Beyond Requesting

Diane Ellis, Sarah Lach, Patricia Bedell Author

03/16/2021 Added

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Beyond Requesting

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[00:00:00.290]Welcome to our presentation titled,
[00:00:02.680]Beyond Requesting - Using Visuals to Build Communication
[00:00:06.220]Throughout a Child's Day.
[00:00:08.070]My name is Diane Ellis,
[00:00:09.830]and I am currently an early childhood facilitator
[00:00:12.440]for Bellevue public schools.
[00:00:14.420]My background is an early childhood special education,
[00:00:17.330]and I have worked with children on the autism spectrum
[00:00:20.410]for almost 40 years in a variety of roles.
[00:00:23.520]My co-presenters are Sarah Lach and Patricia Bedell,
[00:00:26.650]who introduce themselves
[00:00:27.770]prior to their portion of the presentation.
[00:00:31.180]This presentation is meant to be for those people
[00:00:33.280]beginning to implement visual supports and strategies
[00:00:36.400]with children who have autism.
[00:00:38.480]The use of visuals to request items are using visuals
[00:00:42.112]as a picture schedule to support a child's understanding
[00:00:45.920]are pretty common these days.
[00:00:47.930]However often teams are not using visuals
[00:00:50.710]to go beyond these early language skills.
[00:00:53.670]Communication is happening throughout a child's day.
[00:00:56.720]So we hope to give you some ideas
[00:00:58.730]on how to support a child's communication
[00:01:01.120]and related social skills in their daily routines.
[00:01:07.930]Here are the objectives we identified
[00:01:10.000]as the focus of this presentation.
[00:01:12.230]As a beginning level workshop,
[00:01:14.690]we will share some information on the benefits and types
[00:01:17.630]of visual supports that can be implemented with students
[00:01:20.930]in a variety of settings, as well as communicating functions
[00:01:24.100]that go beyond just requesting.
[00:01:26.510]We will hopefully conclude
[00:01:27.670]with an opportunity to use visual strategies
[00:01:30.490]to embed communication in a classroom routine,
[00:01:33.340]in order to encourage engagement and participation.
[00:01:40.350]As you may know,
[00:01:41.183]visual supports have proven to be an effective intervention
[00:01:43.980]and are considered evidence-based strategies.
[00:01:46.800]Some of the strategies we'll share may not be new to you
[00:01:49.920]but we hope to guide you on how to utilize
[00:01:52.450]these visual strategies throughout a child's day.
[00:01:55.830]Typically, we would show a multitude of materials
[00:01:58.000]for you to see in person, but since we are virtual,
[00:02:01.670]we have included photos of some of these strategies
[00:02:03.917]and we'll discuss them in more detail
[00:02:06.320]as we go through the presentation.
[00:02:09.150]Trish will start out discussing ways
[00:02:10.730]visuals can support a child's work all communication skills,
[00:02:14.190]receptive language, expressive language,
[00:02:16.490]and pragmatic or social language.
[00:02:19.000]She will discuss a variety of community functions
[00:02:21.160]that can be supported using visuals.
[00:02:24.180]Then Sarah will show ways to use visuals
[00:02:26.170]to support a child's behavior, which is often tied
[00:02:29.230]to their ability to be effective communicators.
[00:02:32.330]I will end with a discussion on some simple ways
[00:02:34.800]to engage a child in learning
[00:02:36.630]and to support their participation.
[00:02:42.022]Okay, so good afternoon.
[00:02:45.230]I'm Trish Bedell,
[00:02:46.350]and I'm going to talk to you this afternoon
[00:02:49.250]about communication.
[00:02:51.590]I am an SLP, I work for the Bellevue public schools
[00:02:56.380]in assistive technology,
[00:02:58.690]and have a real passion for early learners
[00:03:03.090]and children with complex communication needs.
[00:03:08.130]If you check out the dictionary,
[00:03:10.200]Merriam Webster defines communication as a process
[00:03:14.180]by which information is exchanged between individuals.
