Download pdf - Part 1 Handout - Jane Farrall Consulting · ... , but this is not a short-term plan for me! ... – Making text universally accessible requires making it ... and Decision Making

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Why we do what we do: Balanced Literacy for All Students

Jane Farrall

Thanks to

– Centre forLiteracyandDisability Studies, especiallyProfessor KarenEricksonhttp://www.med.unc.edu/ahs/clds

– Professor DavidKoppenhaverhttp://www.litdis.com/

Assumption of the Possibility of Universal Literacy = The Least Dangerous Assumption

“No student is too anything to be able to

read and write”

David Yoder, DJI-Ab leNet Li teracy Lectu re, ISAAC 2 0 0 0

Words from Erin Sheldon

– Let’s focusondoingthosethingsthatweknowwork!!Ratherthanasking if its possible,lets dowhattheresearch tells usweneed todotomake ithappen. Then wecan lookback onwhatwedidanddecideif itworked!

– The onlyway wewill knowif anyof ourchildrencanlearn toreadorwriteis togetthem theliteracy instructionandcreate theopportunitiesforthemtolearn.

– Isay thatwe are onthe50yearliteracy planwithMaggie. Iwill giveuponherdeveloping literacy in 50years, whenIf igureshe's atretirement age anddeserves abreak, butnotbefore.Iwillbehappilypleased if she isreader and writerbeforethen,butthisisnotashort-termplan forme!

– Facebook, 8thFebruary2014

“Reductionist Interventions”

– Katims(2000) reviewedliteracy instructioninspecial educationandidentif iedreductionistinterventionsas oneswhichare

– Sequencedandhierarchical– Employdrillandpracticetotrain– Focusonskillssuchas:

– Letter names andsounds ;

– Worddecoding;

– Sight words ;and

– Fillingout written forms .

– Reductionistinterventionsare approachesthatassume prerequisitesandthereforesetupbarriers toliteracy instruction

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Some Outcomes of Reductionist Approaches

– Christopher, ateenagerwithautism, canreadpassagesfluentlyataYear9level. Hedoesn’t understand thatwhathe readshasmeaning.

– Michael, ateenagerwithDownSyndrome,canonly readaloudwhen pointing towords.Hedoesn’t knowthatyoucanreadsilently.

– Chloe, ayoungwomanwithcerebralpalsy, cansigneveryletterofthealphabet butdoesn’t knowthat thesignsrelate totheprinted letters.

If we only teach parts of literacy, then

students will only learn parts.

A Balanced Diet

– EmergentReaders andWriters – Conventional ReadersandWriters

Literacy&

Language

Shared Read in g

“Writin gwith ”

Shared

Writin g

“Writin gb ymysel f”

In dependen t

Writin g“Writin g fo r”

Teacherwri tes fo rstuden ts

Sel f-Selected

Read in g

Workin gwith Letters and Sound s

Literacy&

Language

ReadingCom pr ehens ion( anchor , r ead,

apply)

Self - Select edReading

I ndependent

Wr it ing

Wor king wit hWor ds

Universal Design for Learning

Jane Farrall

What is Universal Design for Learning?

– UniversalDesign forLearning isascientifically validframework forguiding educationalpracticethat:

– Providesflexibilityinthewaysinformationispresented,inthewaysstudentsresponseordemonstrateknowledgeandskillsandthewaysinwhichstudentsareengaged;and

– Reducesbarriersininstruction,providesappropriateaccommodations,supports,challengesandmaintainshighachievementexpectationsforallstudents,includingstudentswithdisabilitiesandstudentswhoarelimitedEnglishproficient.

Highe r Educatio n Oppo rtunity Act, 2008 (US) http://als.csupro je cts.o rg /he o a

Why Universal Design for Learning?

– Studentscometo theclassroomwith avarietyofneeds,skills, talentsand interests

– The typicalcurriculum –which includes goals, instructionalmethods, classroommaterials andassessments – hasmanybarriers androadblocks.

– Studentsand teachersareexpectedtomakeallofthenecessaryadjustment.

– UDLplaces theburden toadapton thecurriculum itself.

Erickso n & Ko ppe nhave r (2013)

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Principles of UDL

– Providemultiple, flexiblemeansof:

– Representation

– Expression

– Engagement

www.cast.o rg

Why Universal Design for learning?

