AAC Implementation Plans: Preparing for Successful Communication

In this session, Laura Kessel, M.S., CCC-SLP, ATP, will discuss how to develop and utilize an Augmentative and Alternative Communication (AAC) Implementation Plan to support communication across activities or settings. Crucial components include descriptions of tools and strategies used with an individual, detailed communicative expectations for specific activities across an individual's day, and determination of team members' various responsibilities regarding the AAC system. An AAC Implementation Plan can be used as a framework for team discussion, a training resource, and a launching point for data collection. (Get the presentation slides.)

Transcript: 

- [Ana Maria] Good afternoon. Thank you for joining CTD for our webinar, AAC Implementation Plans: Preparing for Successful Communication.

- [Moderator] Alright, so I'm gonna let people in. Sounds good. Ana Maria, could we reposition the Web Links pod? It's actually blocking the chat for me right now.

- [Ana Maria] Good afternoon everyone. Thank you for joining us for the CTT Webinar, AAC Implementation Plans: Preparing for Successful Communication. For this session, we are pleased to welcome Laura Kessel. She's a speech language pathologist and AAC specialist, and is RESNA ATP Certified. In this session, we will discuss how to develop and utilize an augmentative and alternative communication implementation plan to support communication across activities or settings. Learn about these plans and how they can be used as a framework for team discussion, training, and a launching point for data collection. I'll go ahead and pass it off to Laura now. Thanks.

- [Laura] Hi everyone. Ana Maria has already amply introduced me. I will say that my email address is Kessel.Laura@gmail.com, and you're welcome to reach out to me with any questions after. I'll tell you a little bit more about me. I'm currently working part time for a public school district. I do some work with CTD obviously, and I also contract with a group called AT for Education. I'm working mainly with students these days, so I've tried really, really hard to use individual or AAC user throughout this presentation, because everything I'm talking about does apply to AAC users of all ages, but I might slip up and say student occasionally because that's who I'm working with these days. So if I do that, please just know that it does still apply to everyone who's using augmentative communication.

So we're gonna start off with a quick poll just to give me a sense of who is here today. I'd love to know if you are a parent, a service provide, a service coordinator, a teacher, working in a related, or anyone else, and if it's something else, please write in and just let me know, because I'd be really curious to know as well who's here. And we'll let that run for just a slide or two as a quick update, and I can try to tailor this presentation a little bit as we go, depending on what you'll all say. Our goals for today are to discuss creating an AAC implementation plan, data collection based on AAC implementation plan, and some resources to draw on. And the resources are mostly embedded into the bigger discussion today.

A couple of quick definitions. I'm sure most of you are aware since you're joining this presentation. But according to ASHA augmentative and alternative communication includes all forms of communication, other than oral speech, that are used to express thoughts, needs, wants, and ideas. It is for any individual who requires visual or gestures be paired with speech for receptive language input to be understood and/or any individual who is struggling to communicate face to face via speech in one or more situations. So we're all starting off on the same page. So what is an AAC implementation plan? Because that's why you're all here today, right? It is a document that's drawn up by an AAC user's team that define successful AAC use, defines the signs that troubleshooting is required, describes all communication systems and use with that individual in detail, describes all strategies that apply to AAC use for this individual, lays out individualized prompting hierarchies, includes detailed descriptions of activities and communication target, and includes team member roles and responsibilities.

So there is a lot. The idea of an AAC implementation plan was introduced to me as a concept around the same time by two different SLPs, Audra Francisco and Amy Golding. So I have to give a shout out to them, because my plan template draws heavily on elements from both of their templates that they were wiling to share with me. Most of these are things that you probably already have or have already discussed as a team, but my experience has been that they often aren't necessarily all written down or they're not necessarily all in one place. And that can be an issue if there's a substitute or if you're trying to run a training, or if you're having a team discussion and just realizing that over time things have shifted and people are doing things differently in different environments or doing different activities. So I like to put together kind of one comprehensive resource that's available for everyone. And why would you want one?

