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CSD 5230

Aided Language Stimulation

Goossens', Crain, & Elder (1992)

Aided Language Stimulation -A language stimulation approach in which the facilitator points out picture symbols on the child's communication display in conjunction with all ongoing language stimulation. Through the modeling process, the concept of using the pictorial symbols interactively is demonstrated for the individual.

System Design Issues (p 5) - the manner in which we design aided AAC systems for the nonspeaking preschoolers often hinders rather than promotes frequent,interactive, generative use of those systems.

  1. Large Diluted Message Set versus Concentrated Message Pool -The vocabulary/message content provided for communication during the various activities is reflective of a diluted, as opposed to concentrated message pool. When a student is provided with a diluted message pool, he experiences the dilemma of being able to say a little about a lot of different topics but is unable to say a lot about any one topic.
    1. There is not sufficient vocabulary to be interactive and the limited array of activity-specific vocabulary available does not lend itself to multi-symbol combination. Although we want our users to use their AAC systems frequently, interactively and generatively, we often fail to give them AAC systems with potential for doing so.
  2. A more useful approach is one that establishes several activity-based communication displays, each designed to address, in greater depth, the potential interactions for a particular target activity.

System Training Issues (p 10)

  1. Osmosis Training (p 11)
    1. Children are provided with AAC systems and expected, by osmosis, to know how to use their AAC system frequently, interactively and generatively.
    2. Prospective users must be provided with frequent examples of interactive, generative use to acquire any semblance of proficiency.
    3. No one would dispute the fact that it would be very difficult to become a fluent speaker of XX, if your instructor seldom used XXX in your presence.
    4. Likewise, it is difficult for a nonspeaker to become a proficient AAC user if the facilitator seldom models interactive use of graphic symbols during all aspects of the classroom routine.
    5. If children are to gain proficiency in using their aided AAC systems, facilitators must begin to use the children's system to communicate with the children.
  2. Aided Language Stimulation - is a training strategy that attempt to address this dilemma.
    1. When conducting Aided Language Stimulation, the facilitator points out key symbols on the child's communication display in conjunction with all ongoing verbal language stimulation being directed toward the child.
    2. Considerable preplanning necessary to ensure that the communication display(s) required for a target activity are readily accessible to facilitators for providing Aided Language Stimulation.
  3. Word Based - Commentary (p 28) -
    1. You are looking for the vocabulary that will allow you to conduct a running commentary of what is happening while engaged in that particular activity.
  4. Phrase Based (p 30)
    1. As sentences/phrases are more limited than words in their generative power, care should be taken to make messages as generic as possible, to enhance their repeated use within the activity.
    2. For example, rather than include several highly specific messages such as"Put it in the Bowl, Put it in the measuring cup, Put it in the oven," the facilitator might opt for a more 'economical' message such as "Put it in."
  5. Making Displays Readily Accessible (p 83, 84, 86)
    1. Communication displays must be stored in closed proximity to where they will be needed in the classroom to ensure that Aided Language Stimulation can be overlayed on ongoing activities. Storing displays in the geernal are where needed, however, is not sufficient to guarantee successful use. Display must also be stored in a format that facilitates quick retrieval and quick setup.

Receptive Training (p 101)

  1. Many facilitators have embraced a strategy of conducting symbol comprehension training as a step preceding symbol production training.
    1. Symbol comprehension training was typically conducted much like receptive language testing e.g., "Book, point to Book" or " Ball,find the Ball."
    2. When the child demonstrate a certain level of proficiency on these symbol comprehension tasks, language production training started..
    3. Such as training format is very different from the way in which children normally acquire language i.e.,
    4. they come to understand the language as a result of hearing the language used frequently and interactively, in context. This is referred to as augmented input (Beukelman & Garrett, 1988) or Aided Language Stimulation (Goossens', Crain, & Elder, 1988).
  2. Aided Language Stimulation is a teaching strategy in which the facilitator highlights symbols on the user's communication display as he interacts and communicates verbally with the user. Similar to a Total Communication Approach, symbol selection is always accompanied by its spoken gloss (what the symbol stand for), e.g., "We've got to OPEN (pointing to the symbol for OPEN) the box and PUT it IN (Pointing to the symbol for PUT IN) the BOWL (pointing to the symbol BOWL).
    1. In observing ALS being performed by the facilitator, the child can begin to establish a mental template of how symbols can be combined and recombined generatively to mediate communication during the specific activity for which the display was designed.
    2. As this technique mimics that natural way normal children learn to comprehend language,it eliminates the need to set aside therapeutic time specifically for symbol comprehension training.
  3. General Verbal Language Stimulation Guidelines (Below 2 year level) (p 102)
    1. Use primarily single words (symbols) and short grammatically correct phrase (symbol phrase) to talk about what the child hearing, seeing, doing and feeling.
    2. Speak slowly, inserting numerous pauses into the conversational flow.
    3. Use lots of repetition as you describe ongoing events.
    4. Whenever the child indicates something nonverbally, provide the child with single word (symbol) needs to communicate the exact same intent.
    5. Whenever the child indicates something with a single word (symbol), expand the message into a semantically equivalent two-word (symbol) combination.
    6. Avoid Zig-Zags all over the communication display. When the child is cognitively young, however, the Aided Language Stimulation tends to be slower and focuses more on highlighting single key concepts in an utterance.
  4. Developmental Milestones - Following a Point
    1. Normal infants learn to follow a point somewhere between 8 and 12 months. Prior to 8 months, they will continue to stare at your finger rather than extending their gaze beyond your finger.
    2. By 12 months of age normal babies are demonstrating expressive use of point to request and point out objects for joint attention.
    3. As the child who is developmentally between 12 and 18 month level has just acquired receptive and express use of a point we tend to conduct ALS that does not zig-zag quickly all over the communication display.
  5. Highlighting symbols on the communication display can be achieved by the facilitator using an:
    1. Index Finger Point
    2. Light Point (squeeze light) tends to be more salient when working with young children. It does not block the child's view of the symbol.
    3. Squeaking Finger is a small squeaker that is concealed in the palm of the facilitator's hand.
    4. Helping Doll with a Pointer Finger - The facilitator assists the helping doll in using the display to communicate with both the facilitator and the child. As the doll is "nonspeaking" the facilitator must then interpret verbally for the doll. For example, when the helping doll communicates on the snack display that he WANTS a COOKIE, the facilitator might comment, "What's that Billy? (This focuses the child's attention on what Billy is communicating). Billy communicates again WANT COOKIE, to which the facilitator comments "Oh I see..Billy say he WANTS a COOKIE. OK, Billy. Here's your COOKIE.
    5. When Aided Language Stimulation is being conducted within a group format, the facilitator conducts ALS on her own master display.