[00:03:18.700]A key part of that definition is the, between, part.
[00:03:24.210]It is a social behavior which occurs between people.
[00:03:30.670]Babies learn at a very early age to gain social interactions
[00:03:35.220]through their communicative behaviors
[00:03:37.670]and they are reinforced by those social interactions.
[00:03:42.260]Attributing, meaning to communication acts
[00:03:45.220]is an important part of all communication development.
[00:03:49.980]It happens whenever the adult assigns meaning
[00:03:53.320]to behaviors that they observe.
[00:03:55.860]Those behaviors include facial expressions, gestures,
[00:04:00.410]vocalizations, body movements.
[00:04:04.620]Many children on the spectrum, however,
[00:04:07.320]don't respond to the social reinforcement in the same way,
[00:04:12.210]so they may need more tangible reinforcement.
[00:04:16.650]The easiest way then to teach basic communication,
[00:04:20.400]is through requesting.
[00:04:22.540]Requesting gives the communicator a tangible reward,
[00:04:27.110]commenting is more social.
[00:04:29.490]In fact, requesting is the only form of communication
[00:04:33.280]which directly benefits the communicator
[00:04:36.100]because they get back what they have requested.
[00:04:39.740]However, we must move beyond basic requesting.
[00:04:46.020]Our students with complex communication needs
[00:04:49.210]must be able to,
[00:04:52.300]not just request but comment, label,
[00:04:55.460]ask and answer questions, accept or reject what's offered,
[00:05:00.150]relay information, express emotions,
[00:05:03.560]share personal experiences and so much more.
[00:05:07.490]Initially we may need to prompt
[00:05:10.850]or provide a model for imitation,
[00:05:14.630]but the goal is truly spontaneous initiation,
[00:05:21.100]spontaneous communication.
[00:05:23.860]So here's the key question, is talking always communicating?
[00:05:30.500]No.
[00:05:32.350]If there is no one listening
[00:05:34.930]when Susie Q recites the lines from her favorite movie,
[00:05:38.940]she is talking but she is not communicating.
[00:05:43.770]If there's no one listening
[00:05:45.440]when Susie Q rocks back and forth at her desk saying,
[00:05:48.977]"I want drink, I want drink," over and over.
[00:05:52.560]She is talking, but she's not going to get her needs met.
[00:05:57.500]There are many reasons, good reasons,
[00:06:01.130]for using visuals for communication
[00:06:04.640]for our young children with complex communication needs.
[00:06:09.390]Many children who struggle with communication
[00:06:12.070]experience frustration,
[00:06:14.080]which then in turn leads to problem behavior.
[00:06:18.580]By providing a visual option for communication,
[00:06:22.970]we can address the function and control the antecedents
[00:06:26.990]to set them up for successful communication.
[00:06:31.040]Because visuals can be accessed without an adult present,
[00:06:34.860]they are an easier form of prompting to fade
[00:06:38.500]than verbal prompts and models.
[00:06:41.050]And by becoming independent of adult prompting,
[00:06:44.450]that student is more empowered
[00:06:46.910]to become a truly independent communicator.
[00:06:51.480]Research shows us that a large majority
[00:06:54.350]of what we understand in any communicated interaction,
[00:06:59.760]comes from the nonverbal cues that we use,
[00:07:03.750]our facial expression, our body posturing and gestures,
[00:07:08.410]with the next highest meaning
[00:07:12.300]coming from our non-verbal vocals, our intonation,
[00:07:18.010]only about 7% comes from the actual words that we use.
[00:07:24.330]Another reason for using visuals
[00:07:27.120]is that visual information is more stable
[00:07:30.970]than oral information.
[00:07:33.050]So using visuals for comprehension
[00:07:35.450]give students more time to process the information
[00:07:40.420]and leads to better understanding
[00:07:42.670]and retention of our instructions.
[00:07:46.150]That also lessens their stress,
[00:07:48.570]makes them more available for learning.