Well, again, like I just said, it provides a training resource and reference for the team. It can clarify expectations across settings. It reduces confusion around which staff members to approach with a given concern. It encourages data collection, and we'll talk more about that towards the end. I have a bunch of resources and different data sheet example shared with you. And it brings the team together for an in-depth AAC discussion or several. And that's, honestly, I think, the most valuable part I found, because often we're talking about AAC kind of one on one with different people as we catch them. And I feel like it's quite rare for us to actually all to have sat down together to discuss how are we implementation AAC for the student, or why is their system set up this way, and having that actually hashed out as a group can be very enlightening, because sometimes you find out different things about how the student is using AAC. Excuse me, individual is using AAC. And just clarifying for everyone involved.

So how do you make one? The number one thing I'm gonna suggest is to get administrative support if it's possible. And by that, I mean kind of in the sense that it helps get as many team members together as possible, bullet two, especially if it's in a school setting, if an administrator agrees that this is a valuable thing for you all to spend your time doing. It can help free up time in people's schedule or kind of give them permission to reschedule or rearrange their schedule a bit. But it's also, I think, important to invite administrators to come to these meetings if they're willing and supportive, because I think often administrators don't realize how many pieces and people are involved in implementing AAC. And I think it can be really helpful for them if they're able to come and participate in this sort of a meeting, because then they can see just how much work we're all doing and all the different moving parts that are involved. As far as the team members, it really is as many folks that you can get together.

For school-age kids, I would say at a minimum, you probably want the teacher, the SLP, the AT or AAC specialist if they're involved, their paraprofessional if they have one, if they're able to join us. Ideally, you wanna try to get everyone, OT, PT, the BCBA, the family, but you can kind of start sometimes and hash things out with a smaller group. And you're gonna wanna use whatever plan template you've put together as a framework for this discussion, and you might wanna ask some folks questions, like what is everyone currently doing to support the AAC use, what would they like to be doing, and what would they like the individual to be doing, especially when they're with them, if it's an outside provider or OT and they're only seeing them in certain activities or certain setting. You're gonna wanna determine as a group some potential communication targets in each environment, and then you're gonna wanna draft and distribute the plan.

Now, if you're in a school or you're in a building that's using Google Suite or like a shared server, I recommend not only printing out the plan, but also sharing it electronically as well. It makes it a lot easier to find and to update, especially if you blocked it for updating, and then the SLP or the AAC specialist can kind of perpetually update it, and folks can check back and see the update resources. So one of the first things you wanna do is define was successful AAC looks like. And I found that teams often don't know what to look for, because it needs to be customized for each individual. And some of the things that I'm looking for as an AAC specialist are things that are maybe outside of the indicators for success better laid out on like an IEP for example.

So I might put a statement something to the effet of the AAC system and strategies will be considered effective if the individual demonstrates, and then I list out individualized for that individual what I would like to see them demonstrating. Increased independence is usually one. Increased comprehension of communication partner's messages via aided-language stimulation, increased vocabulary use. I might also say things like increased self-advocacy, increased initiation, increased communication across settings or partners, whatever is gonna apply to that individual that you're working with. I also try to list out what are our red flags that need trouble shooting. Because again, I found that team, the extended team especially, may not know what red flags to look for, and it needs to be customized for each individual. So my statement might be something like the AAC system and strategies will need to be reassessed if the individual demonstrates reduced social engagement or participation, decreased vocabulary use, or a lack of vocabulary growth, decreased independence.

I might include something like decrease in initiation when using the AAC. Or if the individual is demonstrating kind of consistent problematic behaviors around the device in some way, that maybe we need to rethink how we're presenting it or how we're modeling it or something, but that would be a sign that we need to troubleshoot something. The other thing that I'll include if I'm setting this up for someone who's doing a trial is something about not doing better with the AAC system than without the AAC system. If we're trying to see if this system is gonna improve this individual's quality of life, and we introduce it, and nothing really changes, that's a red flag to me as the AAC specialist that what we're doing is not an effective strategy or use of the system, and that we need to rethink something.

