Today we are thrilled to have Deanna Wagner, Assistive Technology Specialist, share her expertise regarding engaging students who have complex communication needs in conversations around their personal stories. NOTE: This article refers to learners as students, and they may be of any age.
Students with complex bodies may experience difficulties producing speech and manipulating objects (including photographs and books), which ultimately affects their ability to share thoughts and ideas with others. We all use stories to share our personal identity, culture, and create a sense of belonging and closeness. Personal photos and personalized multi-media presentations are contexts that enable students to comment, describe, and label in addition to ask questions and engage in information transfer. Stories are important for all students as they help develop literacy skills, as well as (a) connect them to experiences; (b) expose them to diverse narratives and (c) value their home languages, as well as unique ways of communicating (Palafox, P., 2018). By creating and sharing their personal stories, students can learn to manipulate multiple familiar elements including words/text, pictures/symbols, visual and auditory content.
This article aims to share a holistic balanced approach for engaging students who have complex communication needs in conversations around their personal stories. Conversational forms may include gestures and body language (non-symbolic language) as well as graphic images and words (symbolic language). Holistic teaching strategies include four elements, all of which are necessary for true learning to take place: immersion, demonstration, autonomy, and response. We also need periodic evaluation and data collection to keep track how our students are progressing and making sure that further adaptations are not needed in order for learning to take place. These principles are based on studying multiple resources related to AAC best practices (Beukelman & Miranda, 2005; Sennot, Light & McNaughton, 2016), the role of literacy and AAC (DeCoste, 1997; Erickson & Koppenhaver, 2007), teaching poetry (Wilson, 1994), strategies for students with Cortical Vision Impairment (Roman Lantzy, 2019) and access methods for students with complex physical challenges (Burkhart, 2018).
This article will describe four activities we can do with our students to build storytelling skills. These activities could be seen as a developmental progression, as sharing a personal story may be considered a culmination of the first three activities. Using holistic instructional strategies can help us to be mindful of learning that can take place during each activity, regardless of the level of challenges that a student faces. Active daily engagement in all four activities provides a balanced approach: 1) looking at photos, 2) reading personal stories, 3) writing personal stories, and 4) sharing personal stories.
Activity #1: Looking at photos
It is critical for an intervention team to know whether a child with complex communication needs (CCN) can see (and under what circumstances), interpret two-dimensional materials, including photos and to provide accommodations to the environment and/or modifications to materials accordingly. Difficulties may include not only problems with seeing, but also with positioning, attention, interest, fatigue, as well as the degree to which they can use AAC/AT devices and/or other materials and the ability of their communication partners to support them. A holistic approach engages in meaningful exploration and discussion of our photos. Opportunities to interact with photos should be integrated into daily routines. We may need to adapt the photos themselves, the presentation of photos, and the way we discuss photos.
Immersion: Students need exposure to functional use of photos throughout the day. To optimize joint attention (looking together), we may need to highlight salient features or simplify the image. Tools/adaptations may include:
- Presenting images on a backlit screen (smart phone, tablet, interactive white board);
- Using draw tools to add color or eliminate backgrounds;
- Using occluders to block out distracting elements or draw attention to a specific area;
- Teaching students language around looking at photos, and observing their individual methods of paying attention (including body language).
Demonstration: Experts who use photos meaningfully demonstrate how we point to pictures as we talk: pointing out important parts, remembering what was happening when the picture was taken, and/or showing a picture to another friend. We can explore and discuss cultural diversity in the images we choose to talk about. Takeaway message: Photos need to be organized and experts need to model how we talk about them. Tools/adaptations may include:
- Adapt the physical environment when necessary for students to look or listen;
- Electronic photo albums: While looking at the photos, experts demonstrate how they talk about them and how to organize photos into various categories (albums);
- Communication systems: Experts demonstrate how to use the words in communication systems to express a variety of intents: comment, choose, direct, ask, inform.
Autonomy: When students have an opportunity to explore at their own pace, making their own choices, we can reduce stress and increase learning. Students need experiences actively manipulating photos on their own, pointing to them, choosing favorites, and talking about them using the words/methods they choose. Tools may include:
- Page-turning adaptations (e.g., board books, gestures on iPad, PowerPoint arrows)
- Communication systems: Whether voice output or paper-based, students need to be offered choices and allowed opportunities to make selections on their own. They may choose words to label, comment, or describe what is in the photo.
