Transcript
PARENTS AS PARTNERS WORKING TOGETHER TO SUPPORT PODD USERS
• Karen Casey, MA, CCC-SLP • Durham CDSA •
[email protected]
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 • Lynn Carswell, MA,CCC-SLP • Right FIT Speech and Feeding Therapy •
[email protected]
• Caitlin Burke, MS, CCC-SLP
• 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
• Talk About It •
[email protected]
Pragmatic Organization Dynamic Display (PODD) Communication Books (Gayle Porter)
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
WHAT IS A PODD BOOK?
3 CD Set of templates and printable manual for direct selectors (14 different communication books); 3 styles
Available from MayerJohnson
PODD pages are available as an option on the Tobii Dynavox Speech Generating Devices and the iPad through Compass software or app.
CREDITS, TRAINING, RESOURCES • Gayle Porter, SLP, Australia
• 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
Karen Casey & Lynn Carswell & Team 2017
• 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
1
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
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
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: 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
Karen Casey & Lynn Carswell & Team 2017
2
VOCABULARY ORGANIZATION • Faster predictive links • “Something’s wrong” leads to complaining messages
• PODD’S Include “Sections”/Categories, Operational commands, Activity Displays and Anecdote pages
• Predictably associated vocabulary • Ex. Verbs for dressing and eating different
• 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
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.
customization needed.
• 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
Karen Casey & Lynn Carswell & Team 2017
3
MORE TIPS FOR MAKING A PODD
MORE TIPS FOR MAKING A PODD
• Can make a PDF and take to printing shop (sample cost: $38)
• 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
*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
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
ESSENTIALS FOR USING THE PODD
• Listener and Speaker use the book
Aided Language Stimulation: Input before output.
• NO prerequisite skills needed - Learn through immersion
• Typically developing child has been exposed language for
throughout the day
• Presume Competence • Expect that they have something to say, but have no expectations as to what that might be!
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
• Allow response time
AIDED LANGUAGE INPUT “ROUND-UP”
RESOURCES: PARTNER AUGMENTED INPUT: DR. JILL SENNER AND MATT BAUD
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)
https://www.facebook.com/groups/PartnerAugmentedInput/
Karen Casey & Lynn Carswell & Team 2017
4
RESOURCES
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 • https://www.pinterest.com/talcaac/partner-augmented-input/ ** 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
Karen Casey & Lynn Carswell & Team 2017
5
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
• 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.
by type and easy to construct sentences left to right.
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.
Karen Casey & Lynn Carswell & Team 2017
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
6
AUDITORY AND VISUAL SCANNING
AUDITORY + VISUAL SCANNERS • List vocabulary using monotone voice for scan and social
• Additional Options are Available in the Operational Column
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
TIPS FOR IMPLEMENTING A PODD PARTNER ASSISTED SCANNING RESOURCES
• Carry it all of the time!
• Learning Partner-Assisted Scanning with PODD
• Begin by using 1A and 1B pages only for 2 weeks.
• http://www.spectronics.com.au/blog/resource/learning-
• Practice “Patterns”. Choose a pattern to start.. • “I like”/ don’t like; sharing opinions • “Something’s Wrong” • I want… Activity
partner-assisted-scanning-with-podd-2/
(Quick Words)
• In a classroom setting, different people might focus on different branches that each can learn through observing the others modeling.
Karen Casey & Lynn Carswell & Team 2017
7
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;
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
YouTube- We Speak PODD
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
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).
• ASHA SLP’s: Obtain free Compass App with PODD pageset: www.mytobiidynvox.com
• 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.
• Gayle Porter recorded webinar: Introduction to PODD for Dynavox Compass
• http://uk.dynavoxtech.com/training/online/recordedweb-classes/details/?id=4269
• 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.
Karen Casey & Lynn Carswell & Team 2017
8
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
EARLY INTERVENTION LETS GET STARTED EARLY!
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 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)”
FACTORS THAT ENHANCE LEARNING
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.”
EARLY INTERVENTION AND AAC: WHAT A DIFFERENCE 30 YEARS MAKES • 2. “…The importance of providing AAC in the context of
• Active participation; affective engagement • Children learn best when skills are presented just beyond their present knowledge…zone of proximal development
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.”
Karen Casey & Lynn Carswell & Team 2017
9
KUHL, P. K. 2007. IS SPEECH LEARNING ‘GATED’ BY THE SOCIAL BRAIN? DEVELOPMENTAL SCIENCE, 10, 110-120
CENTER ON TECHNOLOGY AND DISABILITY (CTD INSTITUTE.ORG)
• “Young children develop their skills in the context
• Technology Solutions For Early Childhood Symposium
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.”
NEW DATA!
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 GUIDANCE-AAP
SLIDE FROM TAMARA KALDOR, ERIKSON INSTITUTE
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
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?
WHY DON’T WE DO WHAT WE KNOW IS HEALTHY AND SAFE? • Not enough time.
• CONCLUSIONS:
• 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.
• INFORMATION is not enough of a reason to do things.
• We all have good reasons to avoid making change.
10. Do you abstain from using your cell phone while driving?
Karen Casey & Lynn Carswell & Team 2017
10
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
MI RESOURCES
• Open versus Closed Questions • Affirmation: • supporting, encouraging, recognizing difficulties
• http://www.motivationalinterviewing.org/ motivational-interviewing-resources (studies)
• 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
• 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
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)
from the beginning!
• Positive impact on parent and child as social communication partners
Karen Casey & Lynn Carswell & Team 2017
11
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.
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
Collaboration, coaching & teaching parents and others during typical routines.
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
Karen Casey & Lynn Carswell & Team 2017
• Top 10 Articles for Early Intervention Providers • Learning principles, modules for FGRBI
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
12
ACTIVITIES TO GET STARTED: HABITS
OUR SCHOOL AGED CHILDREN
• Developing and practicing Yes/No responses • Developing and practicing using her voice for signaling • Create opportunities for communicating, aided language
• All had speech language therapy and augmentative
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)
Karen Casey & Lynn Carswell & Team 2017
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.
13