And sometimes teams don't realize that because it's not what they consider a problem, so I try to state that as explicitly as I can. So you're gonna wanna layout as well, potentially in a table or chart, or some sort of a bulleted list format, all of the systems that you're using with this individual for communication. You're gonna wanna especially include any high and low-tech systems that are being used, how the individual accesses each system, and I try to be really specific about access. For example, I have a student who uses Eye Gaze, and she has different dwell activation settings, depending on her fatigue levels. So we have one setting that we use when she's very fatigued, and one that we use on just a regular day, and I wanna make sure I've explained all of that in this section of the plan.

If we're using aided language stimulation, I might include that, that individual is visually or auditorily attending to that if appropriate. So that is a way in which they're accessing their system. I'm also going to want to note any required accessories for successful AAC use, like switches or mounts, and how often the system should be used. And this could be something very general, like across the entire school day, or it could be if we're talking about a specific low-tech system that's used in a particular setting. I might say explicitly for 40 minutes a week during adapted PE or something like that. I also often will try to include here any set up instructions that are really vital, especially if there are accessories.

I've had situations where we've had a substitute come in, and no else knew how to set up a switch or get the Bluetooth to pair. And so, I wanna make sure that, that information is gonna be readily available as well. You're probably going to want to include any pass codes that all team members should know, and that's guided access, if there are editing restriction, that kind of thing. Where the system should be stored when it's not in use. I realized, ideally, our students or individuals are using their devices or system as much as possible, but I have students who go swimming every week, and they use low-tech or alternative option at the pool. So where should they device be when they're gone to the pool? Is it in their locker? Is it in their desk? I don't really care where it's being stored, but I wanna know if I come into the room and need to grab it, to do programming, or if there is a substitute, where should this device be? Who owns the system an whether it travels between settings, such as home and school? I'll also often include here whether the charger travels back and forth as well, because sometimes, thinking of the school district I'm in, sometimes the classroom has a charger and the parents also have a charger, and so there isn't any actual need to pack that up.

And I also try to make a note here if there's any no-tech strategies that are in use and how to carry them out with the student. So, for example, I have a student right now who uses a high-tech communication system, but can also do some Eye Gaze choices. If I assign a choice to each Of my hands and hold them up, he can look at one to make a choice. So I would wanna make sure I detail how to do that with him in this section as well. So an example of it, kind of in chart format would be something like this. This is an example for a student who perhaps is using a communication system with accessories. So you'll note that I've listed out both the system itself and the accessories there. I've got the guided access code listed under the iPad with Proloquo4Text as part of the system. I tried to be very detailed, not too much information, but enough information on the stuff like where should it be.

So, for example, the student's iPad should be attached via a flexible mount to the front center edge of the student's wheelchair tray when it's in use. And if it's not in use, it should be in her teacher's middle drawer, plugged in, and charging. So again, you don't wanna have to have too much information, or make it too long and wordy, but just enough information that it should be very clear if someone new comes in, and it's reading the kind of what the plan is. For how it's used, I try to give some information about what the student is doing. And when it's used, this is a general sort of throughout the school day. Here's an example of a similar sort of description of the communication system, but broken out into a list format, instead of a chart. So you can see I've tried to give, again, just enough information to be clear, but not too much information to be overwhelming.

I've got it broken out into the device, the way the student accesses it, and the locations and storage. And then this student, for example, also uses a low-tech board at the pool. So I've noted out that same sort of information for that system as well. So then you're gonna wanna talk about the strategies that you're using with this student or individual. And you're gonna wanna describe them in detail. And you're gonna wanna note which team members are responsible for implementing a given strategy. And if it's everyone, you can say everyone. I actually find it can be better sometimes to list out specifically all of the roles that are expected to be involved, because sometimes people interpret everyone as everyone except not me.

So, sometimes being very explicit like, "Nope, OT and PT are involved in this too." or, "Yep, BCBA, you're there and you're working the student, "and the device is out. "I want you to be able to do these things." can be helpful if that's something you're running into with your team. And again, this is something you might wanna set up as a chart or as a bulleted list, whatever is gonna make the most sense and be the easiest to distribute with your team. You're also gonna wanna make a note here around the situation or situations under which each strategy should be utilized. Some example of the strategies that you might wanna include would be things like a least to most prompting hierarchy or a most to least prompting hierarchy. You might wanna include something about descriptive teaching, which we don't have time to go into today, but it's amazing, and I have a link there if that's a resource you would like to drawn on.

