Family Members Enhance the Literacy and Communication of Teens with Significant Disabilities

Planting the Seeds of Inclusion Conference - 2015Denise Clark

clarkd@uwosh.edu Teri Wegner

wegner@uwosh.edu Ann Mickelson

mickelsa@uwosh.edu

In Collaboration withStacey SkoningFlo Muwana

Overview of Today’s Session• The Broader Mission and Literature• Overview of this Literacy and Communication

Study• Procedures• Participants• Results• Limitations

• Results and Implications • Next Steps: Where do we go from here?

The Mission Continues

“…We are all acutely aware that the ability to read,

spell, and write is the only cluster of skills that enables people with severe communication disorders to say what they want, when they want to…" (Mirenda, 1993, p.7).

Literacy is…• Emergent literacy researchers define

literacy learning as a life-long process, beginning at birth, and supported by natural explorations (Koppenhaver, 2000).

• Literacy includes reading, writing, speaking, and listening.

What We Know from Research• Historically, many students have been

excluded from literacy instruction (Katims, 2000; Kleiwer & Biklen, 2001).

• Others receive limited instruction with limited foci• (e.g., functional skills and/or “sight

words”)

• Traditional views of and approaches to reading and writing have promoted low expectations for this population.

• Exclusion from initial instruction perpetuates exclusion.

ACCESS

Literacy Instruction Benefits

• Young students with severe communication, motor, and cognitive disabilities benefit from emergent literacy intervention (Koppenhaver, 2000).

• Studies confirm benefits of parent-teen storybook reading interactions in fostering increased communication.

• The ability to benefit from emergent literacy

activities depends less on cognitive ability than on “learning opportunity, modeling of possible uses of print and communication symbols,

and access to supportive

texts and technologies” (Koppenhaver, 2000, p. 273).

Historical approach…• The often preferred literacy instruction used by

many special education teachers for individuals

with severe disabilities focuses on life-skills training, such as picture schedules or identifying simple words and phrases frequently occurring in the home and community

(Ruppar, Dymond & Gaffney, 2011) rather than literacy elements.

Beyond Functional Literacy• Though improving the” functional” reading skills of students

with severe communication disabilities is a necessity, other

literacy elements have been incorporated in the instruction of this population with very promising results.

Increased Expectations and Literacy Gains• Research has shown increased gains in reading skills when instruction incorporated literacy elements, such as visual and discussion-based interventions, wh-questions, and rereading texts in addition to oral presentation of texts using adapted, age-appropriate reading materials (Hudson & Browder, 2014; Morgan & Moni, 2008; Shurr & Taber-Doughty, 2012).

Another Aspect to Consider• Westgate & Pesola (2008) reported the

positive effects of using age-appropriate poetry and adapted materials combined with a variety of learning strategies on the reading decoding and reading comprehension of young adults with Down syndrome.

Curricular Materials• When teens with significant disabilities including

those with Down syndrome received literacy instruction in inclusive environments that used general education curricular materials, they displayed higher reading skills than their peers who were solely taught in segregated classrooms (Bochner, Outhred, & Pieterse, 2001).

The Study• Began in the Fall of 2013- data presented here is

part of a larger study.

• Examined the effects of home-based emergent literacy experiences on the communication of teens with severe communication and motor disabilities who ranged in age from 14-16.

• Three reading dyads (Family member and teen)

The Study• Three phases:• Baseline• Intervention 1-Textual/Story Communication Focus• Intervention 2-Literary Elements

• We wanted to know the effects of:• Supportive literacy strategies• Age-appropriate literature• Visual strategies• Guiding questions

Quantity Measures• How often and in what way did teens

communicate during reading?• Rate- number of occurrences per minute• Categories-

• manipulates the book, vocalizations, verbalizations, eyepoints, points/gestures, moves away, manual signs, AAC, and other book/object

Quality Measures• Examined the purposes for teens’ communication

across study phases.• Categories- • responds to adult, comments on book, unrelated

comments, directs reader, points/gestures unrelated to book, physical movement unrelated to adult commands, and nonspecific

Quantity and Quality Measures regarding the Family Member• Categories of responses to teens’ communication:• Adult responds to student communication attempts• Adult asks a question related to the book• Commands related to the book• Commands unrelated to the book

Preliminary Data

• Length of time analysis• General trends in change of behaviors for baseline and

intervention 1 for two of the three participants

• Instructions for dyads:• Read three times per week for 10 minutes

for a duration of two weeks.• Choose books that are typically read to/with

the teen• Video record each session.• Begin each reading session by stating the

time, date, and name of book.

Baseline

Intervention & Training

• Materials• Abridged books based on teens’ interests and

ages• Communication cards with questions used

during and after the reading • (who, what, where, which, and how)

• Instructions• Use abridged books, communication cards, and

questions• Expand and relate to teen’s life• Read three times per week for 10 minutes for a

duration of two weeks• Video record each session

Teen Participant 1• Male, Age 14, Grade 8• Enjoys watching televised sports-hockey, soccer• Diagnosed with autism• Home-schooled ½ day, school ½ day• Functional use of echolalic speech• Reported to have a 75-100 word expressive

vocabulary• Reading Milestones Level 1• Proloquo2go in IEP but did not see used• No literacy goals in his IEP prior to 6th grade.