[00:07:51.630]Using visuals also helps the adults by providing,
[00:07:57.180]or helps them to provide a consistent,
[00:08:00.620]organized and non-intrusive support.
[00:08:04.590]They're using the same language and terminology.
[00:08:09.070]By going beyond just having the students request,
[00:08:13.090]we can facilitate and encourage peer interactions.
[00:08:18.510]So let's take a look at some examples here.
[00:08:24.260]Here are some examples of some communication boards.
[00:08:28.650]Students using the simple printed boards
[00:08:31.520]may be very early communicators
[00:08:34.450]who still require adult support,
[00:08:37.160]or maybe students with strong language skills
[00:08:41.500]but severely decreased speech intelligibility.
[00:08:46.470]And they just need a quick way to repair communication
[00:08:50.360]breakdowns from time to time.
[00:08:52.790]Boards may be as simple the sensory choice board
[00:08:57.770]in the top corner, or as complex as the core board
[00:09:03.360]with the fringe flip vocabulary that is pictured below.
[00:09:09.260]The sensory choice board may be stationary,
[00:09:13.200]visual support posted in the sensory area of the classroom,
[00:09:18.450]while the core choice board, or the core board,
[00:09:21.330]is likely more portable and intended to go with the user
[00:09:25.961]from place to place as they go throughout their day.
[00:09:32.660]Here we have a couple examples of some topic boards.
[00:09:36.480]These topic boards can provide ideas for language,
[00:09:40.010]things to talk about during a specific activity,
[00:09:43.680]or they can be used to give the listener context
[00:09:47.150]for a student who is still developing
[00:09:49.520]intelligible speech patterns.
[00:09:53.030]The parts of speech are color coded
[00:09:55.450]which helps support grammar development.
[00:09:58.470]I can cue a young communicator when I want them to use
[00:10:02.150]a blue word and a yellow word to describe an object,
[00:10:06.260]cold French fries, yuck.
[00:10:12.780]This is one of my favorite, low tech supports.
[00:10:18.740]Although many people mistakenly use the word PECS,
[00:10:23.440]to refer to any form of low tech picture communication,
[00:10:28.630]even calling schedules and the symbol cards themselves PECS.
[00:10:34.360]PECS is actually a registered trademark name
[00:10:37.710]for a specific process for teaching communication.
[00:10:41.730]It was developed by Andy Bondy and Lori Frost, in 1985.
[00:10:47.930]It is the number one best way I know,
[00:10:52.620]to teach an early communicator
[00:10:54.790]to initiate communicative interactions
[00:10:58.460]and to engage with a listener.
[00:11:01.240]These are very critical skills,
[00:11:03.440]because as I mentioned previously,
[00:11:05.730]communication does not happen
[00:11:08.010]unless there are at least two individuals.
[00:11:12.540]The PECS protocol begins at phase one
[00:11:16.300]with simply teaching a student to exchange a card
[00:11:21.940]for a desired item.
[00:11:24.280]Motivation for that item is either captured in the moment
[00:11:27.660]or contrived by setting up situations
[00:11:30.400]to encourage the child, to initiate a request.
[00:11:34.730]It then continues through five more phases,
[00:11:38.760]with the end goal of being able to converse with others.
[00:11:42.580]It covers using attributes, commenting, answering questions
[00:11:48.770]and taking conversational turns.
[00:11:52.120]The focus is not just teaching language
[00:11:54.780]but teaching how to be a functional communicator.
[00:12:02.630]Can I talk for just a minute here about the advent of iPads.
[00:12:07.010]Choice boards, topic boards, score boards,
[00:12:09.590]picture vocabulary becomes instantly
[00:12:12.430]more robust and dynamic when it's placed on an iPad
[00:12:15.980]with a speech generating app.
[00:12:18.220]However, we need to continue to be very intentional
[00:12:24.130]about choosing a system for the child
[00:12:26.260]with complex communication needs.
