Parents' Corner
Please join us in welcoming Pam and Josh Harris as June’s guest columnists. This month’s column focuses on how graphic and lexical symbols can be used to supplement the use of a high-tech AAC communication system or to enhance the environment to support activities of daily living. Pam and Josh have been gracious enough to provide a look at various low-technology options they have created.
Please,
… Pam and Josh Harris
Robin
Intro to our Guest Writer
Josh is a young adult with Rubinstein-Taybi syndrome (RTS). Like most people with RTS, he has an intellectual impairment, muscular/skeletal concerns and complex communication challenges. Josh doesn't have functional speech so he relies on augmentative and alternative communication (AAC) methods. Pam is Josh's mom, personal care attendant and advocate. Together they develop family-friendly AAC strategies and materials while organizing a variety of social and recreational opportunities for people who use AAC and their families. If you’d like to see what Pam and Josh are up to, visit their blog at: http://aacfamily.vox.com/
Josh uses a Vantage Plus speech generating device with Word Power 84. It is the anchor of his communication system. However, Josh also relies on lots of light tech communication tools. Our home is filled with visual schedules, choice boards, topic boards and communication boards. This month, we will explore the answer to the question . . .WHAT’S THE DIFFERENCE BETWEEN VISUAL SCHEDULES,
CHOICE BOARDS, TOPIC BOARDS AND COMMUNICATION BOARDS?A visual schedule, also known as a picture schedule, is a collection of pictures/symbols and/or text that are sequenced from beginning to end. There is NO communicative function. Visual schedules are a great strategy for identifying the order of one’s day, or the steps that are needed to complete a task.
For many years, Josh’s IEP had the same goal: Josh will follow 2 -3 step directions. It took a skilled and knowledgeable speech-language pathologist to determine that Josh cannot follow multi-step auditory information. Over the course of two years, we worked on this with Josh using visual supports and then fading them away. Whenever the visual supports were faded, Josh became frustrated and then used inappropriate behavior to avoid the task. We use a visual schedule to support Josh’s ability to follow multi-step routines.Back in early elementary school, we realized that Josh responded more positively to transitions if he followed a written schedule of his day. Using an index card, Josh’s paraprofessional would write the morning schedule on the index card and slip it into a clear laminate pocket taped to the upper right hand corner of his desk. Josh would use a dry erase marker and draw a line through each activity as it was completed. Since lots of days had the same schedule, it was easy for the para to get the card ready. The afternoon followed the same routine. At the end of each school day, Josh and his assistant selected an activity to write about for “Home News” – using the written schedule cards. Today, we still use a small memo spiral notebook for writing Josh’s daily schedule on days that something new is occurring. We use written schedules to help Josh understand the order of his day and give him the visual prompting he needs to talk about a particular activity. He can flip back through the pages and bring our attention to a past activity. We use visual schedules to help Josh make transitions and accept changes in his routines and keep these accessible for Josh.
I dreamt of Josh being able to get up in the morning, get himself cleaned up and dressed independently so I could be doing something else (Drinking coffee? Watching Oprah?). Once Josh becomes familiar with a routine and builds a level of competency with each step, we can fade the support person and Josh can use the visual support. We use a visual schedule to support Josh’s independence.
It’s tough for Josh to remember sequences and it’s especially difficult when the task involves fine motor activity. Fine motor activities are taxing for Josh. Using visual schedules to identify each step within a fine motor activity helps reduce Josh’s frustration because he can clearly see exactly what is left until the task is completed. We use visual schedules to help Josh break down complex fine motor tasks so he does not give up or become frustrated.
Here is an example of Josh’s morning routine set up as visual schedule.
A choice board is a display of choices like chocolate chip, peanut butter or sugar after it’s been established that it’s time for cookies. Choice boards are used to offer an opportunity to control one’s environment. There is a single communicative function, selecting a choice. Choice boards are an excellent way to determine preferences. We also use choice boards to expand vocabulary.
Josh’s first choice board was a display of his computer games. He was 4 years old. Josh required an adult to get the CD out of the jewel and insert it into the drive. I made this simple choice board and velcroed it to the side of the computer cabinet. Josh would pull it off and bring it to me. By pointing, he could tell me what computer game he wanted. We used this choice board so Josh could make a selection from a large group of options.
Using his garden choice board, Josh can tell me what vegetable he prefers or what flower is his favorite. Josh is learning what a rose is and how it is different from impatiens. Flower is no longer the only word he uses to describe the blossoms in his environment. Because the rose bush is in his garden and the impatiens are growing in the flower pot outside his bedroom window, these choices have importance. This choice board is supporting Josh’s meaningful and positive interactions with his environment. We use choice boards for Josh to indicate his preferences. We use choice boards to expand Josh’s vocabulary.
A topic board offers communicative vocabulary specific to a single topic. Whether it’s having a tea party, reading a book, or baking a cake, a topic board can provide access to general communicative vocabulary but it always includes vocabulary specific to a single activity or topic.
Bedtime Topic BoardEvery night Josh gets tucked into bed, read a story and then he has some time to listen to music or watch TV. He always has his talker in bed with him. When he was younger, it was during this time that Josh explored and played with his talker on his own. When it was lights out time, he would shut down the talker and I would plug it into the charger. Inevitably, Josh still had something to say. I started to jot down his questions and requests and realized that most of what he asked after lights out was the same. So, I created a simple bedtime topic board on the computer and printed it out on iron-on paper and ironed it onto Josh’s white pillowcase alongside a letterboard. We use topic boards when Josh’s talker is unavailable.
Josh’s photography topic boardThis year, Josh and I started a new project called Project 365. Each day of the year, Josh and I are taking a photograph with our digital camera. I took a picture of our digital camera, printed it on 8x10 photo paper, cut it out and laminated it. It became the board. Then Josh and I identified the new general vocabulary, the steps of taking a photo, the vocabulary for reviewing the photo taken and then the vocabulary for processing the photo. We organized them in a Word document, then printed them out, cut them out, laminated them and used Velcro to attach them to our “camera” board. We use this to teach new vocabulary and identify the sequenced steps of taking a photo.
Communication boards and communication displays offer opportunities to express a variety of communicative functions. Josh is an active guy who doesn’t always remember to carry his talker with him. There are also places where we prefer he not bring his talker, like the bathroom. To make sure that Josh can communicate with us everywhere, we have laminated communication boards in each room of our home and in each automobile.
Josh’s communication board is printed on magnetic paper and “stuck” to the refrigerator.
This communication board is laminated and velcroed on the bathroom wall.We use communication boards to make sure Josh can communicate with us everywhere.
Sometimes, it makes sense to combine a topic board with a communication display. Using a lightweight garden kneeling pad with a built-in handle from our local garden center, we combined a garden-specific topic/choice board with a general communication board. Josh uses this when we are working together in our garden. Josh and I also took the garden-specific photos together with our digital camera combining our hobbies of photography with gardening.
Josh uses one side of the garden pad for general expressive communication.
The opposite side of the same garden pad is topic specific.
Josh relies on light tech options that include visual schedules, choice boards, topic boards and communication boards. These light tech options, along with his high tech speech-generating device, support Josh’s full communication. These do not require much time or money to make, but are invaluable in the functions they provide. No one uses only one mode of communication - options are and should always be available. The above light tech solutions can be adapted for everyone.
I (Robin) always value your feedback. parents@aacinstitute.org.
