NCACA 2017 PODD Karen Lynn handoutncaca.info/wp-content/uploads/2017/03/NCACA-2017... · use AAC. Augmentative and Alternative Communication, 23, (1) 30 – 43. • Bruno, J. & Trembath,

Karen Casey & Lynn Carswell & Team 2017 1

PARENTS AS PARTNERS WORKING TOGETHER TO SUPPORT PODD USERS

• Karen Casey, MA, CCC-SLP •  Durham CDSA

•  [email protected]

•  Lynn Carswell, MA,CCC-SLP •  Right FIT Speech and Feeding Therapy


• Caitlin Burke, MS, CCC-SLP •  Talk About It


PARENTS AS PARTNERS WORKING TOGETHER TO SUPPORT PODD USERS • Summer Kinard, M.Div, Th.M,

•  Parent of a 3 year old boy with ASD

•  Elizabeth Bradford •  Mom of 8 year old with BPAN

•  Terri Campbell •  Mom of 8 year old boy with CP and apraxia

• Margarita Escaler •  Mom of 9 year old girl with CP

OUTLINE

• What is a PODD, Who is it for, Why?

• Vocabulary Organization & Getting Started

•  Tips for Making a PODD

• Using a PODD: Essentials and Conventions

• Navigation Tips

• Tips for Implementing Use of a PODD

•  Early Intervention and Coaching

• Parents Perspectives & Tips

Pragmatic Organization Dynamic Display (PODD) Communication Books �� (Gayle Porter)

3 CD Set of templates and printable manual for direct selectors (14 different communication books); 3 styles

Available from Mayer-Johnson

PODD pages are available as an option on the Tobii Dynavox Speech Generating Devices and the iPad through Compass software or app.

WHAT IS A PODD BOOK?

• PODD stands for: •  Pragmatic – the ways that we use language socially

• Organization – words and symbols arranged in a systematic way

•  Dynamic Display – changing pages

• PODD offers a robust vocabulary for each developmental level

CREDITS, TRAINING, RESOURCES

• Gayle Porter, SLP, Australia

•  Linda Burkhart, Special Educator

• www.Lburkhart.com

•  Locally: Debbie Reinsharsen

• [email protected]

•  Two (2) day and five (5) day trainings

• Novita Children’s Services

•  http://www.novita.org.au/Content.aspx?p=683

• RightFIT website (Lynn Carswell)

• www.rightfitspeech.com


NOVITA SITE www.Novita.org.au

WHO IS A PODD BOOK FOR?

•  For all developmental levels and all diagnoses.

• Particularly powerful for the child with complex communication needs and visual impairments.

• Accommodates different physical and sensory challenges and communication needs of the person.

AIM FOR AUTONOMY

“Being able to say what I want to say, to whomever I want to say it to, whenever I want to say it” (G. Porter)

• Autonomous communication is not necessarily independent

• Work together to construct a communicative exchange

• PODD books allow the conversation to be driven by the child’s intent. You don’t know what the child is thinking!

• Establishing a HABIT for authentic communication

WHY USE A PODD BOOK? “SMART PARTNER”

• A “Smart Partner” can:

• Read subtle non-verbal cues and adjust the interaction as needed

•  Interpret movement, recognize intent and ignore associated reactions

•  Focus on developing language and communication skills separately from motor skills

VOCABULARY ORGANIZATION: QUICK WORDS

• On the first pages of PODDs

•  Include words that allow for “quick communication” (e.g. more, done, different)

• Can be used across all communicative situations

VOCABULARY ORGANIZATION: PRAGMATIC BRANCH STARTERS

•  Establish Intent - ex. Asking a question, requesting, pretending

•  Compensates for lack of gestures and intonation typically used

•  Seeing all Pragmatic Branch Starters encourages use of a variety of language functions


VOCABULARY ORGANIZATION

•  Faster predictive links

•  “Something’s wrong” leads to complaining messages

• Predictably associated vocabulary

•  Ex. Verbs for dressing and eating different

• PODD’S Include “Sections”/Categories, Operational commands, Activity Displays and Anecdote pages

• Design of All PODDS have similar features and vocabulary placement to allow smooth transitions

CONSIDERATIONS FOR GETTING STARTED: CHOOSING A PODD

• Communication and Language Requirements

• Vision Considerations; high contrast symbols

• Motor considerations

•  Think up

• Based partially on the team expectations and ability to implement the PODD.

CONSIDERATIONS FOR GETTING STARTED (cont’d)

•  Trial PODD suggestions:

• Black and white trial PODD

•  If using a laminated trial PODD, tape on personalized vocabulary as needed, can be easily removed later.