Expressive Training (p 107, 118)

  1. Templating for Gradual Exposure - When communication displays are created to reflect maximum long range capacity, the display can still be tailored to meet the needs of the individual student by gradually exposing symbols over time. This can be achieved by covering up symbols by covering up symbols a) using duct tape or b) using a paper template with cutout windows that is placed over the communication display.
  2. After a sufficient period of ALS, many children spontaneously begin to demonstrate expressive communication. With other students, expressive communication needs to be trained more explicitly, I.e,, additional emphasis needs to be placed on nurturing spontaneous self initiated productions from the child. This can be achieved using 2 training techniques: Nonverbal Juncture Cues and Shadow Light Cues
    1. Nonverbal Juncture Cues (p 111)- When training a cognitively young (less than 2 years, developmentally) to use an aided AAC system interactively, it is helpful to embed nonverbal juncture cues into ongoing ALS.
      1. A nonverbal juncture cue is defined as a nonverbal (achieved via facial expression, gesture, body posture) performed by the facilitator that precedes the highlighting of a symbol on the communication display.
      2. Nonverbal juncture cues serve 2 functions.
        1. From a comprehension perspective, they code the essence of the target symbol in a more basic, easier to understand nonverbal form.
        2. From a production perspective, they a) "drum roll" the target symbol allowing the child to anticipate its selection by the facilitator and b) impose a delay in which children familiar with these subroutines begin to 'jump ahead,' spontaneously selecting the target symbol they know from past experience will follow.
      3. When attempting to nurture expressive communication, it is important to think in terms of 'setting the stage' for a communication rather than attempting to elicit production through:
        1. excessive questions
          1. "What do we need?"
          2. "What do we have to do?
        2. commands to respond.
          1. "Open it"
      4. Setting the stage can be achieved
        1. verbally and/or
          1. "We're not done yet!"
          2. "Uh,oh... Something's missing here!"
        2. nonverbally
          1. set the stage for the message OPEN IT by inadvertently attempting to pour the contents of a package into the bowl without opening the package
      5. When conducting sabotage routines, a nonverbal "helping doll" can prove to be invaluable to the interactive process.
        1. Not only does the doll use the communication display to communicate with the facilitator and the child, but he helps to "set the stage" by orchestrating various sabotage routines. For example, when the child produces the multi symbols utterance PUT..BUTTER..BOWL, the helping doll might misinterpret the child's message, placing the butter under the bowl.
    2. Shadow Light Cues (p 113)
      1. In the early stages of shadow light cueing the shadow light cuer (facilitator) assumes primary responsibility for
        1. recognizing when a communicative opportunity exists and
        2. determining what message is appropriate given the linguistic and non-linguistic context.
      2. In the first instance (Hi, Jimmy...How are you?) the facilitator would unobtrusively shine her penlight on the symbol depicting the message, I'M FINE. Jimmy need only press the symbol that is highlighted. The facilitator might then strive to take the interaction one step further by shining the penlight on the symbol depicting the message I'M RUNNING ERRANDS.
      3. It is important to stress that the shadow light cuer does not speak throughout this process.
        1. His role is not to serve as an interpreter, but rather to cue the child as to appropriate message use.
      4. The goal is spontaneous, self-initiated expressive use. For some:
        1. the strategy of a constant or flashing light cue is sufficient to spontaneous expressive use,
        2. to nuture a shift, a slight time delay prior to providing the constant/flashing light cue may be sufficient to move the child on to the spontaneous, self initiated use;
        3. or a hierarchy of prompts may be necessary:
          1. contextual cue -> indirect verbal cue -> search light cue -> direct verbal cue -> momentary/flashing light cue
      5. Types of Light Cues
        1. search light cue - the facilitator scans the light across all or a portion of the symbols on the display.
        2. momentary light cue - the facilitator shines the penlight on the target symbol (not it sensor) for a brief 2 second period, remove the light. If after this level of cueing the child still fails to produce the correct communication, a constant or flashing light cue is provided until the child selects the target symbol.

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