Alternative Augmentative Communication (AAC) is a great tool to help our individuals with moderate to severe language impairments. Many individuals are now coming to us with iPads with language software on their devices. Many times parents or caregivers have heard of the “miracles” that can happen when using iPads and will jump right in and buy an expensive language application, hoping they will be able to use it right out of the box, which we all know rarely happens. AAC therapy is generally geared for individuals who may have severe to profound apraxia, autism, aphasia, Down syndrome, or very young children who are not producing any intelligible utterances. The most popular AAC apps that are language based are Proloquo2go and Touch Chat.
The most important thing to remember when using these types of apps is to see if the individual understands basic cause and effect. Generally when working with a new individual, I will choose a page where their specific item is listed (if is not on the page, I will edit the page and add it). One of the icons will be a specific reinforcer that the individual wants. Try to choose something that you have direct access to. This could be a short movie or song (that could play for a short time), drink, food, etc… Be careful if it is something the individual wants to hold or use, because if they choose the icon for their preferred item, and they use it for 10-15 seconds, you will then need to take it from them in the hopes that they will learn to request it again. Many individuals may exhibit behaviors and will not give you their preferred item back and possibly have a temper tantrum, engage in aggression or self-injuring behavior. Always use a reinforcer that you have direct access to.
When determining cause and effect, I will generally show the individual whatever item they are trying to obtain (food, drinks, preferred movie clip etc…). For this example, I will be discussing the basic communication vocabulary on Proloquo2go. From the home page, I will click on the food icon and the individual will be presented with various food icons to choose from. I will then say “look, here are the chips” while pointing to it on the screen, as well as having the actual potato chips in their field of vision. I would then say “If you want the chips, point to it” while giving them a gestural prompt, pointing to the icon on their iPad. Note the prompt level it took for the individual to ask for the item. I would repeat this until the individual shows mastery of requesting the chips (8-10 trials with over 80% accuracy). After mastering the chips, I would work on seeing if they are able to locate any other edible icons on the page and will ask “If you want cookies, show me”.
Once they are able to do this, I would then work on categorization. I would go back to the home page and show the steps it will take to ask for chips. “First, we press food, and then we press chips”. This is a hard step for our individuals but it opens the door to see if they understand the basic concepts of choosing icons that are not in their immediate field of vision. If they are able to do this successfully, you can move on to other reinforcers they can try and obtain (drinks, preferred places to visit, etc…). Learning how to link is very important. Don’t rush ahead and add more pictures until your individual can successfully link between 2 pages. If the individual can’t understand links and continues to show frustration, you may need to make a custom board with just the images they wish to request without category folders or go with something more low-tech ( PECS, communication books, etc…)
AAC is a great tool to help individuals be able to express themselves. As our individuals become more comfortable using AAC, they will hopefully become more compliant throughout the day. This can lead to a decrease in their overall frustrations, and allowing for more skilled intervention to occur, which may increase their overall language skills.
If you have any quesions about Alternative Augmentative Communication you can contact Steve Rossi here.
DDI is on the verge of opening up an expansion to our current Children’s Residential Program by bringing 24 students with intellectual disabilities back to their families in New York. Below are a few questions parents have asked us regarding enrollment of their child into our residential program.
How will you help my son adjust to the new environment?
We use the first 30 days as an assessment period where we get to know your son and your son gets to know us in his new environment. Although we know it may be hard for you, we ask that your son not visit home during this period because we do not want to unnecessarily confuse him while he adjusts. On the other hand, visits to the residence and phone calls are encouraged during the acclimation period and after. We only ask that you call the residence prior to your arrival. When your son moves in, it is inevitable that new routines will be developed in the new environment. For example, a student may have had trouble sleeping at home, we may find that they will sleep through the night without a problem once they move in. Conversely, the opposite can happen as well and we have no true way of knowing how a student will handle the change until they move in. As a parent, you should be prepared for this. After the 30 day assessment period, home visits can begin.
What kinds of activities will my daughter engage in outside the residence?
Your daughter will have the opportunity to engage in a number of activities in the community. Community outings are tailored to the likes of the students going. Our residences regularly take trips to a wide range of places like a Long Island Duck’s game, bowling, or to a movie. Our agency and agencies like ours are governed by the Office for People with Developmental Disabilities (OPWDD). OPWDD has minimum requirements for the amount of times a student should be going into the community. In the CRP, we strive to go above and beyond the minimum requirements and have as much community integration as possible. In any residence there are bound to circumstances that can affect the number of outings available such as behavioral and staffing concerns. Safety is always of utmost concern and we will never knowingly put our students or staff in a situation that is likely to become unsafe.
My son engages in aggression towards others and I am concerned for the safety of those around him. How will you ensure the safety of my son and his peers?
Staff members are always diligent about protecting students but not every situation is avoidable. In the event that a student is injured, for any reason, we will notify the parents of that child. All incidents are recorded and reviewed by a committee that looks for any trends or systematic concerns that may be present.
Will the goals my son is working in school be the same goals he has in the residence?