Recognition Networks

– Thewhatoflearning

– Identifyand interpret patternsofsound, light, taste, smelland touch

www.cast.o rg

Strategic Networks

– Thehowoflearning.

– Plan, executeandmonitor actionsandskills

www.cast.o rg

Affective Networks

– Thewhyof learning

– Evaluateandsetpriorities

www.cast.o rg

Differentiation

– Providestudents withdifferentavenues toacquireandexpresscontent.

– Allow themtoprocess, constructormakesenseof ideas.

– Differentiate through:

– Content

– Process

– Product

– Learningenvironment

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FromLearningForAll(2013),OntarioMinistryofEducation

Differentiation

– Need tomakesure thatwearen’tprovidingdifferentiationinways thatdon’t help.

Talking Texts

– Acommonexampleofdifferentiation is toprovide talkingversions oftexts so thatstudents whostruggle with literacycanunderstand them

– However, 48%ofstruggling 3rd– 9thgradestudents can’tunderstand gradelevel textevenwhenothers read it tothem.(Erickson&Koppenhaver, 2013)

– Written language format is somethingstudents need tolearn tounderstand. Itisdifferent fromspoken languagestructures.

Picture Supported Text

– Symbolsappear tomaketextmoreuniversally accessiblebutdo they?

Differentiation

– Making textuniversally accessible requires making itEASIER

– Determine the listening comprehension levelofthestudent for text

– Textmustbe targetedat thatlevel

– Forstudents with significant languagedelayor intellectualdisability, thatmeans textmustbeEASY!


Dreamtime: How the Birds Got Their Colours

– Backin theDreamtime(Alcheringa) all thebird tribeswerethesamecolour, and thatwasblack.

– OnedaythePeacefulDovecaughthis footonasharpprongofwood onabrokenoff treebranch.TheDovecalledoutpiteously forhelp, andall theotherbird tribes heardhiscryandcametotheplacewhere theDovelay.TheDovewas ingreatpainandhis foothadswollen up.

http://www.okulture.com/Black%20Opal/index-19.html

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www.tarheelreader.orgHowtheBirdsgottheirColours

FromaDreamtimeStory

DLM on Tar Heel Reader

– Therearearangeoftextswhichhavebeenbrokendownandsimplified onTarHeelReader

– Seethis link fora listhttp://dlmpd.com/clds/instructional-resources/

Use illustrations to support meaning

– This is howyoungchildren learn to read

– Picturesupport (onepicture tosupport thecontentonapage)isverydifferenttoaddinga symbolontoeverywordwhichcandistract fromthetext

Multiple Means of Action and Expression

– PhysicalAction

– ExpressiveSkills andFluency

– ExecutiveFunction


Technology Supporting Multiple and Flexible Means of Expression– WritingTools

– Making writingmoreaccessible– Talkingwordprocessors– Spellcheckers

– Wordprediction

– MultimediaandStorytellingTools– Providean alternative towrittenresponses

– Digitalstorytelling– Scrapbooksandf lipbooks– Videoproduction


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Multiple and Flexible Means of Expression in Writing

– Writing withAlternative Pencils

– DevelopedbytheCentre forLiteracyandDisability Studieswww.med.unc.edu/ahs/clds

Multiple Means of Engagement

– Recruiting interest

– Sustaining Effort/Persistence

– Self-Regulation


Technology Supporting Multiple and Flexible Means of Engagement– Collaboration Tools

– BlogsandWikis

– iPadsandapps

– Planning Tools

– GraphicOrganisers

– CorrectiveFeedbackandGuidance

– Onlinefeedbackregardingperformance


Sometimes Engagement has

NOTHING to do with Technology

Augmentative & Alternative Communication

Literacy andLanguage

Communication

– Occursallday,everyday,ineveryaspectofour life

– Impactsgreatlyonourquality oflife

– Itis fundamental in literacydevelopmentand forparticipation ineducation;

– And, most importantly, it isahumanright (UnitedNationsUniversalDeclarationofHumanRights 1994)

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Success vs Abandonment of AAC

– Factorsimpacting long-termsuccess– PersonwhousesAACsystemexperiencessuccess91.76%

– Degreetowhichthesystemisvaluedbytheuserandpartnersasameansofcommunication90.58%

– Systemservesavarietyofcommunicativefunctions89.85%– Systemisusedforcommunication,notjustasatoyortherapytool(Realcommunication)87.20%