I might mention something about core vocabulary and motor planning here just because sometimes those have a big impact on how we're setting up our teaching materials for students or individuals, or how we're presenting things to them. If that matters, if that's important, I might include a brief description or include a hand out about that in this plan, just so that there is clarification around that for the rest of the team. And you may even wanna include those resources. I will say a blanket statement, I am a huge fan of not reinventing the wheel. So if you read this link on descriptive teaching and you're like, "This is exactly what we're doing "with my students." great, print that out or link to it in the plan that you developed. Don't try to re-explain something that's already explained beautifully else where at all. I highly recommend using what's already out there. There are brilliant folks in our field, and they've already made beautiful resources.

One plan I will, or one implementation strategy I am gonna talk about in a little more detail is aided-language stimulation because I use it frequently and it comes up in many of my examples. It is very research-based. I've got a link to an abstract there. And aided-language stimulation, a communication partner interacts with the AAC user using the AAC system or a duplicate system, and they construct messages by selecting symbols while also using his or her speech to say the utterance. So my example for this is if I am talking to someone who is an AAC user, and I wanna say, "Let's go outside and play." I might find go and outside on their talker and show it to them. The idea is that there is no expectation that the individual is going to respond while I'm doing this. It's about increasing the language exposure and increasing input on the system. There is more information on the handout there as well.

And again, that is something that I have sometimes just printed out and stuck right at the back of a plan. And under the description for aided-language stimulation, I have just put the attached handout, which is exactly what I've done in this next example here. So right there, aided-language stimulation, see attached hand out. That's a strategy that I expect to be used throughout the child's day by all team members. For something like least to most prompting, I will often try to be very specific about when they should be using that sort of a prompting hierarchy. So, this example here says that it should be used during designated activities with vocabulary that the individual has demonstrated increased independence with. The team members I'm expecting to do this are the teacher, the SLP, the family, and the paraprofessional. For most to least prompting, I will usually say something about how it should be used when we're teaching new vocabulary, just trying to be clear about exactly when you're expecting these different strategies to be implemented I found could be very helpful for the extended team and bring a lot of clarity to this process.

We're gonna pause for a sec and have another poll. Based on what we've talked about so far, I really like to know if you've ever made AAC implementation plan. Your choices are yes, no, or you've made something similar but not quite the same. And I'm gonna let that run again for a couple of slides, so I'll keep going. So, most of your are probably pretty familiar with prompting hierarchies, but they're a big part of what I try to include in my plan, so I'm gonna talk about them for a little bit. As I'm sure most of you know, they should be individualized for each AAC user. They should be described in detail within the implementation plan, and update it if needed, and you may want to include photos or other visuals in your plan when you're talking about this if that's helpful for consistency or training purposes. I also strongly encourage you to have a really frank discussion with the team around the fact that the prompting hierarchy or hierarchies that you're using with the AAC system.

It might be different from the ones that are being used during work activities. I found that sometimes that can be a big source of confusion, so I try to make sure we say that upfront, especially if I know it's different or if they're always using a particular prompt hierarchy that's at all what I'm doing with the student. I just try to have that conversation right out in the open. As I'm sure most of you are aware, a few of the common types of prompting hierarchies are most to least and least to most. So most to least prompting hierarchy starts with the most support and fades the help given over time, while least to most prompting hierarchy starts with less support and the increases support until the individual experiences success. The goal overall for both is to fade support. I have an example of a least to most prompting hierarchy that includes both prompts and cues or hints.

This is not anything that I would ever, ever, ever paste into an implementation plan that I was making for a student, because it needs to be individualized and customized. But this is sort of what I used as a template or as a framework to launch some team discussion around it. Audra Francisco and I actually came up with this as sort of our template when we were making a training presentation together for school. And she added this first line that I really, really love, and I now include it on every prompting hierarchy that I make. Although it seems obvious, it often is not obvious, and people forget about it. And that line for this least to most example is secure visual and auditory attention prior to providing or expecting a response. It's so crucial. It seems obvious. I really strongly encourage you to write something like that down where you're making your prompting hierarchies because it is a big reminder for both.