[00:12:29.300]For the brief period that mobile devices such as iPad
[00:12:34.280]and other touchscreen tablets have been available,
[00:12:37.920]they have proven to be an amazingly popular item,
[00:12:42.590]and have quickly become very useful and effective tools
[00:12:46.330]for education, entertainment and communication.
[00:12:51.600]For students with complex communication needs,
[00:12:55.280]there are now a large number of powerful AAC apps available,
[00:13:01.060]that transform this readily available tablet
[00:13:04.300]into a speech generating AAC device.
[00:13:08.370]Advantages of using the tablets as AAC tools
[00:13:11.930]are obvious and numerous.
[00:13:14.270]However, as with any other augmentative strategy,
[00:13:18.540]one size does not fit all.
[00:13:22.400]And despite their instant and undeniable appeal,
[00:13:26.270]iPads will not be an appropriate choice
[00:13:28.980]for all students in all situations, it all depends.
[00:13:34.900]It is not a magical tool that will turn your child
[00:13:38.570]into a communicator just by handing it to them,
[00:13:41.430]it takes a lot of instruction and practice.
[00:13:45.320]When selecting a communication system
[00:13:47.930]for a struggling communicator,
[00:13:50.140]we need to consider the context, the communication partners,
[00:13:54.770]and the overall goals.
[00:13:56.320]You know, the who, what, when, where, why, how,
[00:13:59.320]of the situation.
[00:14:01.680]Ultimately iPads and apps are amazing tools,
[00:14:07.230]but they are only one of the many tools
[00:14:09.810]in an AAC tool box.
[00:14:16.840]One critical function of language
[00:14:19.100]is being able to request assistance.
[00:14:22.990]I have used the PECS help hand,
[00:14:26.670]or simply a line drawing on a communication card.
[00:14:32.830]Often I use some basic signs for help or toilet,
[00:14:37.920]because that system, the communicators hands,
[00:14:41.770]is always available.
[00:14:44.490]If you use communication cards for this,
[00:14:47.370]you'll want to have a plan for ways
[00:14:49.580]to make those important cards available
[00:14:52.900]across all environments.
[00:14:56.050]Tobii Dynavox sells sloppy bracelets you see pictured here,
[00:15:02.470]or you could easily make your own.
[00:15:07.160]When teaching generalized words for requesting
[00:15:11.610]such as help and more,
[00:15:14.130]it is important to also work on more specific words such as,
[00:15:21.750]open, or juice,
[00:15:27.446]help, shoe.
[00:15:30.110]You might want to use a sentence strip
[00:15:32.640]to request those more specific items
[00:15:36.520]and make your individual's communication
[00:15:41.670]more clear and understandable.
[00:15:47.880]Visual communication is also important
[00:15:51.080]for receptive language development.
[00:15:54.170]And as we communicate information
[00:15:56.660]to our students using a visual,
[00:15:59.450]we are modeling that form of communication for them,
[00:16:03.160]so that they can tell us what they want need, think or feel.
[00:16:07.730]A visual schedule is a common visual tool
[00:16:10.920]used to build language, receptive language.
[00:16:14.810]After all, we all use schedules to remind us
[00:16:18.320]of our important commitments.
[00:16:21.060]Schedules are used to give the user
[00:16:24.100]a way to understand the sequence of their day,
[00:16:27.880]they also build symbolic understanding.
[00:16:31.640]When I first introduce an emergent communicator
[00:16:34.810]to a schedule, I teach them to match the symbol
[00:16:38.750]to a symbol in the location where they are to go.
[00:16:42.320]They don't have to know what that symbol means,
[00:16:45.260]they just have to know that it is the same.
[00:16:48.930]Once they make that connection between the match
[00:16:53.690]and they understand the meaning of the symbols,
[00:16:56.435]then we can advance
[00:16:58.200]to gradually more sophisticated schedules,
[00:17:01.640]until eventually they are able to use
[00:17:03.890]the same type of schedule as their peers.
