Crain, & Elder (1992)
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
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
- 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.
- 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
- 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.
Training Issues (p 10)
- Osmosis Training (p 11)
- Children are provided with AAC systems and
expected, by osmosis, to know how to use their AAC system
frequently, interactively and generatively.
- Prospective users must be provided with
frequent examples of interactive, generative use to acquire any
semblance of proficiency.
- 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.
- 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.
- 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
- Aided Language Stimulation - is a
training strategy that attempt to address this dilemma.
- 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
- 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.
- Word Based - Commentary (p 28) -
- You are looking for the vocabulary that
will allow you to conduct a running commentary of what is
happening while engaged in that particular
- Phrase Based (p 30)
- 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.
- 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
Displays Readily Accessible (p 83, 84,
- 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
Receptive Training (p 101)
- Many facilitators have embraced a strategy of
conducting symbol comprehension training as a step
preceding symbol production training.
- Symbol comprehension training was typically
conducted much like receptive language testing e.g., "Book,
point to Book" or " Ball,find the Ball."
- When the child demonstrate a certain level
of proficiency on these symbol comprehension tasks, language
production training started..
- Such as training format is very different
from the way in which children normally acquire language i.e.,
- 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).
- 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).
- 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.
- 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
- General Verbal Language Stimulation
Guidelines (Below 2 year level) (p 102)
- Use primarily single words (symbols) and
short grammatically correct phrase (symbol phrase) to talk
about what the child hearing, seeing, doing and
- Speak slowly, inserting numerous pauses
into the conversational flow.
- Use lots of repetition as you describe
- Whenever the child indicates something
nonverbally, provide the child with single word (symbol) needs
to communicate the exact same intent.
- Whenever the child indicates something with
a single word (symbol), expand the message into a semantically
equivalent two-word (symbol) combination.
- 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
- Developmental Milestones - Following
- 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.
- By 12 months of age normal babies are
demonstrating expressive use of point to request and point out
objects for joint attention.
- 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.
- Highlighting symbols on the
communication display can be achieved by the facilitator using
- Index Finger Point
- 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.
- Squeaking Finger is a small squeaker that
is concealed in the palm of the facilitator's hand.
- 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.
- 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)
- 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
- 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
- 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
- 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
- Nonverbal juncture cues serve 2
- From a comprehension
perspective, they code the essence of the target
symbol in a more basic, easier to understand nonverbal
- 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.
- 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:
- excessive questions
- "What do we need?"
- "What do we have to
- commands to respond.
- "Open it"
- Setting the stage can be
- verbally and/or
- "We're not done
- "Uh,oh... Something's missing
- set the stage for the message
OPEN IT by inadvertently attempting to pour the
contents of a package into the bowl without opening
- When conducting sabotage routines, a
nonverbal "helping doll" can prove to be
invaluable to the interactive process.
- 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.
- Shadow Light Cues (p 113)
- In the early stages of shadow light
cueing the shadow light cuer (facilitator) assumes
primary responsibility for
- recognizing when a communicative
opportunity exists and
- determining what message is
appropriate given the linguistic and non-linguistic
- 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.
- It is important to stress that the
shadow light cuer does not speak throughout this process.
- His role is not to serve as an
interpreter, but rather to cue the child as to
appropriate message use.
- The goal is spontaneous,
self-initiated expressive use. For some:
- the strategy of a constant or
flashing light cue is sufficient to spontaneous
- 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;
- or a hierarchy of prompts may be
- contextual cue -> indirect
verbal cue -> search light cue -> direct
verbal cue -> momentary/flashing light
- Types of Light Cues
- search light cue - the
facilitator scans the light across all or a portion of
the symbols on the display.
- 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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