Supporting Higher Level Communication Skills Folden Supporting Higher Level... · Supporting Higher...

Supporting Higher Level Communication Skills

in the Classroom, Community, and Home

Jillian Baldwin M.Sc., RSLP, S-LP(C)

604-444-3773

jillian@dsrf.org

Marla Folden M.Sc., RSLP, S-LP(C)

604-444-3773

marla@dsrf.org

Long Term Goals

• What is going to be most important to your

students’ “quality of life” down the road?

�Lasting relationships

�Employment

�Independence

• Focus on functionality

Today’s Goals

Skills

• Communication strengths

• Communication challenges

Demands

• Environmental demands

• Communication opportunities

Strategies

• Build skills

• Compensate

• Professionals

• Resources

What is communication?

• How people

communicate

– Spoken words, sounds

– Voice

– Facial expressions

– Body language

– Gestures

– Pictures

– Sign language

– Writing

– Devices

• Why people

communicate

– Meeting needs

(getting/refusing

things), safety

– Exchange information

– Social interaction

– Build/maintain

relationships

Get to know your child’s learning profile“The profile should inform practice”

Consider:

1. Physical, perceptual, and sensory factors

2. Cognitive factors

3. Communication factors

Identify both strengths and challenges….

Then work from strengths!

Vision (60%)

Hearing (65-80%)

Touch (49%)

Perceptual and Sensory Factorsin Communication

• Attention

• Verbal short-term

memory

• Reasoning / problem-

solving

• Abstract thinking

• Memory for words

• Sequencing /

organization

• Generalization

Cognitive Factorsin Communication

= Communication Profile

Strengths vs. Challenges

Receptive Language

(understanding) + gesturing

Expressive Language (speaking)

+ speech clarity

Visual processing + memory Auditory processing + memory

Vocabulary (especially for

things)

Grammar (putting words

together in sentences)

Concrete words Abstract concepts

Repetitive language Novel sentences

Social motivation Social skills (pragmatics)

Today’s Goals

Skills

Demands

Strategies

• Build skills

• Compensate

• Professionals

• Resources

Health status

Child’s current health status will affect behaviour, skill, and

sensory abilities.

OpportunitiesSkill Demands

Day-to-day interactions

• Home

• School

• Community

Communication

profile:

• Strengths

• Challenges

Include:

• Environment

• Cognitive load

Social & emotional state, and learning

How your child responds to others affects willingness to try something new.

Learning challenges affect skill acquisition

Child factors in Communication

Today’s Goals

Skills

Demands

Strategies

• Build skills

• Compensate

• Professionals

• Resources

Key Strategies

Understanding

others

Following

directions

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

Sentence length Social interactions

Fixing

communication

break-downs

• Follows directions accurately

• Responds meaningfully

• Respond consistently to similar directions/ requests

Does the child understand me?

• Bored and fidgeting

• Starts doing self-directed things

• Responds incorrectly

• Smile

• Say ‘yes’, ‘ok’, or ‘no’!

• Pick the last choice you gave

• Say the last word you said

When You’re Giving Information

�Reduce distractions

�Length and simplicity

�Use visuals*

Reduce

Distractions

Highlight Your Language

www.hanen.org

Length & Simplicity

Key Strategies

Understanding

others

________________

Following

directions

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

Fixing

communication

break-downs

When You’re Giving Directions

�Labels: Be specific

�Visuals: say it AND show it

�Repeat, repeat, repeat!

Following Directions

Labels: Be specific

Hand in your

assignments

Put your chapter 6

definitions in the blue

science homework tray

Labels: Be specific

Put that away. Hang your coat in the

closet.

Demonstrate what you want your child to do

Visuals

Low-Tech Picture

Systems can support

verbal directions.

Visuals: First � Then

Keep it simple, clear, consistent

Visuals: Schedules

Visuals: Size

Visuals: write your own schedule

Let your student help write

the list: this

increases motivation,

provides functional practice

Repeat, Repeat, Repeat!