And then your prompting hierarchy should be as explicit as you think it needs to be to clarify things for your team. And that might be maybe you're all evolving working together for ages, and you have kind of a good short hand worked out and you don't need to be super explicit, or maybe you're gonna go on a turnover, you don't know everyone as well, or you're just very rarely ever actually in the same clinic at the same time, which is my situation a lot of the times, and you wanna make sure that it's clear and has examples, and is as specific as it can be. So, for example, if I was going through this with one of my team, I would include, after each part of the prompting hierarchy, something like... So if we look at the second line, gesture towards the device, I would say gesture towards the device, pause again, wait for however many seconds we've determined is appropriate for this individual, and then if no response, move to the next line.

And we'd had to put that in after each part of the prompting hierarchy because we realize stuff we're not necessarily realizing that for this student with processing issues, that they needed to still do that, and they still needed to be providing that time. So again, you're gonna customize this. You're gonna make this specific or not specific as you think your team needs it to be. I will also sometimes include information around other tools that we're using with the student during the prompting hierarchy. Since the other student that you're using a light pointer with or an occluder with. An occluder is often cardboard or card stock that's black, and you cut out a whole in the middle of it, the size of a button or a symbol on the individual's AAC system. I put mine on a popsicle stick, and then you can kinda use it to outline or highlight the symbol you want them to select. And those are wonderful resources.

But again, you want to make sure to include in your prompting hierarchy how those tools fit in and where they should be used. And then sometimes we model not as part of either language stimulation, which is often referred to as modeling, but we give a direct model, which is when we're talking about the utterance that we want the student or individual to say. So, if wanted the student to say, "I see "blue sky." I might model that whole utterance on the device, and then go back to the original screen we were on, and wait for the student to say it. I call that directly modeling because I found that teams were getting very confused between that sort of a model where it's what I want the individual to say, versus modeling as part of aided-language stimulation, which is when they were supposed to be highlighting words from their own utterances. That's one of those things you might need to have a conversation with your team about as well as far as clarification, and making sure that, that terminology is all clear. Regardless of the hierarchy you're using, you wanna just make sure you point it out in the implementation plan, and then it's been as clear and as explicit as your team is gonna need it to be.

As I'm sure most of you know, there are tons of resources on prompting hierarchies out there. And again, do not reinvent the wheel. If you can find something that has good definitions or that has a good way out, or is prompting hierarchy that will mostly work for your student, I encourage you to just link or print out and include those resources in your plan. Then we're gonna come to the parts about activity-based target. As a team, you're gonna wanna describe in detail the activities to highlight the communicative function of each activity, the types of AAC that are gonna be used during a particular activity, the specific communicative expectations for that individual during a given activity on the communication partner or partners and their role or roles during that activity. And this is going to, again, be something that's very individualized, depending on who you're working with both the individual and the team as a whole.

This might be something where you're gonna pick just one or two activities for a team that's just getting started with AAC, and really needs that guidance of where to start, and then kinda build up from. Or it might be a student who's mostly a pretty good AAC user, but you're gonna pick a couple of activities to work on refining specific skills or specific vocabulary instruction. Or you might be mapping out an individual's entire usual schedule broken down by activity and what you're hoping to have them communicating during those times. That's something that's gonna vary just depending on the needs of who you're working with. When it comes to picking the activities to highlight, you're gonna wanna focus on regularly occurring consistent activities. And that just gives you the most bang for your back if it's an activity that happens frequently, ideally it's often motivating for the student who you're really trying to get buy-in.