– Otherareas:– Appropriatedeviceselected

– Supportforsystem

Jo hnso n, e t al. (2006)

Success vs Abandonment of AAC

– Factorsleading toinappropriateabandonment:– CommunicationpartnersbelievetheycanunderstandmessagewithoutAAC

(notsolvinganything)- 77.75%– Insuff icientopportunities- 76.80%– Userprefersasimplermeansofcommunication(efforthigherthan

outcome)70.02%– Vocabularydoesnotmeetindividualizeddailylivingneeds67.70%– Otherareas

– Lackofsupport – training, time for programming, knowledgeableprofess ionals

– Time!!!!

– Motivation

Jo hnso n, e t al. (2006)

It takes a community

– Theattitudes, beliefsandknowledge ofcommunicationpartnersarepivotal in thesuccess storyofAugmentativeandAlternative Communication (AAC).Thepeoplearoundeveryindividual withcomplexcommunicationneeds mustbelieve thateveryonehasa right tocommunicate.

AAC is for…

– Anyonewith ComplexCommunicationNeeds (CCN)

– That is,anyonewhohasdifficulties communicatingwithspeechalone.

– iepeoplewho arenon-verbal, peoplewhoonlyhavealimited numberofspokenwords orpeoplewhose speech isdifficult tounderstand.

AAC Myths and Legends

– IntroducingAAC will stopsomeone fromdeveloping speech

– LowtechbeforeHigh tech

– Hasalittle speechsodoesn’t needAAC

– Toocognitively impaired forAAC

– AAC will fixall communicationdifficulties

– Tooyoung forAAC

– Doesn’t needAAC as theycanexpressbasicneeds

– Symbolhierarchy

Symbols

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Symbols

– Thesymbolhierarchydoesn't apply (orevenreallyexist)!

– "Abstract andiconic symbols function thesameto theearlycommunicator"Romski andSevcik,2005

– Weneed touseanysymbol tohelp the individual learnwhat itmeans (PorterandBurkhart, 2010)

– There isnohierarchyofaided-visual symbols;experienceplaysasignificant role in learning aidedvisual symbols andgeneralising theiruseage

– (DaFonte,2008)There isnoneedto limit ourselves toanAAC systemwith objectsorphotographs

Amount of Vocabulary


– “WEUSEDTOTHINK:Startwith justafew (4-6)picturesymbols andaddafewmoreatatime,as thestudent [withASD]shows thatheor shecancommunicateappropriatelywith themusually byrequesting

– Nowwe think:Really?Where is theresearch thatdefendsthispractice?

– This is certainlynothowotherkids learnnewwordsandacquire language.”

– Professor PatMirenda, 2014


– Forindividuals tolearnlanguage,weneedtoprovidenot justafewpicturesymbols– butawide rangeofsymbolsthatrepresentarobustvocabularythatsupportsthemtolearnhowtoputwords together,supports themtocontributeineverysituationandsupports themtodevelopintoanautonomouscommunicator.

– Thisvocabularyneedstoconsistofarangeofpartsof speech– theyneedadjectives,verbs,adverbs,pronouns,prepositions, conjunctions, interjections,determinersandevensomenouns.TryusingawelldesignedcorevocabularysystemorPragmaticallyOrganisedDynamicDisplay(PODD)

Prerequisites??

– Moving onfromthecandidacy modelof the70sand80s....

– Romski& Sevcik (1988) "relationshipbetweencognitive,communicative and linguisticskills is notaspredictable as itmighthave been initially viewed";

– Kangas & Lloyd(1998) - summarisedresearchthatsigning may beeasier tolearnthanspeech; individualswith"severe mentalretardation"can learn tobeexpressive withsymbolsata relativelyearly age;

– Romski& Sevcik (2005) "someindividualswithsevere sensori-motordisabilities cannotdemonstratetheir cognitive abililties withoutameans bywhichtocommunicate sowecannotinsistonevidence of thoseabilities beforeprovidingAACservices and supports."

AAC Myths and Legends -Resources

– Romski, M.A.&Sevcik,R.A.(2005).Augmentativecommunicationandearlyintervention: Mythsand realities.Infants&YoungChildren, 18:3,174– 185.

