More Than A Score
11/5/17
More Than A Score Language and Communication Assessment in Minimally Verbal and Pre-Verbal Students
Vicki Clarke, MS CCC-SLP
Minimally Verbal a definition: small number of words or learned phrases words are used in limited contexts may limit words to specific functions (ex: requesting) low rate of spoken language may include scripted, trained phrases (“I want …”) may include non-functional echolalia speech.
Forms of Assessment
Testing
Watching
Listening
1
11/5/17
Standardized TestingLimitations
“Less Than 55” Phenomena Unfamiliar Environment Lack of Access to AAC Lack of Appropriate Peers for Comparison
Autism Specific Challenges
Kasari, C., Brady, N., Lord, C. and Tager-Flusberg, H. 2013. Assessing the Minimally Verbal School-Aged Child With Auti
The Value of Standardized Tests Justify professional time & money for services
IEPs
The Value of Standardized Tests- Guide Treatment Comparison of Aided and Spoken Language Skills & Comprehension
2
11/5/17
Language Concepts to Consider Noun Categorization Understanding of Grammatical Organization Understanding of Question Forms Single Word Vocabulary Understanding Single Word Expression: Aided and Unaided Progress in Single Word Expression
Vocabulary Evaluation Instruments
Comprehensive Language Evaluations Specific Skills Assessment & Comparison of Results Over Time
Not for Age Equivalencies or Standard Scores!
3
11/5/17
Modifications to Standardized Test Administration
Get Everyone Comfortable
Allow All Forms of Communication • Provide sufficient wait time to allow for response latency
Reporting Standardized Test Results Use Raw Scores to show growth over time Use Subtests/Test Items to Inform Need for Further Info Avoid Age Equivalencies Report Standard Scores Cautiously Document Testing Accommodations Carefully When Reporting
Don’t Forget!
Consider related developmental assessments Gather Medical History Assess Speech & Sound Production
4
11/5/17
Speech, Language and…. Blah blah blahdeeblah
Language
Speech
…Expressive Communication “Communication is a range of purposeful behavior which is used with intent within the structure of social exchanges, to transmit information, observations, or internal states,
or to bring about changes in the immediateenvironment.” Susan Stokes: “Developing Expressive Communication Skills for Non-verbal Children With Autism” under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction. “ accessed at https://www.cesa7.org/sped/autism/nonverbal/non11.htm June 7 2017
Expressive Communication purposeful intent social exchanges transmit information changes in the immediate environment
5
11/5/17
How Do We Communicate? PurposefulBehavior Pre-Intentional Behavior: facial expression vocalization eye gaze motor movements
Pre-Intentional Communication
facial expression & orientation
How Do We Communicate? PurposefulBehavior Intentional Behavior: gestures to draw attention gestures to convey meaning symbolic gestures conventional gestures distinct & differentiated vocalization
6
11/5/17
Intentional Gestures
Reject
Commenting & Requesting
Intentional Gestures: Requesting
Requesting Action using vocalizations, pointing and pushing to indicate
Intentional Gestures
You decide, what is Chad’s message?
7
11/5/17
How Do We Communicate? PurposefulBehavior
Symbolic Communication Representative Objects Picture Symbols ASL Spoken/Written Words
Symbolic Communication
Object Symbols on Voice Output Device
Pointing to Symbols
Symbolic Communication: AAC Device
Spelling with Voice Output Talking with Symbols
8
11/5/17
Intent
“expressive communication is a function of the child’s intent.” Burkhart & Porter, 2010
Key Concept
NO true expressive communication occurs without the child intending to do something
How Do We Know They Mean It? performs behavior only when others are present individual directs the behavior toward another person individual waits for a response from his behavior and then stops when responded to individual persists or tries another way if not responded to individual reacts if she’s given something different than what she requests Rowland, Charity 2013
9
11/5/17
How Do We Teach Intent?
Motivation Provides Intent without motivation, intent is external and requires more cognitive effort to perform Linda Burkhart
Every Move Counts, Clicks and Chats
Sensory Assessment
Every Move Counts, Clicks and Chats
Sensory Assessment visual, auditory, proprioceptive, gustatory, vestibular tactile information
10
11/5/17
Every Move Counts, Clicks and Chats Sensory Assessment
Every Move Counts, Clicks and Chats Summary of Sensory Responses
Key Concept
Communication is SOCIAL. There must be at least 2 people involved or it’s not communication.
11
11/5/17
Social Interaction Request Social Routine Solicit Attention Affirm Greet
Acknowledge Request Permission
Transmit Information Relay Information
Request Information Comment
Transmit Information Relay Information
Request Information
Comment
12
11/5/17
Joint Attention Acts
Why Do We Communicate? Or to Control the Environment
Behavioral Regulation
Obtain RequestObject RequestAction Refuse Protest Deny Reject
13
11/5/17
Tools for Assessing Early Language
Every Move Counts-3: Communication Assessment
Communication Matrix
Communication Sampling & Analysis
Every Move Counts, Clicks and Chats Communication Assessment
Communication Matrix
www.communicationmatrix.org
14
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
15
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
16
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
17
11/5/17
Communication Sampling & Analysis
Communication Sampling & Analysis
Goal Setting
More Abstract Language Forms
More Communication Functions
18
11/5/17
Goal Setting
Thank You! Please feel free to connect with me! Vicki Clarke www.mydynamictherapy.com [email protected]
Facebook: Dynamic Therapy Associates, Inc Twitter/Instagram: AACchicks
19
More Than A Score Language and Communication Assessment in Minimally Verbal and Pre-Verbal Students
Vicki Clarke, MS CCC-SLP
Minimally Verbal a definition: small number of words or learned phrases words are used in limited contexts may limit words to specific functions (ex: requesting) low rate of spoken language may include scripted, trained phrases (“I want …”) may include non-functional echolalia speech.