PRE-TEACH

concepts

PRE-TEACH

concepts

REPEAT

key points

REPEAT

key points

REVIEW

concepts

REVIEW

concepts

Key Strategies

Understanding

others

Following

Directions

_____________

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

Fixing

communication

break-downs

Sequencing – putting events in order

Understanding stories

Identifying WH details

Understanding stories

Key Strategies

Understanding

others

Following

Directions

Comprehending

stories

________________

Asking and

answering

questions

Communicating

about day-to-day

experiences

Fixing

communication

break-downs

Explicitly teach

what type of

information each

question word

Asking and Answering Questions

Harder

(abstract)

Easier

(concrete)

Asking Questions

Visuals: Asking for help

Key Strategies

Understanding

others

Following

Directions

Comprehending

stories

Asking and

answering

questions

________________

Communicating

about day-to-

day experiences

Fixing

communication

break-downs

Communicating day-to-day experiences

Visuals

Asking and Answering questionsCommunicating day-to-day experiences

“…evidence that suggests individuals with DS have strengths

in visual processing that can be leveraged to improve relative

weaknesses in narrative language (Chapman et al., 1998;

Roberts et al., 2008).”

Communicating day-to-day experiences

Key Strategies

Understanding

others

Following

Directions

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

________________

Sentence

lengthSocial interactions

Fixing

communication

break-downs

Improving Expressive Language

�Vocabulary (words your student knows)

�Sentences (putting words together)

Sentence Length

Through

UnderStart!

Between

Bounce

Your turn!

Vocabulary: Teach a Variety of Words

Sentence Length

Combine

HotStir

Spatula

Creamy

Measuring cup

Vocabulary: Teach a Variety of Words

Sentence Length

Vocabulary: Personal Dictionary

Sentence Length

Improving Expressive Language

�Vocabulary (words your student knows)

�Sentences (putting words together)

Sentence Length

Building Sentences: Pacing

Sentence Length

Building Sentences: Visual Manipulatives

Sentence Length

Building Sentences: Visual manipulatives

Sentence Length

Building Sentences:

Communication Binders

Sentence Length

AACAugmentative and alternative communication

“Any method that assists with or supplements speech and language, or that replaces speech as the primary communication system.”

– Libby Kumin

• sign language

• picture

symbols

• Electronic

devices

• voice output

machines

• low

intelligibility

(speech)

• difficulty

formulating

messages

(language)

Sentence Length

Key Strategies

Understanding

others

Following

Directions

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

Sentence

length

________________

Social

interactions

Fixing

communication

break-downs

• Appropriate greetings (Hi! Bye!)

• Taking turns in a conversation

• Commenting on what someone said

• Compliments, jokes, questions

• Eye contact, facial expressions and body

language

• Proxemics (personal space)

• Repairing communication breakdowns

What are the challenges?

Social Communication

How can we address them?

• Teach directly*

• Model

• Scripts

• Role play

• Visuals

• Prompt

• Specific feedback

• Generalize

Direct Teaching Tool

1. Identify expected and unexpected social communication behaviours.

2. Use social behaviour mapping to teach the consequences of each choice.

Direct teaching tool: Teach Concepts with a

‘Social Story’

Direct Teaching

Conversation: Scripts & Role-Play

Supporting Peer Interactions

• With parents’ permission, talk to the class

about the peer and their differences

• Teach peers the skills and language to use

• Encourage as many INTERACTIONS in a day as

possible – facilitate early on

*Think: Can a peer or the individual can do

this instead of me?

Key Strategies

Understanding

others

Following

Directions

Comprehending

stories

Asking and

answering

questions

Communicating

about day-to-day

experiences

Sentence

length

Social interactions

________________

Fixing

communication

break-downs

What to do if you don’t understand

the child’s speechUnderstand it can be frustrating!

• Stay relaxed

• Show that you’re interested and trying to understand

Ask your student to:

• Say it again, say it slowly

• Write it, sign it

• Say it a different way, Tell you the 1st sound

• Show you

Ask questions:

• Choices: “Do you mean X or Y?”

• Yes/no: to narrow it down – “Is it on TV?”

