Speech Generating Devices
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TashaCase Study: TashaTasha is a 14-year-old high school student with pervasive developmental disorder-not otherwise specified (PDD-NOS). She is included with her general education peers during physical education, music, and art classes. She participates in a reading group with other special education students that focuses primarily on functional reading skills. She likes this group of students and considers two of them her friends. Tasha enjoys younger children, and she works as an assistant in the district's early childhood classroom once a week. Tasha is verbal, but she does not like speaking to unfamiliar adults and can be difficult to understand when utterances are out of context. She uses two- to four-word utterances to make requests, protest, call attention, and greet. She understands language at a level that falls just below the average range for her age. She has tried a variety of the district's SGDs in the past, but was easily discouraged and preferred using her limited verbal language instead. Tasha's case manager, Miss V, recognizes Tasha's potential for work and recreation in the community; however, she wishes that Tasha could verbally participate with peers, teachers, and community members. She wonders if Tasha would be able to use a dynamic screen SGD, and if having access to a larger vocabulary and the opportunity to create novel sentences might be motivating to her. Miss V calls Tasha's mother to talk about her ideas and to let her know that they can borrow a device from state agencies if they decide to move forward with the SGD. Tasha's mother is confused and does not understand why Tasha needs a machine to talk for her when she can talk for herself. When Miss V explains that she thinks that the device would be especially useful when Tasha interacts with less familiar people, her mother agrees that the SGD might be beneficial. After Miss V acquires a VantageTM system from a state educational agency, she shows it to Tasha. She tells her that the device is like a computer that she can take anywhere. Together, they download some of Tasha's favorite music onto the device's MP3 player. Miss V introduces Tasha to the home screen and shows her how to use the device to make requests and get attention. They sit together and develop an "introduction page" with Tasha's name, the names of her pets, and some of her favorite things. They take the device to her reading group where she practices introducing herself. Her classmates think the device is cool, and Tasha is happy to show it off. Miss V allows Tasha to tinker with the device much of the week so that she begins to figure out the layout. When Tasha has time with an assistant or the speech therapist, they work with the device together - finding vocabulary and practicing how to use it with unfamiliar people through role play. For example, they found pictures of clothing and then used them to compliment each other and some peers with the phrases "Nice shirt!" and "Cool shoes!" Miss V decides that it would be good for Tasha to use the VantageTM during her job at a preschool where Tasha's tasks are usually nonverbal: passing out paintbrushes, organizing the block shelf, and wiping tables. The preschool teacher and Miss V decide to let Tasha call the children to line up after circle time. Miss V and Tasha practice in the resource room and then bring the VantageTM to the classroom. Initially, Miss V cues Tasha to call a child; however, Tasha catches on quickly and continues through the class: "Line up, Eric. Line up, Chrissa. Line up, Juan." The children are thrilled and love to be called on by Tasha. Miss V hopes that as Tasha's comfort with the VantageTM increases, she will be able to call on learners based on attributes, as their teacher does (e.g., "Line up if you are wearing red"). The preschool teacher and Miss V identify other jobs where Tasha could use the SGD, such as reading simple books to a small group, and asking a group question at circle time and then calling on individual children to answer it. Back at school, Tasha's reading group often goes on community outings where they have opportunities to read functional material like menus and environmental signs. Tasha begins bringing the VantageTM on these outings and becomes more comfortable ordering food from and asking questions of unfamiliar people. If she cannot find the appropriate word on her VantageTM, she says it out loud to the accompanying adult who usually understands and can help her locate the word on the device (since she is familiar with Tasha). These community-based learning opportunities help Tasha generalize use of the VantageTM to environments outside of school. Tasha also brings the VantageTM home occasionally, but her mother reports that she does not always use it because she and Tasha understand each other without the device. However, her mother has been able to meet Tasha for lunch in the community and has been delighted to see Tasha order her food independently. Tasha's team has been so pleased to see her use more verbal exchanges with the SGD. She is able to use the VantageTM in the workplace, in her classroom, and in the community. She uses it to request items, information, and actions, as well as to describe objects and activities and use social greetings. Because Tasha was already verbal, Miss V identified ways to make using the device meaningful. By letting her download music, show it off to her friends, and call it a laptop, Miss V made the device work for Tasha. Rather than seeing it as something to slow her down, it became a cool way for Tasha to expand her communicative abilities. SummaryAccording to evidence-based studies, SGDs are effective in increasing expressive language for learners with ASD who struggle with verbal speech. To ensure that SGDs are used successfully, professionals must consider many factors, such as vocabulary that is motivating to learners and how many symbols learners are able to discriminate at one time. Environments where the device will be used should include familiar routines and activities that are arranged to encourage communicative opportunities. The device should be used across multiple environments and with different communicative partners to encourage generalization and maintenance of skills. When teaching learners to use an SGD, cues and other prompting strategies should be as subtle as possible so that learners do not become dependent upon teachers and other practitioners during communicative exchanges. Frequently Asked Questions (FAQs)Q. Won't the use of an augmentative and alternative communication (AAC) device such as an SGD interfere with verbal development? A. This is a common concern; however, the available research indicates that AAC, such as an SGD, facilitates verbal language by improving interaction or providing a model for speech (Cress, 1997; Romski et al., in press). Learners will likely use the most effective and efficient means of communication available to them. Q. Does a learner need to be at a certain cognitive stage before an SGD is tried? A. In the past, many educators felt that learners needed to have certain cognitive prerequisites before they were considered candidates for AAC such as an SGD. However, this is no longer a common assumption. Early AAC intervention builds on a learner's current behaviors/actions/gestures, which are then shaped into skills for communication. AAC training does not depend on the ability to understand abstract symbols or use complex devices. Clearly, the learner's cognitive abilities will influence decision-making about which device is most appropriate. Q. If a learner appears to have no interest in communicating, should an SGD still be used? A. When deciding whether to use an SGD, teachers/practitioners closely examine learners' communicative styles and try to find out what motivates them. Sometimes it is difficult to identify those interests. SGD intervention can be very powerful when teachers/practitioners identify an appropriate device and situations where the learner is motivated to communicate. When an SGD is used, teachers/practitioners should adapt the environment, modify activities, and alter routines to create learning opportunities that are motivating for a given learner. For some learners with ASD, giving them opportunities to request activities that are sometimes discouraged (e.g., self-stimulatory behaviors like fiddling with beads or jumping) may be particularly powerful. Q. What should we do if a learner isn't using his SGD? Should a different device be purchased? A. It is easy to become distracted by costly equipment and technology and forget that people teach communication, not technology. A device will not provide motivation if it is not part of highly motivating communication opportunities. Therefore, poor use of a device is more likely due to the vocabulary that is selected and whether the individual uses it to initiate requests and comments rather than merely respond to questions. Discussion Questions [ Export PDF with Answers | Export PDF without Answers ]
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