You're gonna wanna think about the vocabulary or the pragmatic functions that you wanna target, and think about which activity has maybe make sense for that. And then you may also wanna think about utterances that the individual is already saying during a given activity, and is there a way to expand that, or shift it to something more appropriate if it's maybe not quite age appropriate or something along those lines. This is also where I sometimes have a conversation with the team and maybe the team as a whole and having this conversation with a family member around the idea of product versus process. Is this an activity where we're focusing on an end product, we're going to art and we're gonna make the art project, and that student is gonna take the project home at the end of the day? Or is this an activity where we could maybe back off of the product a little bit, and maybe the student is gonna do one art project for every two that everybody in the class makes? But we're gonna really focus on the process and spend a lot of time working on communication during that opportunity.

Again, there's not necessarily a right or a wrong answer to that, but it's something that I try to encourage teams to think about, because I think sometimes we get very product-focused, and we forget to focus on the process, if that makes sense. So, some example activities, again, something that is gonna be completely customized for your individual that you're thinking of as you're listening to us. Morning meetings, going to the coffee shop or some other sort of regular community outing, playing with a game or with a toy, clock time, work time, meal time, music therapy, shopping, cooking, taking public transit, going in the car or van, speech therapy session, OT and/or PT sessions.

Others that came up after I had already put together the slides were recess, time in inclusion, swimming, et cetera. Basically it's endless. If its an activity that occurs regular for your individual, you should consider what they might be able to say during it. And again, this is something that you may wanna kind of set up as its own chart or some sort of an active list, whatever is kind of easiest for your team to process. And then you're gonna wanna think about having chosen an activity, what the communication function is for that activity, and you're gonna wanna list all that apply. And ideally, again, this is sort of where you're targeting either a few communicative functions across all of the activities that you've listed in the plan, that might be especially if you're working with an individual who's just trying to refine a few skills, or if you have a new communicator and that you're really pushing for requesting and commenting initially, and you're not as worried about other communicative function. O

r you're gonna work on a wide variety of communicative functions and you're gonna try to have a few different ones for each activity on the plan, so you're spreading things out. Again, there's not necessarily a right or wrong answer here. It just sort of depends on the individual that you're working with, and what you're hoping to achieve with them. Some example of things I've worked out for communicative functions, and a lot of these are probably gonna look familiar to you from speech and language assessment as an ACC assessment. I'll include things like requesting, commenting, directing others, getting the attention of others, protesting, asking questions, answering questions, greeting and leave-taking, group participation. And I use group participation mostly to refer to things like activating a step-by-step to sing a song during morning meetings. It's not necessarily traditional communication, but it is part of social closeness and being involved in the group.

Choice-making, labeling, and sharing information. There are probably others, but I feel like this tends to capture a pretty good chunk of what I'm including on plans. Then you're gonna wanna talk about the types of AAC that are being used during an activity, because an individual may have a ton of different resources available for them. They might use high-tech and low-tech and no-tech, and not all of those necessarily apply to any given activities. So you wanna list out specifically what's available for that activity. And then you're gonna wanna talk about the expectations that you have that student during a particular activity. And this is where you're gonna wanna state it pretty explicitly, either like a specific utterance structure that you're targeting, or a clear description of the type of utterance you're trying to target. These should align with this aided communication focus for the activity. So if your function that you're working on is protesting, you don't want the expectation on the student to be some sort of a comment.

You wanna make sure that the things that you're expecting the student to communicate align with the functions that you're targeting. And you're going to, again, wanna write these in the manner that's most helpful for the extended team, and that I have found may need to include things like writing out the vocabulary in an utterances very explicitly, like including silent navigational hits if those exist. So, for example, a student is needing to open a folder and that doesn't speak before they find the vocabulary word in question and that does speak, I wanna make sure to indicate that if that's what the team needs in order to support the student best. You might wanna draw on existing resources while you're thinking about what utterances to choose or which activities makes the most sense. The Prentke Romich company has a core vocabulary and play routines document, which I have got a link for there, and I have an example at the bottom of this slide.

But basically, they try to talk about both a bunch of core words and different context in which those words could be used. And then they have some example activities, and they have example one, two, and three-word phrases using core vocabularies that might apply within those activities. So if you're using a core word approach with a student or trying to brainstorm some appropriate utterances that would make sense to the expectations for them, this might be a document that's worth looking through. Something else I really like, the Speak For Yourself website has a brainstorming worksheet. And they talk about what does the person love is sort of the root of the activity, but you could make it a keyword for this activity, and then think of a core word that pertains to that, and a noun that pertain to the core word, and verb that pertain, and so on and so forth.