[00:17:08.510]For students who are very rigid thinkers,
[00:17:11.480]reliance on a visual schedule,
[00:17:13.740]rather than on a memorized routine, can teach flexibility.
[00:17:19.120]I use a surprise icon.
[00:17:22.220]The surprise icon teaches the student
[00:17:24.840]to wait for the teacher to give a direction
[00:17:28.210]related to a different activity.
[00:17:31.950]Initially, I introduce it as a pleasant activity.
[00:17:36.060]So maybe the surprise is,
[00:17:38.140]we're going to have an extra snack today.
[00:17:43.100]Something that the student really would be interested
[00:17:47.570]in changing their routine for.
[00:17:51.530]Once they're comfortable
[00:17:52.880]with surprise being something positive
[00:17:56.370]that they really like,
[00:17:58.090]then I introduce it with more neutral activities,
[00:18:01.610]and then finally, with the less pleasant ones.
[00:18:06.530]This example of a schedule
[00:18:08.240]also shows ways that you can build choice into a schedule
[00:18:12.670]using the "go to a choice board" icon or card,
[00:18:19.250]or embedding the choices side by side in the schedule.
[00:18:28.420]Here are some examples of First Then schedules.
[00:18:32.980]For a very early learner,
[00:18:35.050]you may need to start with a short, simple schedule.
[00:18:39.450]Often the second activity in our First Then schedule
[00:18:43.330]is a more preferred task,
[00:18:45.080]which encourages the learner to complete the first task.
[00:18:49.880]My rule of thumb for providing a schedule of events,
[00:18:56.760]is that it'd be at least one activity longer
[00:19:01.050]than the learner is able to plan ahead in their mind.
[00:19:05.280]This way they aren't filling in the blank
[00:19:08.180]with their own plan and then are disappointed
[00:19:11.660]when that is not what happens.
[00:19:14.220]However, it is better to implement
[00:19:18.230]part of a schedule consistently then to try and do it all
[00:19:24.370]and be very inconsistent with your implementation.
[00:19:31.600]Similar to schedules, here's another way to use visuals
[00:19:35.320]to communicate to your learner.
[00:19:37.710]Using visual directions
[00:19:40.520]to help students understand the steps of a task
[00:19:44.890]or to learn a new routine,
[00:19:47.930]is more concrete and more permanent than vocal directions,
[00:19:52.980]and it reduces the need for constant adult prompting.
[00:19:59.700]Here are examples of a mini schedule,
[00:20:05.800]or a task board for home use.
[00:20:08.730]So it prompts the child through common home routines,
[00:20:13.010]such as the bedtime routine or the morning routine,
[00:20:18.470]the toothbrushing routine, some of those common
[00:20:25.970]regularly occurring routines within the home.
[00:20:31.410]Wait, is another concept that every child needs to learn.
[00:20:36.820]A wait card can be used as a tangible exchange
[00:20:42.020]for teaching wait.
[00:20:43.990]When the learner wants something,
[00:20:46.670]edibles are great for practicing this.
[00:20:49.560]So let's pretend my learner wants a snack,
[00:20:52.950]I can first give him the wait card
[00:20:55.660]and then exchange it for the snack item.
[00:20:59.180]And I start with just a few seconds of wait time.
[00:21:03.050]So my learner says, "I want popcorn."
[00:21:07.690]And I give him the wait card, and I tell him, "Wait."
[00:21:11.280]And then almost immediately, one, two, three,
[00:21:14.630]I exchange that card for the desired popcorn.
[00:21:20.010]Maybe just one or two kernels of popcorn
[00:21:24.400]so that he has that opportunity to practice again,
[00:21:28.860]depending on the time and the situation.
[00:21:32.660]Over time, I'm gradually going to increase
[00:21:36.510]to longer wait periods.
[00:21:40.450]And then finally, some pragmatic
[00:21:43.950]or social language supports.
[00:21:47.710]As I mentioned on my first slide,
[00:21:49.830]communication ultimately is social, it takes two.