• Use pockets from notebook stands as storage for notes of customization needed.

TIPS FOR MAKING A PODD

•  Read the Construction File on CD

•  Save a child’s individual PODD with appropriate optional pages for easier printing.

•  If laminating, print it and cut before laminating, then cut again

•  If using weather resistant paper, some prefer to bind first and cut tabs later to keep pages in order.

•  Leave room for hole punching or binding at top

•  Adjust 3 hole punch to not cover symbol.

•  Cost and time: Time is all up front


MORE TIPS FOR MAKING A PODD

• Can make a PDF and take to printing shop (sample cost: $38) *See handout for instructions

• Use weatherproof paper: saves time

•  iGage; Terra Slate 4 mil waterproof; Revlar

•  Need laser printer

•  Laminate first 3 pages, Categories, ‘messy’ pages such as Food/Drink, Messy Play

• Non-glare/matte laminate sheets (3 ml)

• Packing tape on tabs

MORE TIPS FOR MAKING A PODD

• Corrugated plastic for stand

• Spiral Binding (Fed Ex Office: $4-5 for 100 pages)

• Rod through binding for support

• Duct tape stand w/cable ties for rings

•  Mary Louise Bertram Practical AAC tip Nov 2013

• Karen Owens ‘how to’ video https://www.youtube.com/watch?v=mE_fe_Io_zE

ESSENTIALS FOR USING THE PODD

• Listener and Speaker use the book

• NO prerequisite skills needed - Learn through immersion throughout the day

• Presume Competence

• Expect that they have something to say, but have no expectations as to what that might be!

• Allow response time

ESSENTIALS FOR USING THE PODD

Aided Language Stimulation: Input before output.

• Typically developing child has been exposed language for approximately 4,380 waking hours by the time he begins speaking at about 18 months of age

• If someone is using a different symbol set and only has exposure to it two times a week for 20-30 minutes each, it will take 84 years to have the same exposure with his symbols

AIDED LANGUAGE INPUT “ROUND-UP”

Carole Zangari : Praacticalaac.org

•  Over 200 posts

•  April 29, 2016: Summary of the most popular posts on this “pivotal skill for AAC intervention”

AAC Modeling Intervention Research Review •  Samuel C. Sennott, Janice C. Light, David McNaughton

Research and Practice for Persons with Severe Disabilities Vol 41, Issue 2, pp. 101 – 115 (2016)

RESOURCES: PARTNER AUGMENTED INPUT: DR. JILL SENNER AND MATT BAUD

https://www.facebook.com/groups/PartnerAugmentedInput/


RESOURCES

•  https://www.pinterest.com/talcaac/partner-augmented-input/

SMORRES: A STRATEGY FOR BUILDING PARTNER INTERACTION SKILLS DR. JILL SENNER AND MATT BAUD

• S: Slow Rate

• Mo: Model

• R: Respect and Reflect

• R: Repeat

•  E: Expand

• S: Stop

** Verbal Practice of Strategy Steps (Kent-Walsh & McNaughton, 2005)

CONVENTIONS FOR USING A PODD

•  The “smart partner” turns the pages, not the individual until they show ability to navigate without being distracted.

• Begin on front page; follow the numbers to the message.

CONVENTIONS FOR USING A PODD: (GAYLE AND LINDA)

•  “As you Chat.. •  Model the child’s method of initiating •  The “smart partner” turn the pages, not the individual until they show

ability to navigate without being distracted.

•  Model child’s method of access some of the time

•  Speak aloud the label on the symbol as you point

•  Regularly recap (out loud) the message “thus far”

•  Repeat the message in normal English at the end.

•  Don’t do “20 Questions”, just state each symbol.”

OPPORTUNITIES FOR MODELING PODD

• Use the child’s communication book to interact

•  Two adults use to talk to each other

• Adults talk to peers in class or siblings.

NAVIGATION TIPS

• Co-constructing the message

•  Try to keep flipping to a minimum; page changes are based on the flow of the conversation

• Start on first page; Go to pragmatic branch starter, topic or category; Stay on specific page to communicate until a reason to leave


NAVIGATION TIPS

• Begin on front page; follow the numbers to the message.

NAVIGATION TIPS

• Attend to color and number cues •  The number and color on the symbol matches the color on the

tab.

• Routine placement of vocabulary to assist automaticity.

One page:

•  e.g. pronouns on every “A” page

• Go to Categories on every page ( except 1st…more to say )

One and Two Page

• Vocabulary is in columns (questions, pronouns, verbs..) easy to find by type and easy to construct sentences left to right.