So this tries to help you kind of brainstorm vocabulary that might be relevant, and then think about the utterances that you could make using those words that you've just generated on this worksheet, and the length for that. I don't actually think I have a length for it, but if you google the the building language, where do I start, it should appear. If you're having trouble find it it, please let me know because I will provide that link. Dynavox also has an an observing the classroom environment form. I like this especially for slightly older students, because one of the thing it asks, it is intended to be used as sort of a comparison Of the AAC user to their peers, is the student able to communicate the same types of message as his or her classmate? And if not, what are they able to communicate.

So if you're trying to figure out what utterances to be targeting, this might be a good way to kind of collect that information and think about, "Okay, they're going to include in class, "or they're going to this place in the community." What are the others able to say? Do those make sense to the student? Is that something that they should be able to convey as well? And the last thing you're gonna wanna consider is the communication partner role. Who's expected to present during this activity? What are they each expected to do to help the student experience communicative success? And that might be, for example, either language stimulation or least to most prompting. The information you provide here should try to answer those questions.

Here's an example of kind of a full break down of a specific activity and the communicative function, the AAC in use, the communicative expectations, and the partners and their role. This is an example based off of a student I worked with who's literate and kind of very fluent with the mechanics of using their system, but really working on using it functionally with peers. So for the activity, we've listed out very explicitly, it's gonna be, we're talking about conversational carry over in the classroom after practicing the same topic and speech. This was something she was doing weekly last year. For the function, we're talking about greeting, kind of taking turns listening and sharing, so basically group participation, and some self-advocacy.

That's what we really wanted to work on with her. This is gonna happen with an iPad with Proloquo4Text app. And so, our specific expectations for the student are that they would listen to another person or story, ask an open-ended or clarifying question, make an appropriate comment, and then utilize pragmatics to maintain conversational control or work on conversational repair strategy. We talked about who is gonna be there, who's gonna be the SLP, the speech interns, the teacher, and her fellow students, and that the SLP and the teacher were expected to provide least to most prompting as needed. Another example for a student who's less proficient at using their system for snack in the inclusion classroom.

I want you to note here under AAC use, I've included the student's device, but I also included the conversation wheel visual that was actual in use in the classroom in general during snack time. This was something that all of the students benefited from, and that they would put out on the table. And even thought it wasn't intended just for this student, it was available to him during the activity. So we wanna make sure that we're noting that here. Under the communicative expectation, again, I've used brackets to indicate silent hits on the device. So, for a staff member who's less proficient at using Accent with Lamp, I want them to know that they need to hit I and then hit I have, that that's the sequence they're gonna follow, or that I don't like is gonna be a silent hit to I, a silent hit to the not symbol, and then I don't like as a message is available. So trying to put it as clearly as possible for team members.

And in this particular case, we had a specific WH question we were targeting, which is, "What do you have?" after looking over what a peer was eating. So we have stated that explicitly right here. And so that sort of thing. You wanna put it just enough detail that it's clear what you're expecting for the student, but not so much detail that it becomes paragraph and paragraph. That's too much information, and folks will not appreciate sitting through a meeting where you're trying to put that together. I also wanna make a quick note that it can be short and sweet. So this was a bathroom activity. The function is requesting, the expectation is that they'll go into their needs category and hit the full message, "I need to use the bathroom."

The expectation here is actually mostly on the partners right now, because this is something we wanna be modeling on scheduled bathroom times before we take the student to the bathroom. And that this is something that if the student were just spontaneously activate, we wanna reinforce it and take them to the bathroom, but that mostly this is actually trying to get the staff up and ready and using this tool to kind of teach this vocabulary of this message to the student. So, after you've written all this out, you're not quite done yet I'm afraid. I try to be very comprehensive about this. You're gonna wanna list out as well all of the team members who were involved, all the aspects of AAC system upkeep and maintenance, and which team member or members are responsible for each aspect about keeping maintenance. I say members because I really strongly encourage you all to indicate exactly who is the primary person and who is the backup person for doing certain things, because everything rests on one person and that person is out.

