports specific to this student
  (AAC device, revised materials)
• Targeted supports materials adapted to support
  the students learning if universal are not
  effective (enlarging, highlighting)
• Universal supports how all students will engage
  in a lesson. Can this student participate in
  this way?
• (Sonnenmeier, 2007)

18
Best Practices for Classroom Intervention Using
RTI

• Start with a language-rich classroom
• Provide appropriate vocabulary for all classroom
  activities
• Organize it for easy access
• Support literacy learning
• Raise expectations
• Provide opportunities for peer interactions and
  support

19
Language Rich Classroom

• Language experienced in various contexts and with
  frequent opportunity
• Language intentionally used surrounding childs
  activities/learning new skills
• Language repeatedly used increased opportunity
• Classroom language involves many different
  words/word types
• Language used to recognize/validate childrens
  communicative attempts.
• (Justice, 2004)

20
Application of AAC

• As Tier 2 interventions are set up in the
  classroom, a primary consideration for students
  using AAC is to define the response modes, via an
  intervention plan, needed for each educational
  task.
• The SLP and teacher should work collaboratively
  on this plan.
• Tasks for each subject area are broken down to
  maximize the participation of the student using
  AAC

21
Ways to Communicate

• Eye Gaze
• Facial Expression
• Vocalization
• Speech
• Gestures/Sign Language

• Pointing to objects, photographs, line drawings,
  and/or symbols
• Writing
• Communication Device (SGD)

22
Participation Plan
23
Communicative Competence

• The goals of communicative competence are similar
  whether one uses natural speech or augmented
  means to communicate.
• (Light,1989)

24
Factors Affecting Communicative Competence

• Intrinsic Factors to the individual who requires
  AAC knowledge, judgment, skills, psychosocial
  factors
• Extrinsic Factors to the individual
  environmental factors communicative demands,
  external barriers and/or support
• (Light, 1989)

25
Linguistic Domain

• Skills in the language(s) spoken by the family
  and community
• Receptive
• Expressive
• Skills in the language code of the AAC
  system(s)
• Content, form, use
• Intervention may be required to build or re-build
  some or all of these skills

26
Vocabulary Needs

• Content specific related to the curriculum
• Lessons involve a range of topics
• Varied lesson structures
• Direct instruction
• Teacher directed
• Small/large group discussion
• Cooperative learning groups
• Partner work

27
Vocabulary Organization
28
Receptive Skills in the Spoken Language(s)

• Spoken language is primary language of input for
  individuals using AAC
• Partners seldom augment their speech
• Receptive language skills are critical to
  communicative competence
• These skills are vulnerable
• (Light, 1997)
• Aided language stimulation techniques facilitate
  receptive language learning

29
Modifying Responses

• Short answer/single word responses can be
  supported by topic-specific vocabulary
• Multiple choice - child has a, b, c choices
  teacher verbalizes answer for each letter
• Yes/no questions verbal approximation, gesture

30
Preteach Skills

• Vocabulary
• In classroom setting
• In pull-out Tier 2 or 3
• Social/pragmatic skills beyond requesting
• Share stories/information
• Ask clarifying questions
• Participate in discussions
• Demonstrate understanding of key topics

31
Literacy learning

• Need to address
• Appropriate instructional content
• Appropriate instructional materials
• Make adaptations to allow active participation of
  individuals who cannot produce spoken responses
• Expect movement from emergent readers and writers
  to fluent readers and writers
• (Fallon, et al., 2004)

32
Literacy Builds Language

• Semantic knowledge
• Syntactic skills
• Morphologic skills
• Knowledge of different written genres (i.e.
  narrative, persuasive)
• Language skills should not be viewed as a
  prerequisite to literacy instructions

33
Phonologic Awareness and Letter Sound
Correspondences

• Segmenting sounds of words
• Blending individual sounds to form words
• Rhyming
• Voice each of childs choices
• Allow student to actively engage in learning -
  attempt vocalization and/or verbalization
• Use keyboard on SGD or computer

34
Decoding

• Decoding involves integration of knowledge of
  letter-sound correspondences
• Look at written word
• Recognize each of the letters and retrieve sound
  in sequence
• Blend sounds together to form word
• Retrieve meaning of word
• Use foils including target word, one that differs
  in initial sound, one that differs in medial
  sound, and one that differs in final letter sound

35
Sight word Recognition

• Needs to accompany other literacy instruction
  not only strategy
• Irregular words that are difficult to decode
• Can be complex, high-interest words to increase
  motivation
• Meaningful shared reading activities
• Guided reading partner pauses for student to
  read word using SGD or low tech overlay
• Type word on keyboard if cant recall
• Light McNaughton (in press)

36
Writing

• Dictating/telling stories
• Patterned story telling
• Writing a familiar story
• Expanding the story line
• Planning, organizing, generating text
• Opportunities for revision
• Read back either through SGD, Computer software,
  or communication partner creates inner speech
  (Singer Bashir, 2004)
• Practice! Practice! Practice!

37
Writing

• Use writing for other purposes - narratives,
  poems, persuasion, description
• Lists
• E-mail/chat room
• List-serves
• Text Messaging
• Provide opportunities for functional and
  motivating practice!