As a residential school placement we work hand in hand with the school to meet the specific needs of your son. With this collaboration, there may be some goals that are the same across settings, but not all are feasible. In the residence, we are in the perfect setting to help teach some of the independent living or self care goals, like completing laundry or showering that are not practical for the school setting.
How does my daughter become eligible for residential placement?
A residential referral must come from the child’s CSE (committee on special education) meeting. From the approved CSE a referral packet is sent out by district. A referral to DDI/CRP includes approval from both the Children’s Residential Program and the Children’s Day Program. Once a packet is received the CRP Social Worker reviews and assesses if the child is appropriate for our program. Several different factors go into assessing if a child is appropriate ex; diagnosis, age etc. Once a packet is deemed appropriate a screening team reviews the packet as well and if deemed appropriate a screening with the family and child is held.
As part of the requirements for completion of her doctoral degree in psychology at Hofstra University, Ms. Juliana LaRossa worked with DDI families while conducting her dissertation research. A summary of her results follows: Previous studies demonstrated that parents of children with ASDs report significantly higher levels of parenting stress compared to parents of children with other disabilities and parents of neurotypical children (Hall & Graff, 2011). Therefore, the current study aimed to learn what factors may worsen reported levels of parenting stress experienced by families of children with ASDs and what factors may lessen the levels of parenting stress experienced by these families. With further understanding of what these factors may be, interventions can be developed, standardized, validated and then implemented to lessen the levels of stress experienced by parents of children with ASDs. These interventions can also serve as a means to strengthen and bond the relationships of parents of children with ASDs and this may also indirectly lower levels of parenting stress.
The relationship between early intervention (EI), communication skills, conflict resolution skills, life satisfaction, marital satisfaction, family cohesion and parenting stress were examined in the current study. Different hypothesized and modified path analysis models were tested using a statistical program called AMOS in order to identify the model that best accounted for the relationship among these variables and parenting stress in couples who have children with ASDs. Repeatedly across the various models, the statistically significant relationship between communication skills and conflict resolution skills was supported. This consistent finding strongly suggests the strength between the variables of communication skills and conflict resolution skills. When couples report higher levels of communication skills, they are better able to resolve conflicts as they possessed communication skills that allowed for the effective communication and resolution of problems.
The relationship between high levels of family cohesion and lower levels of parenting stress was also found, if the couples also reported higher levels of communication skills, conflict resolution skills and marital satisfaction. When couples reported higher levels of connectedness and bond, they are more likely to also possess greater abilities to communicate and resolve conflicts with one another. With the ability to communicate effectively and resolve conflicts in an adaptive manner, couples feel more satisfied in their marriages, as there are no unaddressed topics or issues that cause tension within the couple. Couples who reported higher levels of marital satisfaction also reported lower levels of parenting stress as marital satisfaction protects against high levels of parenting stress as higher levels of marital satisfaction are associated with happiness and stability within relationships. When the marital satisfaction between the parents of children with ASDs suffers, this has been found to be related to distress and more negative parent-child interactions (Stoneman & Gavidia-Payne, 2006).
These findings demonstrate the areas that interventions need to be developed and implemented in families and couples of children with ASD's. These interventions should aim to improve the communication skills, conflict resolution skills and family cohesion of these couples which would in turn increase marital satisfaction which would lower levels of parenting stress.
Developmental Disabilities Institute (DDI) is pleased to offer customized educational opportunities for service providers, families, and members of the community who are seeking knowledge in the principles and practices of applied behavior analysis. Our training in Applied Behavior Analysis (ABA) was developed by a team of experts in the fields of autism and applied behavior analysis, including professionals who have achieved the prestigious board certification in behavior analysis. Applied Behavior Analysis is the leading evidenced-based approach for treating the learning and behavioral challenges associated with autism and related disabilities. ABA has been endorsed by the U.S. Surgeon General and the New York State Department of Health, as it has hundreds of peer-reviewed empirical studies supporting its efficacy.
Experienced professionals will introduce participants to the principles and practices of Applied Behavior Analysis and its application to socially significant behaviors for the purpose of facilitating positive quality of life. DDI’s training in Applied Behavior Analysis offers an extensive curriculum that is both comprehensive and flexible. Instruction may be held at virtually any site including but by no means limited to our many Long Island locations. Training can be tailored to meet educational and scheduling needs,at an affordable price.
Training in ABA is ideal for: school district teachers, Para-professionals, and administrators; afterschool program staff, respite workers, coaches; daycare employees; employment supervisors and families.
For more information
Dr. Michael Romas
99 Hollywood Drive
Smithtown NY, 11787
DDI will soon be serving 24 additional residential school students in our Little Plains campus in Huntington. Four big new beautiful classrooms are being added to our school in Huntington where the children’s residences are also being built. The new wing will include separate boy’s and girl’s training lavatories, a training laundry room, a new playground and a large office space for some of our additional staff, such as behavior specialists. Pictures of the new residences and school wing under construction are attached.
We are eager to share our expertise in providing a coordinated residential school with our newest students and are passionate about our mission to implement outstanding and innovative individualized programs to all we serve.