• Mother agreed to be the reading partner

Teen Participant 2• Male, Age 15, Grade 8• Enjoys soccer, baseball, videogames at K1 level,

and food• Carries large set of books around frequently• Diagnosed with Down Syndrome and autism• Reported to be nonverbal and to use

vocalizations• Communicates with sign language and AAC but

neither used consistently at home• IEP literacy goals: read short sentences,

comprehension of basic questions, spelling words from books he is reading

• Mother agreed to be the reading partner

Teen Participant 3• Female, Age 16, Sophomore in self-contained high school

classroom• Enjoys television-commercials, Sponge Bob and Shrek,

watches crime shows with sister, music, and food• Significant communication, physical, and visual impairments• Nonverbal: Uses eye gaze, vocalizations, and some hand

movements• No literacy goals in her IEP • Assistive Technology needs included in IEP: keyboard,

switches, voice output system, communication pictures/photographs

• A teen-aged sibling agreed to be the reader in this pair

Preliminary Results

• Length of Reading Engagement• Behaviors during Baseline• Behaviors during the Intervention

Reading Dyad 1

1 2 3 4 5 60:00

2:24

4:48

7:12

9:36

12:00

14:24

16:48

19:12

21:36

24:00

Length of Reading Engagement- P-1

BaselineIntervention

Sessions

Tim

e in

Min

utes

Reading Dyad 1

Average reading length

0:00

2:24

4:48

7:12

9:36

12:00

14:24

BaselineIntervention

• Range Baseline:• 5:56 – 14:07

• Range Intervention:• 7:23 – 21:13

Reading Dyad 2

1 2 30:00

6:00

12:00

18:00

24:00

30:00

36:00

42:00

48:00

Length of Reading Engagement – P-2

BaselineIntervention 1

Sessions

Tim

e in

Min

utes

Reading Dyad 2

• Range baseline• 4:45-10:11

• Range intervention• 22:52-40:50

Average reading length0:00

2:24

4:48

7:12

9:36

12:00

14:24

16:48

19:12

21:36

BaselineIntervention

Reading Dyad 3

1 2 3 4 5 60:00

4:48

9:36

14:24

19:12

0:00

4:48

Length of Reading Engagement- P-3

BaselineIntervention

Sessions

Tim

e in

Min

utes

Reading Dyad 3

• Range baseline• 5:06-6:21

• Range intervention• 13:00-23:48

Average Reading Length

0:00

2:24

4:48

7:12

9:36

12:00

14:24

16:48

19:12

Baseline

Intervention

GENERALIZED CODING TRENDS

Next:

Reading Dyad 1-TeenBaseline

• Manipulated book, vocalized, verbalized, pointed/gestured

• Many unrelated comments and point/gestures to environment and not book

• Frequent repeated references to PE teacher, line therapists, hockey

• Directed reader to end session: turned page, closed book, threw book

Intervention • Increase in book manipulation,

pointing/gesturing, verbalizations

• Increase in responses to questions and directing reader

• Used his hooded sweatshirt to play role of a Jawa

• Increase self-initiated comments about story

• Considerably more language than 75-100 words• Usually 1-3 word

utterances, but some longer

Reading Dyad 1- Family MemberBaseline

• Commands for on-task behavior: many

• AAQ: many questions were asked consecutively

• Often answered questions before teen could respond

• Few times related story to teen’s life

Intervention• “He won’t like these books."• Questions presented one at a

time more frequently• Allowed more wait time for

student to respond• Was more animated in

comments and verbal praise• Related story to teen’s life more• Paired physical actions with

vocabulary• Uttered phrases like “your not a

fan on this book are you” with multiple presentations in sequence.

Reading Dyad 2-Teen

Baseline

• Enjoyed the reading sessions-laughed and imitated actions from the book• Used AAC two times• Used few signs

Intervention • Increased use of sign

language to comment on book• Took ownership of one

book• Liked action books such

as sports• Answered and asked

many questions during readings

Reading Dyad 2-Family Member

Baseline

• Basically read the story• Few verbal interactions

such as commenting on story or asking questions

Intervention • Unsure of books• Did not always understand

that teen was signing to her• Did not always understand

what teen was verbalizing• Increased animation• Increased questions• Increased comments about

reading• Increase in relating story

elements to teen’s life

Conclusions from Both Participant Dyads

Teen• Increased

communication attempts using new material• Increased engagement

with material• Responded to most

questions during intervention correctly• Acted out characters or

verbs in stories

Family Member• Increased animation

during readings• Increased questions and

comments• Increased time spent in

reading activities• For P-1, less time getting

teen on-task

Lessons Learned

• Organize literacy cards and questions in a format that families are comfortable with• Check recordings for sound and completion of phase

before introducing next phase• Be more aware of statements about inability to finish a

phase-• “I hope this is okay.” “I’m not sure if this turned out.”

• Provide more opportunities for family members to practice the interventions with us

Lessons Learned continued…

• Recruit participants from schools• Family members’ slight resistance to reading age-

appropriate books• Set up a designated space for readings-indicate space for

camera set up (tape on floor) so that we can see both teen and family member• Technology limitations

Conclusions from the larger study• Persistent lack of recognition of teens’ communication

attempts• Reader stamina• Family members were overwhelmed with literacy questions

and cards.• Participant attrition• Technology

Where do we go from here?

Study the effects of using age-appropriate reading material and supportive literacy activities

on the communicative and literacy skills of young adults with severe communication disabilities

Next…

Our Questions

Does the adult readers’ use of literacy elements and strategies

increase young adults’ with severe communication disabilities

opportunity for active communicative engagement in

reading?

More QuestionsDoes the use of age-appropriate texts increase the young

adult with severe communication disabilities opportunity for active communicative engagement in reading?

Does the use of age-appropriate reading material provide higher levels of satisfaction during reading activities for adult reading partners and young adult with severe communication disabilities?

Comments & Questions??