REsponse: How we respond helps build skills. We attribute meaning to gestures and body language, building symbolic language based on the student’s attempts at expression. An example would be commenting when a student smiles at a particular picture. A holistic response from an expert communication partner might look like this, “You are smiling, I think you LIKE that picture,” followed by pointing out the word LIKE on a communication system and giving the student an opportunity to imitate using the same communication system or another method. A responsive holistic methodology invites revision based on feedback (i.e., using the communication system rather than just smiling, or choosing a different photo to talk about). We consider how the student is actively engaged in learning and evaluate whether our methods are effective in teaching him/her new skills.
Useful Web Links and Tech Tips for Looking at Photos:
- Look here for tips when editing images – http://www.pathstoliteracy.org/resources/
- Use Partner-Assisted Scanning techniques while switch activation skills are becoming more automatic (Interactive Speech Pathology PODD Tips)
- Model how to give opinions (PODD Tip for Giving Opinions)
- Explore Project Core Professional Development Modules: Beginning Communicators, Aided Language Input http://www.project-core.com/professional-development-modules/
- Use a Recipe from the iPad Accessibility Switch Settings to reduce frustration and increase focus on the task (e.g., Turn Pages)
Activity #2: Reading Personal(ized) Stories
A holistic approach engages our learners in meaningful exploration and discussion of stories. We may need to adapt and personalize stories, to promote a connection to the individual.
Immersion: Students need exposure to lots of personalized stories for multiple functions throughout the day. This is particularly critical for students who are emergent readers. Personalized stories can be incorporated into most curricular areas and themes. Tools may include:
- Reading stories on a backlit screen (smart phone, tablet, interactive white board)
- Using adaptations as needed (such as gestures for turning pages on the iPad) so that the student can independently watch/listen to stories of his/her choosing and turn to pages of interest
- Using a camera and apps to capture events and add pages to personal stories
- Changing words or pictures in stories by others to make them personal
- Using a story format for schedules (i.e., turning pages for each instruction/step)
Demonstration: Experts who can read stories meaningfully demonstrate how we talk about stories as we read. This may also include turning pages forward and back to find favorite pages, pointing to images of the student in the story, and talking about other story elements such as people, setting, and events/activities. Tools and adaptations may include:
- Electronic stories: Using stories with voice output can demonstrate how the voice on a communication device may sound when reading connected text in a story format.
- Electronic stories (eBook, PowerPoint, websites) can also be displayed on a large interactive screen for group shared reading or guided reading activities.
- Communication systems: Experts demonstrate how to use the words in communication systems to express a variety of intents while reading stories: comment, choose, direct, ask, and inform.
Autonomy: Students need experiences actively manipulating stories on their own, turning pages, pointing out elements that they like, choosing favorites, and talking about them using the words/methods they choose. Autonomy means that the intent comes from the student, not others. Choosing what to say about the story (and how to say it) must be a personal choice, in an environment where students feel safe to share thoughts and ideas. Tools may include:
- Page-turning adaptations (e.g., board books, gestures on iPad, PowerPoint arrows)
- Communication systems: whether voice output or paper-based, students need to be offered choices and to make selections on their own. They may choose words to label, comment, or describe elements of the story (and how it relates to themselves).
Response: Respond to all child’s communication in an authentic manner, noting modes/methods he/she uses. Try to determine meaning and expand child’s communication/language skills, while fostering participation, engagement with others and interest in the story. How we respond helps build conceptual and communication skills. We attribute meaning to gestures and body language, building symbolic language based on student’s attempts at expression. An example would be commenting when a student smiles at a particular page. A holistic response from an expert communication partner would look like this: “You are smiling, I think you LIKE that,” followed by pointing out the word LIKE on a communication system and giving the student an opportunity to imitate using the communication system. A responsive holistic methodology invites revision based on feedback (i.e., using the communication system rather than just smiling), but does not require it. A more advanced student would need demonstrations and encouragement for producing word combinations (i.e., I see you smiling when we get to this page, “I think you LIKE ANIMALS”). Finally, as we respond we need to be aware of our level of support and evaluate whether we are doing everything we can to promote learning. Are we providing the least level of prompts? Are we providing learning opportunities that challenge the student without frustrating him/her?