– YAACKhttp://aac.unl.edu/yaack

– DynaVoxImplementationToolkit

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AAC should be:

– Used frequently, interactivelyandgeneratively toexpressawide rangeofcommunicative intents

– Occurringduringatleast 80%ofongoingclassroomprogramming (as speechormanual signuse is)

– Beingused tomediatecommunicationwithclassmates aswell aspersonnel (ie teachers, support officers, therapists)

– Bedesigned andimplemented inas timeandcosteffectiveamanneraspossible

Evidence Based Practice (EBP) and Decision Making

Decisionsabout

Treatments/Interventions

High qualityresearchevidence

Professionaljudgmentanddata-based

clinical decision-making

Values andpreferences of families and

otherstakeholders

Capacity of thedelivery systemtoimplement theinterventionwith

integrity

Sou rce: National Au tism Cen ter (h ttp ://www.nationalau tismcen ter.o rg) and National P ro fessional Developmen t Cen ter on Au tismSpectrum Diso rders

(h ttp ://au tismpdc.fp g.un c.edu /con ten t/evid en ce-b as ed -p ra ctic es)

AAC Evidence Base

– AmericanSpeech&HearingAssociationhttp://www.ncepmaps.org/index.php

– SpeechBitehttp://www.speechbite.com/

– EvidAAC http://www.evidaac.com/welcome.php

– Communication Mattershttp://www.aacknowledge.org.uk/

A good comprehensive AAC system

– Hasarangeof language

– Supports theuser todevelop linguistic competency

– Canbeused foraided languagestimulation through theday

– Canbeused tocommunicatethrough theday

– Canbeused forarangeofcommunicative functions

– Supports theuser todevelopcommunicationautonomy

Communicative Functions

System for todaySystem for tomorrow

– Participation Model (Beukelman&Mirenda, 2005)

– Initialassessment fortodaylooking atcurrentcommunicationneeds/abilities;

– Detailedassessment for tomorrow identifyingcommunicationsystems thatwill support theuser innewcommunicationenvironments into the future;

– Follow upassessment tomaintain acomprehensivesystemtomeetthechangingcapabilities and lifestyleof theindividual.

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AAC

– TwosetsofAAC-related decisions should bemadefromtheoutset: thoseaimedat“today”andthoseaimedat“tomorrow”.

– Beukelman&Mirenda, 2013

Communicative Competence

– Light(1989), Light&Mcnaughton (2014)

– LinguisticCompetence(masteryofthelinguisticcode)

– OperationalCompetence(accessmethods,on/off)

– SocialCompetence

– StrategicCompetence(makethemostofthevocabtheyhave)

– SeeKovach(2009) foranassessment basedon thisstructure

Linguistic Competence

– Does theuser knowhowtocombinewords toget theirmessageacross?

– Does theapphavevocabulary thatsupports languageinputand languagedevelopment?

Operational Competence

– Does theuser knowhowtoturn the iPadonandoff?

– Dotheyknowhowtochange thevolume?

– Dotheyknowhowtoopen their AACapp?

Social Competence

– Does theuser understandnot just when it isappropriate tocommunicatebutwhat it isappropriate tocommunicate?

– E.g.wordswedon’tuse inat school.

– E.g.small talk

Strategic Competence

– Istheuserable tomakethebestuseof thevocabularytheyhavein their system?

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Yes and No

Yes/No

– Notall yes/noquestions arecreatedequally:

– Doyouwantabiscuit?

– IsthecapitalcityofRussiaMoscow?

Ahern (2012)http://teachinglearnerswithmultipleneeds.blogspot.com

Getting Started

– Prioritise questions thatare:

– Natural

– Authentic

– Empowering

Doyouwantmetotake youtoyourclassroom?

Didyoulikethestory?Doyouthinkthey gotogether?

Doyouwanttogofirst?Doyouwantthe bluepaint?

YES

Isthisashoe?

Isthistheletter B?

Are youheretoday?NO

Other Hints

– Don’tassumethatyouknowwhat thechildwants.

– Don’tusewords tofill space.

– "Yesorno?

– Doyouwanttheball?

– Yesorno?

– Theball?

– Tellmeyesorno?"