[00:21:55.200]For some learners, a visual conversational script
[00:21:59.570]or conversation map helps them understand
[00:22:03.330]the give and take of communication.
[00:22:05.790]So this one by Joe Gusma gives the general outline
[00:22:10.820]of a simple conversation with some choices.
[00:22:15.810]Other times I have spelled it out more specifically
[00:22:19.100]for an identified routine
[00:22:20.880]such as checking out a book at the library.
[00:22:24.280]I say this, I can expect my conversation partner
[00:22:28.200]properly the library and to say this,
[00:22:30.380]and then I say this and they say this.
[00:22:35.411]Our learners also need to understand
[00:22:39.070]the non-verbal discourse skills such as orienting your body
[00:22:46.850]towards the communication partner.
[00:22:53.220]What is appropriate vocal volume,
[00:22:57.620]the eye gaze dance.
[00:23:03.180]and our students need to be able to request
[00:23:09.300]and comment and label and all of those different functions.
[00:23:13.730]Sometimes I have taken,
[00:23:17.090]I'm sure you've heard of the hidden curriculum,
[00:23:20.070]I've had my learners develop little notebooks
[00:23:25.820]of their own social secrets,
[00:23:28.140]the hidden curriculum pieces that they have learned
[00:23:31.910]about how to interact with others.
[00:23:35.490]And they keep their own social secrets book
[00:23:41.280]that talks about all of those rules,
[00:23:45.800]those social rules of how to interact.
[00:23:49.960]Okay, so next step,
[00:23:52.520]Sarah is going to talk about some social emotional supports.
[00:23:59.420]Good afternoon, my name is Sarah Lach,
[00:24:01.450]I have been an early childhood special education teacher
[00:24:04.210]at Bellevue public schools for the last three years.
[00:24:06.830]Prior to that, I worked in various behavior programs
[00:24:10.350]working with students
[00:24:11.230]that had high rates of intense behaviors,
[00:24:16.100]some of them having autism.
[00:24:17.760]So I'm gonna talk with you a little bit today
[00:24:19.920]about social emotional supports
[00:24:21.630]that we can use for students with autism.
[00:24:24.300]Social emotional learning encompasses
[00:24:25.930]so many different things.
[00:24:27.550]It is behavior and learning how to regulate that,
[00:24:30.750]it's making good choices about social and personal behavior.
[00:24:34.930]It's forming relationships with other people
[00:24:37.280]and developing empathy
[00:24:39.220]so that you can respect the thoughts and feelings of others.
[00:24:43.740]Our students with autism often need very specific steps
[00:24:48.500]on how to do those things.
[00:24:49.580]So when we look at behavior supports
[00:24:52.370]they need visual cues that have very specific steps
[00:24:56.270]on ways to calm themselves or how to ask for certain things
[00:25:01.570]and then reinforcement them to continue those skills.
[00:25:05.550]Also, those students with autism often have difficulty
[00:25:09.050]managing all the sensory information
[00:25:10.400]that's coming into their body
[00:25:11.550]and have difficulty calming themselves.
[00:25:13.180]So it's important for us to teach them regulation strategies
[00:25:16.580]to help manage those emotions.
[00:25:20.490]And then finally they need direct instruction
[00:25:23.870]in that hidden curriculum or those social situations,
[00:25:26.660]so that they know how to respond appropriately
[00:25:29.810]in those situations.
[00:25:32.410]Let's talk a little bit
[00:25:33.243]about visual reinforcement systems for behavior.
[00:25:37.300]So this is a token economy of sorts,
[00:25:40.470]it's a very great visual representation
[00:25:43.390]of how much work has to be completed by a student
[00:25:46.300]before a reinforcement is going to be delivered to them.
[00:25:49.560]I would highly recommend using a reinforcement menu for this
[00:25:52.730]because it gives students choices
[00:25:55.300]about what they might want to work for.
[00:25:56.760]And in doing that, you're also reducing the satiation factor
[00:26:00.690]and giving them lots of choices
[00:26:02.370]so that they don't get overwhelmed with one choice
[00:26:04.660]and it stops working.