38
Using Symbols to Read and Write

• Utilize symbol systems for story boards
• As cues along with words
• Symbols substitute for words
• CoWriter (Solo) Word Prediction Program by Don
  Johnston, Inc.
• WriteOutloud by Don Johnston, Inc. - talking
  word processing program with spell checker, easy
  navigation tools, and color coding.
• Mayer-Johnsons Writing with Symbols 2000 with
  Picture Processing

39
If You Give a Mouse a Cookie
and
-ing
to
-ed
-s
the
-er
-ly
40
Peer Interactions and Support

• Peers need individualized training
• Turn-taking, listening, and maintaining a
  conversation with student using AAC
• How to support learning vocabulary - need to
  understand structure of communication system
• Can learn to co-construct messages, aided
  language stimulation, assist with spelling

41
Partner Training for All

• Pause and wait for partner to construct the
  message. Be patient. It might take awhile. (10
  second rule)
• Dont feel you have to keep talking all the time.
  Relax and get into this slower rhythm of
  exchanging information.
• Give partner an opportunity to ask you questions
  or make comments.

42
Partner Training

• Dont finish sentences or words unless your
  partner gives you permission.
• Interact at eye level if at all possible. Grab a
  chair if partner is in a wheelchair. Pay
  attention to facial expressions and gestures.
• Dont look over your partners shoulder.
• Be honest. If you dont understand - admit it.
  Ask for repetition/clarification.

43
Partner Training

• Talk directly to your partner not to
  instructional aide or other support person.
• If you understand the message, dont insist that
  individual using AAC use their device or board.
  Accept whatever mode is used. Allow for a
  combination of modes if needed.

44
Questions to Keep In Mind

• How can we utilize available technology I ways
  that truly give students equal access to the
  classroom curriculum?
• How can teachers use technology as an
  instructional tool to accomplish curriculum
  goals?
• What can we do to help support the process where
  typical peers can begin to provide support?

45
Time for Q and A

• Any questions?

46
Thank You!

• If you have any questions or comments, please
  contact us at the following email addresses
  below
• Sandra M. Grether
• sandra.grether_at_cchmc.org
• Linda Sue Sickman
• lsickman_at_towson.edu

47
References

• American Speech Language Hearing Association.
  (2006). Responsiveness to intervention New roles
  for speech-language pathologists. Retrieved
  April 21, 2007 from http//www.asha.org/members/sl
  p/schools/prof-consult/NewRolesSLP.htm
• Justice L. (2004). Creating language-rich
  preschool classroom environments. Teaching
  Exceptional Children, 37, 36-44.
• Fallon K., Light L., McNaughton D., Drager K.,
  Hammer C. (2004). The effects of direct
  instruction on the single-word reading skills of
  children who require augmentative and alternative
  communication. Journal of Speech, Language, and
  Hearing Research, 47, 1424-1439.
• Fuchs D., Fuchs, L. (2006 ). Introduction to
  response to intervention What, why, and how
  valid is it? Reading Research Quarterly, 41 (1),
  93-99.

48
References

• Grether S. Sickman L. (2008). AAC and RTI
  Building classroom-based strategies for every
  child in the classroom. Seminars in Speech and
  Language, 292, 155-163.
• Kovaleski J. Prasse D. (2004). Response to
  instruction in the identification of learning
  disabilities A guide for school teams. National
  Association of School Psychologists. Helping
  Children at Home and School II Handouts for
  Families and Educators, S8-159
• Light J. (1997). Lets go star fishing
  Reflections on the contexts of language learning
  for children who use aided AAC. Augmentative and
  Alternative Communication, 13, 158-171.
• Light J., Dattilo J., English J., Gutierrez L.,
  Hartz J. (1992). Instructing facilitators to
  support the communication of people who use
  augmentative communication. Journal of Speech and
  Hearing Research, 35, 865-875.

49
References

• Light J., McNaughton, D., Weyer, M., Karg, L.
  (2008). Evidence-based literacy instruction for
  individuals who require augmentative and
  alternative communication a case study of a
  student with multiple disabilities. Seminars in
  Speech and Language, 292, 120-132.
• In Light J., McNaughton D. eds. (in press).
  Accessible Literacy Learning Evidence-based
  Reading Instruction for Learners with Autism,
  Cerebral Palsy, Down Syndrome, and Other
  Disabilities. Solana Beach, CA Mayer Johnson.
• National Research Center on Learning
  Disabilities. (2007). Responsiveness to
  intervention in conjunction with learning
  disability determination Brochure. Lawrence,
  KS.
• Numeroff L. J. (1985). If you give a mouse a
  cookie. Harper Collins Publisher.

50
References

• Singer B., Bashir A. (2004). Developmental
  variations in writing composition skills. In C.A.
  Stone, E. R. Silliman B.J. Ehren, K. Apel
  (Eds.), Handbook of language and literacy
  (pp.559-582).Guilford Press New York.
• Sonnenmeier, R.M., (2007) Augmentative and
  alternative communication (AAC) supports for
  students with significant disabilities to learn
  academics in general education classrooms.
  Poster presented at American Speech Language
  Hearing Convention, Boston, MA.
• U.S. Department of Education (2006, August 14).
  Assistance to states for the education of
  children with disabilities and preschool grants
  for children with disabilities Final rule.
  Retrieved April 27, 2007, from http//idea.ed.gov/
  explore/view/p/2Croot2Cregs2C