Ahern (2012)http://teachinglearnerswithmultipleneeds.blogspot.com

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Yes/No

– Need towatch thenumberofyes/noquestions weaskAACusers

– BUT

– EveryAAC userneeds todevelopagood, clearYes/Noresponse

Good Practice Approaches to AAC

– PictureExchangeCommunicationSystem(PECS)

– Aided LanguageDisplays (ALDs)

– PODD

– CoreVocabulary

– (Plusa fewothers wewon’t gettodaye.g.manualsign,tactile symbols)

Picture Exchange Communication System

– BondyandFrost1994

– Strongevidencebase forusing this withsomechildren withASDasa firstAACapproach

– Teachesonecommunicativefunction inearly stages -requesting

– Verystructuredprogram

– Teaches joint attention (Yoder&Stone, 2006)

PECS

– Severalsystematicreviewsandmeta- analyseshaveexaminedPECSoutcomes

– Preston&Carter,2009

– Sulzer-Azaroff,Hoffmann,Horton,Bondy,&Frost,2009

– Flippin, Reszka,&Watson,2010– Hart&Banda,2010

– Tincani&Devis,2011

– Ganz,Davisetal. ,2012

– Eachhasprosandcons

From Mirenda (2014)

Improvement Rate Differences

– Calculated ImprovementRateDifference(IRD)scores fromstudydata

– The“differenceorchangeinpercentofhighscores frombaseline to intervention” (p.67)

– ≤.50=smallorquestionable effects

– .50and .70=moderateeffects

– ≥.70= largeorverylargeeffects

GANZ, EARLES-VOLLRATH, ET AL. (2012)

Ganz, Davis et al. (2012)

– 13studies, 32participants,ages3-17

– ImprovementRateDifferencescalculated,asinpreviouswork

– UniquelyexaminedthePECSPhaseattained

– § Phase1:1(IRD.45)– § Phase2:2(IRD.63)

– § Phase3:8(IRD.65)

– § Phase4:2(IRD.33)

– § Phase5:0

– § Phase6:2(IRD.84– significantlybetter)From Mirenda (2014)

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Ganz, Davis et al. (2012)

– Conclusions:

– “PECSappears tobeapromising augmentativesystemthat.. .hasmoderatelypositiveeffectson functionalcommunicationskills” suchasinitiating requests

– PECSeffectsontargetsother than functionalcommunicationare“modestoruncertain” (p.415)

– Socialskills

– Speechdevelopment

– Challengingbehaviour

(From Mirenda, 2014)

PECS

– Somestudies suggest isagoodshort term introduction –thenmoveontoamorecomprehensivesystem

– Oftenseeadecrease inchallengingbehaviour initially andthenmayseeanincreaseafterawhile asitdoesn’tpromote further languagedevelopment

– Somethingwecanimplementwith someofthestudentswithASDshort termtohelp themunderstand thepowerofcommunication

Aided Language Stimulation

– Prospectiveusers mustbeprovided with frequentexamplesofinteractive, generativeuse toacquireanysemblanceorproficiency.

– No-onewould dispute the factthatitwould beverydifficult tobecomea fluent speakerorFrench, if youinstructor seldomused Frenchinyourpresence.

– Likewise, it isdifficult foranonspeaker tobecomeaproficientAAC user ifotherpeoplenevermodel interactiveuseof their systemduring allaspectsoftheday.

Go o sse ns’ , Crain and Elde r (1988); Goo sse ns’ (2010) Po rte r (2004)

Input OutputSpokenlanguagedevelopment

SpokenLanguage SpokenLanguage

SpokenLanguage AidedLanguage

Childlearningaidedsymbols

Po rte r (2004)

Input Output

Childlearningaidedsymbols

AidedLanguageSpokenLanguage(Signlanguage)

AidedLanguage(SpokenLanguage)(Signlanguage)

Aided Language

– Itis critical foranindividual tonotonlyhavesymbols, butalso tohaveexperiencewith those symbols inasymbol richenvironment/print richenvironment.The typicallydeveloping childwill havebeenexposed tooral languageforapproximately4,380 wakinghoursbythe timehebegins speakingatabout18monthsofage.

Jane Ko rste n (2011) QIAT Listse rv 4th April

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Aided Language

– Ifsomeone isusing adifferent symbol setandonlyhasexposure to it two timesaweek, for20– 30minutes each,itwill takethealternate symboluser84years tohavethesameexperiencewith his symbols thatthe typicallydeveloping childhaswith thespokenword in18months!!!