That's when we run into some trouble, right? So making sure you know, okay, well, the student uses a switch, and so on and so knows how to setup the switch. But if that person is out, who's our backup person? Who's gonna get tagged in to take care of that? I recommend doing that via a chart. This is actually from The Bridge School. I think Saltillo had shared it on their website, which is linked at the bottom there. And this is basically a team responsibility chart. It has all of the aspects of maintaining and updating the system down to the left side of the chart. And then along the top, it has different roles and responsibility. Ideally, based on team discussion, this sort of helps clarify for everyone who should be doing what. I highly recommend color coding. I cannot state enough how helpful it would be to color code this chart as you're viewing it by person. A Word document, so I'll make my own tweaks of it based on the needs of my team.

So for example, where I am in school, as the AAC specialist, my role and the SLP role are different, so I usually split off into different columns. One student has a nurse to attend to her, so I might have that, that individual listed here as well, because maybe they're the backup person in charge of the device. Whatever make sense for your team, but just knowing who's on call to do what, who's responsible for making sure that the device is charged, who's responsible for adding new vocabulary, all of that. I cannot overstate how valuable that is. And that is your AAC implementation plan. If you make it that far, you should celebrate it. It's usually a couple of meetings worth work, but it's very exciting when you have it all written out and available. I'm gonna pause for a sec, we have a poll. At this point, do you think that having an AAC implementation plan would be helpful for you and for your team? Yes, no, and maybe, and as usual it'll run for a couple of slides.

Well, we'll just start talking about data collection. So, basically now you have this amazing resource notes, what are you gonna do with it? Well, you're gonna document, document, document like everything else. You're gonna wanna encourage your team to collect data to determine if the system is working or in need of troubleshooting, and to determine that strategies are being implemented as laid out in the plan. And I don't wanna understate how important that piece is. Because if it turns out the strategy you've identified as being successful for teaching an individual their AAC system are not being implemented correctly, that's the part that needs troubleshooting before we jump to making big changes to the system itself. So you're gonna wanna collect data on both of those things hopefully.

So, most of the rest of these slides are basically example of data sheets. I feel like that's always the part I'm curious about, how do people take data and how are they getting this information. So, one of the things, this is an example from Joan Capiro, from a presentation she did call from one AAC Meets ABA.. And it's a checklist meant for the communication partner when they're trying to implement native language stimulation. The idea is that you're really not taking data on the student at all right now. You're actually just collecting information on whether, whatever step and sequence you've set up as being appropriate for native language stimulation were actually carried through, which might be helpful, especially if you're concerned, but staff member is struggling with this or you're trying to figure out where the breakdown is happening. Similarly, an aided-language stimulation example, this is from the Lexington Public Schools.

I'm pretty sure it was made by Amy Golding, although her name is not on it. And it's just collecting information on whether the attended to native language simulation in the first five models that the communication partner made. And that might be helpful if you're trying to get staff on board or trying to get a sense of how many times something needs to be modeled before a student is attending or starting to use it, something like this might be useful. This example is from Gail Van Tatenhove, the Student Augmentative and Alternative Communication Profile and Portfolio, which I have links to there.

This is sort of trying to look at what was modeled for the student. Do they look or listen? So same kind of thing as the Lexington Public School one, right? Do they attend to the model? But then also did they partially or fully imitate the model, or did they actually respond with a unique and appropriate response? So if you were modeling a question, for example, do they attend and then do they imitate my question or did they actually respond to the question and answer me, but just trying to collect some of that information. This one, I had to edit my PowerPoint at the last minute. I visited a conference last week, it's a TechACCESS Conference in Rhode Island, and I learned about this particular data sheet from Communicare out in Western Mass. And they sort of embed the utterances directly into the data collection sheet. So they would not only identify the specific utterances they want the student to produce, but then they would also identify the symbol sequence that's needed to make it, and put that right into the data sheet, like you can see here. And then they have it so that you can check off if it was modeled for the individual, and then if it's...