• Operational Commands: (turn page, go to categories): Model so child can learn how to get to additional vocabulary

• Never leave the page without following the operational commands.

NAVIGATING: FOR VISUAL SCANNING • Scan in columns not rows

•  The “more to say” and “turn the page” buttons are moved to the upper left hand corner so it is the first thing scanned on the page.

NAVIGATING FOR AUDITORY + VISUAL SCANNERS

• Quick Words are moved to page 2

• Pragmatic branch starters are moved to the first page

• A link to “Quick Words” is placed in the upper left corner as the first item scanned on page 1


AUDITORY AND VISUAL SCANNING

• Additional Options are Available in the Operational Column

AUDITORY + VISUAL SCANNERS

•  List vocabulary using monotone voice for scan and social voice for interaction.

• May need “pull offs”

•  “No Book Talk”

• Model the pathways verbally even if don’t have the PODD

•  Lydia’s wearable option

LYDIA’S “NO BOOK” TALK, WEARABLE RESOURCE: PARTNER ASSISTED SCANNING VIDEO EXAMPLES

• http://prAACticalAAC.org

•  August 12, 2012: A PrAACtical Look at Partner Assisted Scanning

•  February 4, 2015: How We Do It: Auditory & Visual Scanning with Jack and Mary-Louise

Facebook page: We Speak PODD

PARTNER ASSISTED SCANNING RESOURCES

•  Learning Partner-Assisted Scanning with PODD

•  http://www.spectronics.com.au/blog/resource/learning-partner-assisted-scanning-with-podd-2/

TIPS FOR IMPLEMENTING A PODD

•  Carry it all of the time!

•  Begin by using 1A and 1B pages only for 2 weeks. (Quick Words)

•  Practice “Patterns”. Choose a pattern to start.. •  “I like”/ don’t like; sharing opinions •  “Something’s Wrong”

•  I want… Activity

•  In a classroom setting, different people might focus on different branches that each can learn through observing the others modeling.


TIPS FOR IMPLEMENTING A PODD

• Make an extra copy of Child’s PODD for practice.

•  Select Routines in which to Practice Using the PODD, Add Routines as Comfortable

• May Need to Focus on Parallel Skills: (e.g. yes/no nod- can work on outside of PODD communication too)

• Offer training: Webinars, Coaching Live; Train Support Staff; YouTube- We Speak PODD

TIPS FOR IMPLEMENTING A PODD REMINDERS MIGHT INCLUDE:

•  Messages to Practice

•  Routines in which to Practice Using the PODD

•  Skills to Focus on: (e.g. yes/no nod)

•  Specific Activity or Topic Display to Practice •  E.g. making something 8c, food/drink for mealtime 15a

INTERACTIVE SPEECH PATHOLOGY HANDOUTS

http://www.janefarrall.com/getting-hands-on-with-podd/

COMPASS SOFTWARE: TOBII DYNAVOX DEVICES AND IPAD APP

COMPASS SOFTWARE: TOBII DYNAVOX DEVICES AND IPAD APP

• ASHA SLP’s: Obtain free Compass App with PODD pageset: www.mytobiidynvox.com

• Gayle Porter recorded webinar: Introduction to PODD for Dynavox Compass

•  http://uk.dynavoxtech.com/training/online/recorded-web-classes/details/?id=4269

REFERENCES (FROM NOVITA SITE) •  C. & Light, J. (2007) The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who

use AAC. Augmentative and Alternative Communication, 23, (1) 30 – 43.

•  Bruno, J. & Trembath, D. (2006) Use of aided language stimulation to improve syntactic performance during a weeklong intervention program. Augmentative and Alternative Communication, 22(4).

•  Cafiero, J. (2001) The Effect of an Augmentative Communication Intervention on the Communication, Behavior, and Academic Program of an Adolescent with Autism. Focus on Autism and Other Developmental Disabilities, Vol. 16, No. 3, 179-189.

•  Drager, K, Postal, V, Carrolus, L, Gagliano, C & Glynn, J. (2006) The Effect of Aided Language Modeling on Symbol Comprehension and Production in 2 Preschoolers With Autism. American Journal of Speech-Language Pathology, 15; 112-125.

•  Harris, M. & Reichle, J. (2004) The Impact of Aided Language Stimulation on Symbol Comprehension and Production in Children With Moderate Cognitive Disabilities. American Journal of Speech-Language Pathology Vol.13 155-167.

•  Porter, G. (2007) Pragmatic Organisation Dynamic Display (PODD) communication books: Direct access templates. Melbourne: Cerebral Palsy Education Centre.