Aided Language

– The typicallydeveloping childwill demonstrate languagecompetencyaround9– 12yearsofagehavingbeenimmersed inandpracticingoral language forapproximately36,500wakinghours.For9– 12years thatchildhasbeenusingand receivingcorrectivefeedbackwhile practicingwith thespokenword.

Aided Language

– At twiceaweek,20– 30minuteseachtime, itwill takethealternatesymboluser701years tohavethesameexperience.

Jane Ko rste n (2011) QIAT Listse rv 4th April

Aided Language Research

– Turn-taking(Beck etal., 2009)

– Receptive vocabulary (Dada &Alant, 2009;Drageret al., 2006;Harris& Reichle, 2004;Romski& Sevcik, 1996)

– 2+word/morphemecombinations(S-V,S-V-O,S-( is) -V- ing-O(Binger&Light, 2007;Bruno&Trembath,2006;Romski&Sevcik, 1996;Romskiet al., 2010)

– Grammatical morphemes ( - ing,- ’s,-ed,-s) (Bingeret al., 2011) – Pragmatics, increased communciationturns,semantics, receptive and

epxressive vocab increases, syntax(multisumbolturns)andmorphonologySennott,S.C.,Light, J.C.&McNaughton, D.(2016) AACModeling InterventionResearch Review, Research andPractice forPersonswithSevere Disabilities, 1 –15

Aided Language

– InevaluatinganyAAC system….

– Ifyou(asaperson proficient in language)cannotuseacommunicationsystemordisplay throughout aninteraction thenhowcanyouprovidedAided LanguageStimulation?

– Ifyoucannotuse it, is itdesigned well?

Pragmatically Organised Dynamic Displays (PODD)

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PODD

– PODDisawayoforganising wholewordandsymbolvocabularyinacommunicationbookorspeechgeneratingdevicetoprovide immersion andmodelling for learning

PODD

– TheaimofaPODDis toprovidevocabulary:

– Forcontinuouscommunicationallthetime

– Forarangeofmessages

– Acrossarangeoftopics

– Inmultipleenvironments

– Provides somepredictive language thathelps earlycommunicatorsbemoresuccessful

PODD

– PODDscanhavedifferent formats,depending on theindividual physical, sensory andcommunication needsofthepersonwhowill use it

Core Vocabulary

– Usingcommon (orcore)English words onanAAC display toenableauser toconstruct theirownsentences

– Approachused in lotsofhigh techsystemsbutnotusedasmuchin low techdue todifficultyofarrangingvocabularyforaccess

Core Vocabulary

– 75%-80%of thewords weusedailycomefromasetof350-400words: theseare theCORE

– “Whatareyoueating for lunch today?”

– “Iwantchickennuggets”

– (Textin red is corevocabulary,all in top200)

– InmanyAAC systems, theonlyavailablewords would bechickennuggetsand thesearenotcore!!

Core Vocabulary

– FRINGEVOCABULARY

– Lowfrequencywords

– Onlyuseful inoneor twosituations

– Often related toa specifictopic

– COREVOCAB

– High frequencywords

– Canbecombined togetyoumessageacross inlotsofdifferent situations

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Core and Fringe

– Overa2-yearperiod, 12youthwith moderate-severeID(somewithASD)wereprovided with35-44 lexigramsonanSGD,including 61% fringeand39%corevocabulary(e.g.,stop, help,more, good,wait, excuseme,I ’msorry)

– BOTHtypesofwordswere learned andused, inequalproportions (Adamsonetal. ,1992)

Core and Fringe

– Includingcoredoesn’t meanexcluding fringe!

– But -- consider aunitonplants. Inhis orher lifetime, howoftenwill astudentneed tosay

– stem,leaf,stamen,pistil,andflower

– Compared to

– not,grow,tall,pretty,green,andhealthy?

Proloquo2Go And remember

– Communication isALLday,EVERYday.

– Youneed to figureouthowAAC is goingtogoeverywherewith thestudents and/oryou

AAC

– Wemustprovideeveryindividual with complexcommunicationneedswith acommunicationsystemthatenables their right tocommunicate.

– Wemustbelieve in theirability touse languageandgivethemasystemthatenables themtodevelopanduselanguage.

AAC

– Ifwe“donothave theskills andcommitment requires toprovidesupport forAACsystemuse,abandonment ofthesystem is likely”.

– Beukelman&Mirenda, 2013