With the growing body of evidence of the effectiveness of speech-generating devices (SGDs) on the communication development of children with autism and other developmental disabilities, more and more school-based speech-language pathologists and teachers are finding themselves part of an AAC team. Among the challenges associated with effective AAC teaching, achieving and maintaining buy-in from the team is often one of the most challenging.
At Bridgeway Academy, the education and therapy center where I work, we have over 100 SGD users so team buy-in has been an area of focus for me and my fellow SLPs. While we are sure to train business office, facility and HR staff on the basics of AAC to facilitate a global culture of acceptance of the devices, we focus our efforts on three groups: 1.) parents, 2.) teachers, 3.) therapists. We define buy-in as “acceptance that the SGD is the student’s voice and should be treated as an extension of their physical body and recognition that the SGD must be taught and modeled” (Paden Cargill, 2016).
In order to solve the problems associated with achieving and maintaining AAC team buy-in, we had to first identify the problems. We found the most significant issues to be:
- Common misconceptions about AAC
- Unfamiliarity with the device
- Not knowing how to teach/prompt
- Intimidation by technology
- Fear of damaging the equipment
Addressing these issues has by no means been refined, but we have found several strategies that make a big difference.
Some of the research that we have conducted at Bridgeway Academy has focused on the what factors influence buy-in from teachers and parents (DeCarlo, et al., 2016) and we were fascinated to learn that the amount of operational competency (i.e., how comfortable a communication partner is with programming, troubleshooting and customizing the software) parents and teachers reported did not have a positive effect on the amount of time children used their AAC devices (assuming there was an AAC savvy SLP on the team). Therefore, the focus of our trainings for therapists, parents and teachers focuses on language training, prompting strategies and how to create communication opportunities (Thiemann, et al., 2018) instead of on how to program devices. These trainings are accompanied by resource manuals for later reference. Some of the topics we emphasize in live trainings and the manuals are:
- How typical language develops and how we can replicate those processes in AAC
- How to physically, verbally and situationally prompt (including how to fade these prompts)
- How to ask open-ended questions that can be answered descriptively, rather than referentially
- How to create communication opportunities within structured and unstructured activities
- How to provide aided language input
- How to respond to seemingly “random” device activations
- How to respond to device-related behaviors (e.g., pressing buttons repetitively or during quiet instruction times)
- How to encourage appropriate device exploration
In addition to trainings conducted by the speech department, Bridgeway Academy encourages teachers and staff to attend other trainings and conferences or specialized trainings like LAMP trainings and we bring in outside trainers to discuss, including AAC users.
A teacher seamlessly incorporating SGDs into lessons is certainly a goal for AAC teams but this level of buy-in does not happen over night. I frequently hear complaints about AAC devices being left in backpacks, turned off and left on shelves or left behind during therapy sessions. Bought-in parents, co-teachers and therapists may be very frustrated with such scenarios but the solution can often be found in setting very simple, realistic goals. A first baby step may just be to have the device unpacked everyday, a second may just be to have the student answer a single open-ended question at some point during the day. My best advice on the road to AAC team buy-in is to be satisfied with baby steps.
We have begun to realize the power of speech therapy integrated into the classroom. When therapists and teachers collaborate, we can learn from each other the opportunities and strategies that can lead to more frequent and more successful AAC use. As an SLP pushing into a classroom, I learn that it might not always be easy to provide natural, reinforcing responses to all a child’s device activations and teachers may learn about my prompting strategies.
The field of special education needs to be data-driven to ensure that our interventions are effective. Sharing hard data can be a great motivator for AAC teams to ensure they are contributing to the success of the student’s communication development. At Bridgeway Academy we use Realize Language in addition to videotaped and live documentation. The time-stamped log on Realize Language and the word clouds have been some of our favorite views to share with parens, therapists and teachers.
While we haven’t done formal programs for peer mentoring (yet), we realize that sometimes being told how to utilize an SGD in a classroom or home environment may not be the most effective when it comes from a therapist. A teacher who effectively uses AAC in the classroom may have a lot more to offer a fellow teacher and a parent who integrates a device into home and community can be a better resource to other parents. During our recent parent training series, we found that parents learned a lot from hearing from the experiences of their peers.
Language instruction relies heavily on a firm foundation of knowledge that of that language. The Chatterbox Challenge was developed in 2014 by the speech therapy team at Bridgeway Academy as a way to help the AAC team develop stronger language modeling and prompting skills through immersive practice. Parents and teachers took part in this practice and we began to investigate its effectiveness in 2017. We found that not only did this strategy enhance the AAC teams’ understanding of where words were located in the device, the exclusive use of the devices in social situations enhanced individuals’ understanding that the devices can (and should) be use used for more socially meaningful communication and not just for requesting or participating in academic tasks (Paden Cargill, Lyle & Ellawadi, 2018, under review).
Sometimes seeing is believing. We know that merely telling a therapist, parent or teacher about the skills their students demonstrate isn’t enough, but sharing videos via private YouTube channels, email, dropbox or apps like ClassDojo or SeeSaw can turn anecdotes into more concrete evidence of performance.
Bean Ellawadi, A., Paden Cargill, L. & Lyle, S. (2018). Investigating the Effect of Parent Training on Increasing Children’s AAC Use. Poster presentation at ISAAC conference 2018. Gold Coast, Australia.
Bean Ellawadi, A., Lyle, S., & Paden Cargill, L. (2018). The Relationship Between Parent and Teacher Buy-In, Operational Competency and Children’s AAC Use. Poster presentation at ISAAC conference 2018. Gold Coast, Australia.
Cross, R. T., & Segalman, B. (2016). The Realize Language System: An Online SGD Data Log Analysis Tool. Assistive Technology Outcomes and Benefits, 10(1), 74-93.
DeCarlo, J., Ellawadi, A., Cargill, L., Lyle, S. & David, A. (2016). Predictors of Augmentative & Alternative Communication in AAC Users with Developmental Disabilitities. Paper presented at ASHA conference 2016. Philadelphia, PA.
DeCarlo, J., Ellawadi, A., Cargill., L., Lyle, S., David, A. (2017). Predictors of Successful AAC Use: What Really Matters? Poster presentation at ASHA conference 2017. Los Angeles, CA.
Ellawadi, A., Lyle, S., Cargill, L. & David, A (2017). Working with Special Education Teachers to Support AAC Implementation in the Classroom. Poster presentation at ASHA conference 2017. Los Angeles, CA.
Neno, C., Ellawadi, A., Cargill, L., Lyle, S. & David, A. (2016). Vocabulary Development in School-Age Augmentative & Alternative Communication (AAC) Users. Poster presentation at ASHA conference 2016. Philadelphia, P.A.
Paden Cargill, L. (2016). Achieving and Maintaining AAC Team Buy-In. Paper presented at the Communication Matters conference. Leeds, UK.
Paden Miller, L., Lyle, S. & Bean, A. (2018). The Chatterbox Challenge: A Method for Increasing SGD Buy-In for Parents and Teachers. (under review).