Useful Web Links and Tech Tips for Reading Personalized Stories:
- Use these links to explore options and ideas when adapting for visual needs: Paths To Literacy Guidelines for Modifying Books and sample Weather Book
- Explore Angelman Syndrome Foundation Communication Training Series Webinars https://www.angelman.org/resources-education/communication-training-series/
- #14. Reading as Communication: Selecting Books with Caroline Musselwhite & Erin Sheldon
- #27. Independent Reading: Text Types, Paper Books, and Digital with Caroline Musselwhite
- Explore Shared Reading and Guided Reading: Project Core Professional Development Modules: http://www.project-core.com/professional-development-modules/
- Explore Tarheel Reader stories like these What I Like stories, written for early readers of all ages with page-turning and reading adaptations already built-in. Download to PPT or convert to Pictello for off-line reading and adding video.
Activity #3: Writing Personal Stories
A holistic approach encourages students to write their own stories in an environment that is immersed in story writing, full of experts who demonstrate daily how to write meaningful stories, and provides a safe place for students to take risks and revise their stories based on audience response. We may need to adapt the way some of our students write their stories.
Immersion: Students need exposure to different writing tools used throughout the day. They also need to be aware of multiple purposes for writing a personal story (i.e., jotting a note to myself, journaling about my day, telling about an experience). Tools/adaptations may include:
- Adjusting classroom schedules so that writing occurs every day, for all students.
- Presenting images on a backlit screen (smart phone, tablet, interactive white board)
- Offering experiences with alternative keyboards that display all the letters, not just selective ones
- Using a variety of communication methods.
Demonstration: Experts demonstrate how we choose letters and words. They use the same methods as the students from time to time. They may have personalized keyboards and communication systems as well as tools that are used by the class as a whole (i.e., Smart Board and Word Walls). Experts should point out how/where high frequency words are represented and displayed in the students’ communication systems. Tools/adaptations may include:
- Alternative keyboards on the Smart Board, tablets, and printed/laminated displays.
- Communication systems: Experts demonstrate how to use words and letters in communication systems, including alphabet pages, word prediction (when available), core words, personal core, and other category-based words.
Autonomy: Students need experiences actively writing on their own, choosing a topic, selecting photos (when appropriate), and choosing their own words and/or letters. Tools/adaptations may include:
- Writing whatever they want to write, using the method of their own choice. Our environment and schedules need to be arranged to offer a variety of choices throughout the day so they experience writing for multiple purposes.
- Communication systems: offering/supporting a variety of communication methods to promote opportunities for personal choice (body language, verbalizations, paper-based systems, tablet-based, and parter-supported strategies) and encouraging them to select the words they want without others telling them what to say. Actively selecting what they want is required for learning to take place. Complying with what others say they should copy is not autonomous learning.
REsponse: As stated earlier, how we respond helps build skills. We attribute meaning to gestures and body language, building symbolic language based on student’s attempts at expression. We talk about the words and letters that the students choose and reflect on the meaning of the message they are expressing. Having the photo as a context can help us make guesses at what the student may be expressing when spelling and words are still emerging. A responsive holistic methodology invites revision of what the student has written based on feedback (e.g., I see that you chose some of the letters from your name. Should I show you how I write your name?), but does not require it. Another response would be considering/evaluating whether updates or modifications to the communication system (or keyboard) are needed to provide challenging learning opportunities that build on personal communication without frustrating the student.
Useful Web Links and Tech Tips for Autonomous Student Writing:
- Explore Alternative Pencils by Hanser & CLDS (currently being updated) https://www.med.unc.edu/ahs/clds/products/available-for-purchase
- Sign up for the AssistiveWare Core Word Classroom https://www.assistiveware.com/blog/assistiveware-core-word-classroom. Discuss what is fun about apps that are interactive and can create a story, like Toca Life: City https://aaclanguagelab.com/mobile/materials/advanced/toca-life-city#smart-charts
- Subscribe to AAC Language Lab http://www.aaclanguagelab.com/
- Read Cool Tricks and Tips from www.aacintervention.com and consider purchasing the Write to Talk CD
- Explore Project Core Professional Development Module on Predicable Chart Writing http://www.project-core.com/professional-development-modules/
- Consider purchasing materials from Teachers Pay Teachers, www.teacherspayteachers.com
- Burkhart & Musselwhite: Can We Chat Social Scripts
- Jenna Rayburn Kirk, Speech Room News: AAC Core Word of the Week materials/sets
- The Speech Zone: Digital CORE WORDS books
Activity #4: Sharing Personal Stories
A holistic approach encourages students to share personal experiences throughout the day with multiple partners in multiple situations. Our mission as educators is to provide a safe place for students to take risks and revise their stories based on audience response.