[00:26:08.280]Also, this is a great way to teach kids to wait
[00:26:11.930]and to delay gratification,
[00:26:13.344]so that they know that the re reinforcement is coming
[00:26:16.260]and they know exactly what they have to do to get there.
[00:26:20.830]Behavior supports, I love these cue cards,
[00:26:23.160]I use them all the time in my classroom.
[00:26:24.760]I have one hooked to the pants pocket
[00:26:29.020]on my pants all the time.
[00:26:31.370]I prefer the staggered ones,
[00:26:32.880]only because they're very quick and easy,
[00:26:35.150]I can see exactly which one I wanna show to a student
[00:26:37.620]and I can flip it open directly to that one
[00:26:40.450]without having to use any verbal cues for that student.
[00:26:43.800]Verbal prompts are very difficult to fade,
[00:26:46.400]and so having those cue cards for students
[00:26:49.210]where you can just show them the picture
[00:26:51.520]or point to it, once you get it open is very, very helpful.
[00:26:59.080]When you are creating these cards
[00:27:00.700]you can use pictures or you can use symbols.
[00:27:03.870]You just kind of have to figure out
[00:27:05.080]what works best for your students.
[00:27:09.070]Visual timers are also a great visual cue
[00:27:11.777]and a behavior cue card for kids.
[00:27:15.070]In preschool, I use a timer almost every day
[00:27:19.640]for a warning for cleanup for center time.
[00:27:22.950]There are many, many kids in my classroom
[00:27:25.010]that benefit from having those warnings
[00:27:26.570]and being able to see that the time is counting down
[00:27:29.010]on our timer so that they know
[00:27:30.360]that the time to clean up is coming.
[00:27:35.450]These are some self-regulation cue cards.
[00:27:38.650]As you can see, they have the steps to help them calm down.
[00:27:42.470]So the one on the left says, "Stop and Think"
[00:27:44.430]and then it says, "Make a choice",
[00:27:45.670]and there's some choices of pictures that they can choose
[00:27:47.610]to help their body regulate.
[00:27:49.330]And then once they get done with that,
[00:27:51.840]it tells them to say that they're ready to work.
[00:27:54.000]The other one's very, very similar.
[00:27:56.940]It's a great card that says, "I'm feeling upset.
[00:28:00.230]What can I do to help myself calm down?"
[00:28:01.800]And there's some choices of things that they can try there.
[00:28:05.080]Cue cards are so helpful for students
[00:28:07.410]in helping regulate their emotions.
[00:28:08.790]Because as we said, or as I said a little bit ago,
[00:28:11.940]a lot of times students with autism
[00:28:13.500]have a very difficult time regulating those big emotions
[00:28:16.930]and knowing what to do to help calm their body down.
[00:28:19.760]So giving them some very prescribed steps
[00:28:21.940]helps them know what to do next.
[00:28:28.770]This is another great self-regulation strategy.
[00:28:32.264]It's teaching students to ask for a break in a calm way.
[00:28:35.730]The important thing to remember
[00:28:36.770]about teaching any self-regulation strategy to any student,
[00:28:39.730]but students with autism,
[00:28:41.340]is you have to teach them how to use it while they are calm
[00:28:44.800]and before the inappropriate behavior occurs.
[00:28:47.540]Because as behavior escalates,
[00:28:52.330]then so does the ability to process words,
[00:28:57.260]so does the ability to be able to think rationally.
[00:29:02.580]Those things decrease, the ability to process language
[00:29:05.360]and to think rationally decreases
[00:29:06.750]as our behavior and our emotions escalate.
[00:29:09.420]So it's important for us to teach students
[00:29:11.650]how to appropriately ask for a break while they are calm
[00:29:14.480]before they will ever need to have to use it.
[00:29:19.060]You need to do it during a period of time
[00:29:20.440]when there are no demands being placed on them,
[00:29:23.530]to help them understand what the break card is for,
[00:29:27.490]how they can use it to get that need met,
[00:29:32.230]when they're calm before the inappropriate behavior occurs.
