5 min read
I've been working with a student and his team. They have moved successfully albeit slowly through using the tools below. At some point a few years ago, this student was evaluated and deemed to be a candidate for a dedicated speech generating device (SGD) with eye gaze (very expensive but a key part of a communication system for the right person). His team (student, parents, teachers, SLP, OT, PT and support staff) was keen to make his SGD work for him. The student has cerebral palsy that reduced his limb movement/accuracy, so much time had already been invested AND after all, this solution was expensive.
Why change? This can be awkward. How do you bring up the topic of a significant change to access and trajectory of the student's goal/language programming? Two things; the eye gaze never really worked as well as expected AND the student became increasingly frustrated often abandoning the device. Eye gaze could be revisited but it was important to recognize that it was not working. Time to think about the S - Student, his M - Moves, his C - Clicks and his C - Chats. More about that later.
Head control/calibration were hurdles interfering with access. Using the tools mentioned below, this student demonstrated enough consistent and accurate improvement to control switches with his head and hand for scanning. His language setup was changed (Core Scanner on an Accent 1400) to work more efficiently with two switch scanning (i.e., he presses one switch to move through icons and the other switch to select his word).
He is reportedly thrilled with his new access method. He smiles more and enjoys communicating often producing spontaneous sentences.
First of all, you must gather data. If you don't have data, it's just your opinion.
I sometimes hear that students "inconsistently respond" to stimuli or questions, it "depends on how they are feeling", "if they're in the right mood", "they are being stubborn", etc. Maybe. Perhaps we have not presented motivating stimuli, observed the tiniest of responses, offered the most appropriate access method, or given the student adequate wait time.
SETT is an acronym for Student, Environments, Tasks, and Tools created by Joy Zabala. It is a FREE resource. "Although the letters form a memorable word, they are not intended to imply an order, other than that the student, environments, and tasks should be fully explored before tools are considered or selected. Some people have tried to explore the first three separately and in order, however, that is nearly impossible because the first three are closely linked." The SETT Framework is so important, it's at heart of our process for the PATINS AAC Consultation Request form.
Another important tool to set the groundwork is the Every Move Counts, Clicks and Chats sensory based approach (EMC3). It is available to borrow from the PATINS Project Lending Library. EMC3 is a sensory-based communication program. It is based on the idea that everyone communicates in some way. The COUNTS Assessment explores sensory, communication, and symbols. The are seven sensory areas: vestibular, proprioceptive, tactile, visual, auditory, olfactory, and gustatory. The CLICKS Assessment looks for purposeful switch use. The CHATS Assessment is used to collect communication skills. It states that "Assessment results are seldom 'final'. Needs, abilities, and environmental demands change over time."
A third tool useful for SETTing students up for success is to establish a baseline for communication skills and determine goals. The Communication Matrix is an online/questionnaire tool for anyone in the early stages of communication. The first 5 assessments are FREE. Communication is more than just receptive and expressive, students also need methods to refuse, obtain items, socialize, and gather/share information. These functions of communication can be measure/quantified by using the Communication Matrix.
Hand in hand with these pieces is understanding the absolute need for flexibility, continuous learning, and ongoing assessment with students. It is a fluid process that can and should be revisited periodically as the student changes, technology changes or when things stop working as well as they had in the past.
SETT your students up for success. Use the SETT, EMC and Communication Matrix to better understand the student, environment, tasks/needs, sensory responses, access abilities AND communication skills. THEN consider the T - Tools to empower your students and goals for success. If the tools don't seem to be working, collect data and try something else!
The PATINS Project Tech Expo is fast approaching - Thursday, April 15, 2021. It's FREE. Get registered!
SETTing Up Successful AAC Use - Lauren Kravetz Bonnet, PhD, CCC-SLP
The Dynamic AAC Goals Grid DAGG-2