Forms of Assessment
Testing
Watching
Listening
1
11/5/17
Standardized TestingLimitations
“Less Than 55” Phenomena Unfamiliar Environment Lack of Access to AAC Lack of Appropriate Peers for Comparison
Autism Specific Challenges
Kasari, C., Brady, N., Lord, C. and Tager-Flusberg, H. 2013. Assessing the Minimally Verbal School-Aged Child With Auti
The Value of Standardized Tests Justify professional time & money for services
IEPs
The Value of Standardized Tests- Guide Treatment Comparison of Aided and Spoken Language Skills & Comprehension
2
11/5/17
Language Concepts to Consider Noun Categorization Understanding of Grammatical Organization Understanding of Question Forms Single Word Vocabulary Understanding Single Word Expression: Aided and Unaided Progress in Single Word Expression
Vocabulary Evaluation Instruments
Comprehensive Language Evaluations Specific Skills Assessment & Comparison of Results Over Time
Not for Age Equivalencies or Standard Scores!
3
11/5/17
Modifications to Standardized Test Administration
Get Everyone Comfortable
Allow All Forms of Communication • Provide sufficient wait time to allow for response latency
Reporting Standardized Test Results Use Raw Scores to show growth over time Use Subtests/Test Items to Inform Need for Further Info Avoid Age Equivalencies Report Standard Scores Cautiously Document Testing Accommodations Carefully When Reporting
Don’t Forget!
Consider related developmental assessments Gather Medical History Assess Speech & Sound Production
4
11/5/17
Speech, Language and…. Blah blah blahdeeblah
Language
Speech
…Expressive Communication “Communication is a range of purposeful behavior which is used with intent within the structure of social exchanges, to transmit information, observations, or internal states,
or to bring about changes in the immediateenvironment.” Susan Stokes: “Developing Expressive Communication Skills for Non-verbal Children With Autism” under a contract with CESA 7 and funded by a discretionary grant from the Wisconsin Department of Public Instruction. “ accessed at https://www.cesa7.org/sped/autism/nonverbal/non11.htm June 7 2017
Expressive Communication purposeful intent social exchanges transmit information changes in the immediate environment
5
11/5/17
How Do We Communicate? PurposefulBehavior Pre-Intentional Behavior: facial expression vocalization eye gaze motor movements
Pre-Intentional Communication
facial expression & orientation
How Do We Communicate? PurposefulBehavior Intentional Behavior: gestures to draw attention gestures to convey meaning symbolic gestures conventional gestures distinct & differentiated vocalization
6
11/5/17
Intentional Gestures
Reject
Commenting & Requesting
Intentional Gestures: Requesting
Requesting Action using vocalizations, pointing and pushing to indicate
Intentional Gestures
You decide, what is Chad’s message?
7
11/5/17
How Do We Communicate? PurposefulBehavior
Symbolic Communication Representative Objects Picture Symbols ASL Spoken/Written Words
Symbolic Communication
Object Symbols on Voice Output Device
Pointing to Symbols
Symbolic Communication: AAC Device
Spelling with Voice Output Talking with Symbols
8
11/5/17
Intent
“expressive communication is a function of the child’s intent.” Burkhart & Porter, 2010
Key Concept
NO true expressive communication occurs without the child intending to do something
How Do We Know They Mean It? performs behavior only when others are present individual directs the behavior toward another person individual waits for a response from his behavior and then stops when responded to individual persists or tries another way if not responded to individual reacts if she’s given something different than what she requests Rowland, Charity 2013
9
11/5/17
How Do We Teach Intent?
Motivation Provides Intent without motivation, intent is external and requires more cognitive effort to perform Linda Burkhart
Every Move Counts, Clicks and Chats
Sensory Assessment
Every Move Counts, Clicks and Chats
Sensory Assessment visual, auditory, proprioceptive, gustatory, vestibular tactile information
10
11/5/17
Every Move Counts, Clicks and Chats Sensory Assessment
Every Move Counts, Clicks and Chats Summary of Sensory Responses
Key Concept
Communication is SOCIAL. There must be at least 2 people involved or it’s not communication.
11
11/5/17
Social Interaction Request Social Routine Solicit Attention Affirm Greet
Acknowledge Request Permission
Transmit Information Relay Information
Request Information Comment
Transmit Information Relay Information
Request Information
Comment
12
11/5/17
Joint Attention Acts
Why Do We Communicate? Or to Control the Environment
Behavioral Regulation
Obtain RequestObject RequestAction Refuse Protest Deny Reject
13
11/5/17
Tools for Assessing Early Language
Every Move Counts-3: Communication Assessment
Communication Matrix
Communication Sampling & Analysis
Every Move Counts, Clicks and Chats Communication Assessment
Communication Matrix
www.communicationmatrix.org
14
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
15
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
16
11/5/17
Communication Matrix
Communication Matrix
Communication Matrix
17
11/5/17
Communication Sampling & Analysis
Communication Sampling & Analysis
Goal Setting
More Abstract Language Forms
More Communication Functions
18
11/5/17
Goal Setting
Thank You! Please feel free to connect with me! Vicki Clarke www.mydynamictherapy.com [email protected]
Facebook: Dynamic Therapy Associates, Inc Twitter/Instagram: AACchicks
19