Immersion: Students need exposure to different ways to share their stories through various multi-media formats. Tools/adaptations may include:
- Adjusting classroom schedules so that sharing about what was written occurs every day, for all students.
- Displaying student writing in creative ways (e.g., student newspaper, critical reviews)
- Presenting images on a backlit screen (smart phone, tablet, interactive white board)
- Using a variety of communication methods, including stickers and emojis
Demonstration: Experts demonstrate how we can celebrate and respond to stories that others have written. They demonstrate how to share their own stories and how to share a story that someone else has written, but has personal meaning. They also talk about how it makes them feel when others validate what they have written. Tools/adaptations may include:
- Alternative keyboards may need to be adapted include the “sharing” button that sends a message as text, e-mail, or social media link
- Communication systems: Experts demonstrate how to use the words in communication systems, including core words, personal core, and other category-based words to comment and encourage others. When telling/sharing a story, experts demonstrate how storing and finding pre-programmed messages can help the intended audience to understand the thoughts and ideas.
Autonomy: Students can learn to share their own stories, when they want, how they want, and with whomever they want. There are some stories that we tell multiple times. Our learners need to practice saving their messages somewhere they can get back to them, so they can share their stories again later. Tools/adaptations may include:
- Using writing adaptations with options for saving what was written
- Learning how to activate the “share” option from the written document
- Learning how to activate the “share” option from the communication device
- Taking pictures of messages and posting them on social media, with the student adding tags to decide who should see them.
REsponse: How we respond helps build skills. We attribute meaning to gestures and body language, building symbolic language based on student’s engagement during sharing of their stories. We can talk about how their body language adds emphasis to their story. An example would be commenting when a student smiles at a particular memory being shared. A holistic response from an expert communication partner would look like this: “You are smiling, I think you really LIKED it when that happened,” followed by pointing out the word LIKE on a communication system and giving the student an opportunity to imitate using the communication system. A responsive holistic methodology invites revision based on feedback (e.g., using the past tense form of the verb), but does not require it.
Useful Web Links and Tech Tips for Sharing Stories:
- Join Facebook groups for families and professionals who use AAC and share stories her
- Read Southwest Human Development (SWHD) Easter Seals, In News (Nov, 2018) article: Celebrate Tradition And Cultural Awareness With Young Children.
- Explore Cool Tricks and Tips from www.aacintervention.com and www.aacgirls.blogspot.com
- Read Heidi LoStracco’s (Nov, 2018) Blog Entry: Love Needs ALL of the Words https://www.speakforyourself.org/uncategorized/love-needs-all-of-the-words/
- Explore more ideas and resources Carole Zangari’s PrAACticalAAC Blog
- Watch these Quick Glimpse Videos. The first one demonstrates composing and saving messages using TarheelReader, Pictello, and LAMP WFL. https://m.youtube.com/watch?v=tLe0vMiIUK4 . The second video includes ideas and examples for choosing a topic with examples from TouchChat and Proloquo2Go https://m.youtube.com/watch?v=tLe0vMiIUK4
Using holistic strategies to guide shared storytelling involves all of these elements: immersion, demonstration, autonomy, response, and evaluation. We need to keep asking ourselves if the student is progressing and if we are doing everything we can to encourage learning. All students have the right to communication and literacy. Storytelling has an important role in personal expression. We can be mindful of these things as we offer daily opportunities for looking at photos, reading stories, writing stories, and sharing stories. I DARE to share my story, and so can you!
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The author, Deanna Wagner, is a speech/language pathologist and assistive technology specialist, who works primarily with TherapyOne in Phoenix, AZ. On a weekly basis she provides therapy services to adult learners in a Day Program who use gestures, some speech, and voice output devices. She also consults for schools and agencies (including Southwest Human Development Easter Seals and Northern Arizona University). In her capacity as an evaluator and trainer, she helps families and their support team select and implement augmentative and alternative (AAC) speech generating devices funded by insurance. She also presents at local, national and international conferences with emphasis on dual language English-Spanish AAC, community-based interventions and literacy.
Jill E Senner, PhD, CCC-SLP