•  Porter, G. (2008) Pragmatic Organization Dynamic Display (PODD) communication books: Direct access templates. US Letter paper version. Melbourne: Cerebral Palsy Education Centre.

•  Porter, G. (2009) Advanced PODD Workshop. Melbourne: Cerebral Palsy Education Centre.

•  Roman-Lantzy, C. (2007) Cortical Visual Impairment: An Approach to Assessment and Intervention. New York: AFB Press. American Foundation for the Blind.


CHASE AND HIS PODD (2 1/2 Y.O. W/LEUKODYSTROPHY)

• Mom: “A whole new way of being. Different from choice making. The using of the system is what is important”

• Chase's mom likened it to the process of making a Tibetan sand Mandala, which is created and swept away. She stated that it isn't so much the end product of the message that Chase produces, which is temporary, but the beauty of the interaction in creating communication together.

EARLY INTERVENTION LETS GET STARTED EARLY!

EARLY INTERVENTION AND AAC: WHAT A DIFFERENCE 30 YEARS MAKES ROMSKI, SEVCIK, BARTON-HULSEY & WHITMORE, AAC, JULY 2015

• Overview of early intervention and AAC over 30 years.

• Review and synthesis of the evidence base in AAC and early intervention.

•  Today: “AAC services and supports are now considered by many, but still not all parents and professionals, as a first line of communication intervention services and supports (Beukelman & Mirenda, 2013)”

EARLY INTERVENTION AND AAC: WHAT A DIFFERENCE 30 YEARS MAKES

•  Examined research articles on AAC ages 0-6

• Of 70 articles that were data based, 26 articles focused on infants and young children (0-3).

•  Findings:

1. “…should be very confident using AAC interventions with very young children early in their development. AAC interventions do not inhibit the development of speech; rather, they support the development of language and communications skills.”

FACTORS THAT ENHANCE LEARNING

• Active participation; affective engagement

• Children learn best when skills are presented just beyond their present knowledge…zone of proximal development

EARLY INTERVENTION AND AAC: WHAT A DIFFERENCE 30 YEARS MAKES

•  2. “…The importance of providing AAC in the context of language and communication intervention. AAC provides the tools a young child can use to learn language.”

•  3. “The family plays a critical role in the development of language and communication skills for the young child”

•  4. “…professional education and training…is a very important component to ensure that the implications are integrated into practice.”


KUHL, P. K. 2007. IS SPEECH LEARNING ‘GATED’ BY THE SOCIAL BRAIN? DEVELOPMENTAL SCIENCE, 10, 110-120

• “Young children develop their skills in the context of affectively rich social interactions involving play with both people and objects.

• Identical information delivered outside the context of an affectively engage social exchange does not result in the same degree or depth of learning.”

CENTER ON TECHNOLOGY AND DISABILITY (CTD INSTITUTE.ORG)

•  Technology Solutions For Early Childhood Symposium November 29, 2016: In the archives.

•  The Benefits of Screen Time: Countless apps that enhance and reinforce learning, social skills, play, language and communication. Relate what seeing to real life!

• BALANCE time with technology with face-to-face interactions. We want intentional adult interactions around the technology!

NEW DATA! SLIDE FROM TAMARA KALDOR, ERIKSON INSTITUTE

– No screens under for children under 18 months – Exception is video chat

– 18 months to 2 years – OK to introduce high-quality media if you watch with them

– 2 to 5 years – 1 hour daily limit, high quality, watch together

– No media use one hour before bedtime

•  Concern about displacement – 12 hours of waking time -1 hour of media use + time for family, reading together, social time with friends, outdoor plays, imaginative play, time for boredom

NEW GUIDANCE-AAP SLIDE FROM TAMARA KALDOR, ERIKSON INSTITUTE

HEALTH AND SAFETY QUIZ

1. Do you have a smoke detector in your home and change the batteries at least once a year?

2. Do you buckle up every time you are in a car, even in the back seat?

3. Do you exercise at least 30 minutes 3 times pa week?

4. Do you wear a bicycle helmet every time you ride a bike?

5. Do you wear a personal floatation device every time you get in a boat?

6. Do you make sure every child who rides in your car up to 8 years old and 80 lbs is in an appropriate car seat or booster every time you drive?

7. Do you have a fire extinguisher in your kitchen?

8. Do you floss daily?

9. Have you practiced a fire safety plan at home and picked a meeting spot outside your home in case of fire?

10. Do you abstain from using your cell phone while driving?

WHY DON’T WE DO WHAT WE KNOW IS HEALTHY AND SAFE?

• Not enough time.

• Don’t think the bad outcome will happen to us.

•  Think we are safe anyway.