Ask if they want to try again later

Repairing Breakdowns

How to fix it:

Repairing Breakdowns

In summary

Today’s Goals

Skills

Demands

Strategies

• Build skills

• Compensate

• Professionals

• Resources

Resources: Who can help?• Public or private SLP, OT

• Resource teachers

• AAC specialists – usually available through the school board

• Behaviour interventionist

• Medical professionals

Private SLP:

https://www.osla.on.ca/en/childirectory

Resources: Language Development

Books• Early Communication Skills for Children with Down Syndrome

– Libby Kumin, 2012

• Helping Children with Down Syndrome Communicate Better– Libby Kumin, 2008

• Teach Me to Talk!: The Therapy Manual– Laura Mize, 2011

• It Takes Two to Talk: A Practical Guide for Parents of Children With Language Delays– Jan Pepper and Elaine Weitzman, 2004

• Social stories http://carolgraysocialstories.com/social-stories/– Caron Gray, 1991

• Zones of Regulation http://www.zonesofregulation.com/index.html

• Social thinking curriculuum https://www.socialthinking.com/– Michelle Garcia Weiner

Resources: AAC

• Boardmaker Achieve website– www.boardmakeronline.com

• SET BC website– www.setbc.org

• Free sign language videos– www.signingsavvy.org

• AAC RERC (Rehabilitation Engineering Research Centre) website– http://aac-rerc.psu.edu/index.php/pages/show/id/44

• Touch Chat app: web resources, manuals, and training videos– https://touchchatapp.com/

THANK YOU!

� Consider skill profiles

• Capitalize on strengths to target challenges

� Goals should focus on long-term functionality

• But go step by step

� Contact an SLP for individualized recommendations and strategies

ReferencesBuckley, S. Bird, G., & Sacks, B. 2006. Evidence that we can change the profile from a study

of inclusive education. Down syndrome research and practice, 9(3). 51-53.

Breslin, J., Spano, G., Bootzin, R., Anand, P., Nadel, L., & Edgin, J. (2014). Obstructive sleep

apnea syndrome and cognition in Down syndrome. Developmental Medicine & Child

Neurology, 3(2), 1 - 8. http://onlinelibrary.wiley.com/doi/10.1111/dmcn.12376/pdf

Bull, M.J. & Committee on Genetics. (2011). Health supervision for children with down

syndrome. Pediatrics, 128(2). Retrieved from:

http://pediatrics.aappublications.org/content/128/2/393.full.html

Chen, C.C. (JJ), Spano, G., Edgin, J.O. (2012). The impact of sleep disruption on executive

function in Down syndrome. Research in Developmental Disabilities, 34, 2033 – 2039.

Capone, G., Goyal, P., Ares, W., & Lannigan, E. (2006) Neurobehavioral disorders in children,

adolescents, and young adults with Down syndrome. American Journal of Medical

Genetics 142C, 158-172.

First years. (2011).Developmental milestones, Birth to 8 years. Available online at:

http://firstyears.org/miles/chart.htm

Forster-Gibson & Berg. (2011). Health watch table: Down syndrome [PDF]. Surrey Place

Centre. Retrieved from:

http://www.cfpc.ca/uploadedFiles/Directories/_PDFs/Down%20Syndrome.pdf

Kumin, L (2012). Early communication skills in children with Down syndrome:

A guide for parents and professionals (3rd.). Bethesda, MD. Woodbine

House.

Kumin, L. (2008). Helping children with Down syndrome communicate better.

Bethesda, MD. Woodbine House.

Lanza, J.R. & Flahive, L.K. (2009). Linguisystems guide to: Communication

Milestones. East Moline, IL. LinguiSystems, Inc.

Motley, W.W. Vision and eye issues affecting individuals with Down

syndrome[webinar]. Retrieved from Webinar Web site:

http://www.ndss.org/Global/Vision_and_Eye_Issues_Webinar.pdf

National Down Syndrome Society. Vision & Down Syndrome. Retrieved from:

http://www.ndss.org/Resources/Health-Care/Associated-

Conditions/Vision--Down-Syndrome/

Paul, R. & Norbury, C.F. (2012). Language disorders from infancy through

adolescence: Listening, speaking, reading, writing, and communicating.

4th. St. Louis, MI. Elsevier.

References

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