• Others aren’t supportive.

• Used to but it didn’t pay off.

• CONCLUSIONS:

•  INFORMATION is not enough of a reason to do things.

• We all have good reasons to avoid making change.


STAGES OF CHANGE

• Precontemplation

• Contemplation

• Preparation

• Action

• Maintenance

• Recurrence

MOTIVATIONAL INTERVIEWING

• A common sense, practical, evidence-based method to partner with people to make and sustain behavioral CHANGE.

• Techniques to elicit ideas and potential plans from families instead of the professional providing them.

• Give advice after asking permission.

WAYS TO EVOKE CHANGE TALK

• Open versus Closed Questions

• Affirmation: •  supporting, encouraging, recognizing difficulties

• Reflective Listening: •  rephrase, identify feelings etc.

• Summarize: •  pull together comments, link topics, highlight talk about change

Resistance comes from forcing, pushing change in some timeline…from pressure. Can diffuse it by being empathetic

MI RESOURCES

• http://www.motivationalinterviewing.org/ motivational-interviewing-resources (studies)

•  http://iprc.iu.edu/training/courses/intro-MI webinar

•  http://mi.kajabi.com/fe/843113-pesi-healthcare-free-ce webinar of the 4 MI processes

SERVICE DELIVERY: COACHING!

•  “Coaching: Involves a live observation and feedback

cycle in the natural environment.” (Joyce & Showers 1980)

• Partner Training

• Adult Learning Principles

• Parents and Caregivers as primary interventionists from the beginning!

• Positive impact on parent and child as social communication partners

SERVICE DELIVERY: COACHING!

• “perhaps long term effects of parent training may be more enduring than any short term intervention by SLP’s or others”. (Kaiser, Ann P. & Roberts, Megan, 2013)


PARENTS AS PRIMARY INTERVENTIONISTS AND COACHING

PARENTS AS COMMUNICATION PARTNERS: AN EVIDENCE BASED STRATEGY FOR IMPROVING PARENT SUPPORT FOR LANGUAGE AND COMMUNICATION IN EVERYDAY SETTINGS

• ASHA Special Interest Groups

• Ann P Kaiser and Megan Y. Roberts, SIG 1 Perspectives on Language Learning and Education, August 2013, Vol. 20, 96-111

•  Teach-Model-Coach-Review approach for teaching parents to implement Enhanced Milieu Teaching (EMT), an evidence based naturalistic intervention for young children with language impairment.

EARLY INTERVENTION: FAMILY GUIDED ROUTINES BASED SERVICES

Listening to and acting on the interests and priorities identified by family.

Involving the family in teaching functional skills during daily routines, using their objects and toys.

Collaboration, coaching & teaching parents and others during typical routines.

FAMILY GUIDED ROUTINES BASED INTERVENTION JULIANN J. WOODS, PH.D, SLP

•  Florida State University

•  http://tactics.fsu.edu

•  Fgrbi.fsu.edu/model.html

•  Information you can use including •  Top 10 Articles for Early Intervention Providers

•  Learning principles, modules for FGRBI

FGRBI MODEL: PROCESSES & RESOURCES

• Process 1: Introducing Natural Environments & Welcoming the Family

• Process 2: Routines based Assessment in Natural Environments

• Process 3: Linking Assessment to Intervention

• Process 4: Involving Caregivers in Teaching and Learning

• Process 5. Monitoring the Progress

• Process 6: Coaching

• Process 7: Family Stories

CHOOSING AND USING ELLY’S PODD

• 9 Location Expanded: Access to consistent vocabulary

•  Text only

• Customization

•  Establishing Habits

• Begin with Quick Words and

•  Teaching Patterns: •  I want Activity

•  Something’s Wrong


ACTIVITIES TO GET STARTED: HABITS

• Developing and practicing Yes/No responses

• Developing and practicing using her voice for signaling

• Create opportunities for communicating, aided language input and for her to respond.

• Balancing input vs opportunity for self expression

• Providing examples of modeling on the PODD to match current daily activities.

•  Incorporating other technology (e.g. BIGmack)

OUR SCHOOL AGED CHILDREN

• All had speech language therapy and augmentative communication interventions prior to their PODDs

•  Their journey

• All started with paper PODD books

• Progression to Speech Generating Devices.

• How did using the PODD change things?

• All kids LOVE their PODD’s!

• Advice for professionals.

Documents

NCACA 2017 PODD Karen Lynn handoutncaca.info/wp-content/uploads/2017/03/NCACA-2017... · use AAC. Augmentative and Alternative Communication, 23, (1) 30 – 43. • Bruno, J. & Trembath,