[00:29:36.280]The break is not a timeout, it's not a consequence,
[00:29:40.230]it's teaching students to recognize
[00:29:42.450]that their body is dysregulated,
[00:29:45.140]and to be able to say, "I just need a minute,"
[00:29:48.520]and to get a little bit of a break
[00:29:51.720]from whatever it is that they're doing.
[00:29:53.900]There's lots of ways to set up these self-regulation cards
[00:29:56.390]in teaching kids to ask for a break.
[00:29:58.860]You can have a specific number of breaks
[00:30:01.550]that they can take each day,
[00:30:02.800]you can have it tied to an activity,
[00:30:05.760]you can have a certain period of time
[00:30:07.730]and then they get a break.
[00:30:10.070]You can, if you're using visuals,
[00:30:12.300]visual schedules with a student,
[00:30:15.130]you can even have break cards put in there,
[00:30:17.270]so they have a set break that they can take.
[00:30:22.610]The nice thing about these,
[00:30:24.270]is that you might start with a high number of breaks
[00:30:26.450]that students might need,
[00:30:27.700]but as they get better at regulating their emotions
[00:30:30.340]and being able to recognize that they need that break,
[00:30:32.310]you can start to decrease the number of breaks
[00:30:34.070]that they will need each day.
[00:30:40.840]I use something similar to this.
[00:30:42.730]I have a calming area in my classroom,
[00:30:44.260]which is a great place for students to go
[00:30:45.740]when they are feeling those big emotions,
[00:30:47.190]that are feeling overwhelmed.
[00:30:49.590]This is a visual scale, a five-points visual scale.
[00:30:52.710]So the one on the left just has pictures of faces.
[00:30:57.070]It's great for kids to be able to point to the face
[00:30:59.890]that they're feeling.
[00:31:01.040]It's a good visual to put with their emotions.
[00:31:06.910]The one on the right has a few more words.
[00:31:09.960]It gives them what it looks like at that level
[00:31:13.620]what it might feel like and what they can do.
[00:31:16.020]We talk a lot in preschool
[00:31:17.240]about how feelings feel in our body
[00:31:19.810]and helping students raise their awareness,
[00:31:23.380]to what does mad look like
[00:31:25.150]and how does that feel in my body?
[00:31:26.370]Oh, when I'm mad, my face turns red and my body feels hot.
[00:31:32.400]So helping draw their attention to those things
[00:31:34.020]so they can start to recognize
[00:31:36.110]when they are starting to feel mad.
[00:31:39.630]These self-regulation skills help them
[00:31:42.210]to verbalize their feelings a little bit more
[00:31:45.730]and be able to have some strategies
[00:31:48.753]that they can use to help them calm.
[00:31:53.460]Power cards can be used in lots of different situations.
[00:31:56.960]You can use them when students lack the understanding
[00:32:00.850]of their own emotions to clarify choices that they can make
[00:32:05.140]when they are feeling dysregulated,
[00:32:09.070]you can use them to teach cause and effect.
[00:32:10.810]They're a great visual reminder
[00:32:12.120]of behavioral expectations also.
[00:32:15.690]These are great because you can use the student's interest
[00:32:20.960]to make the power card.
[00:32:22.830]So if you have a student that's really interested
[00:32:25.280]in the Hulk, you can make a power card with the Hulk
[00:32:28.930]and talk about things that the Hulk wants to see them do
[00:32:32.240]or want some to remember.
[00:32:33.340]Just kind of like the Dora one down there in the corner.
[00:32:37.660]You can have the steps and a brief script if they need it,
[00:32:41.140]you can put it on the back of the card.
[00:32:43.600]It's great to help them remember that they do have choices
[00:32:47.600]and how they can use those choices.
[00:32:54.760]So the Pyramid Model is a framework
[00:32:58.250]of evidence-based practices in a tiered approach
[00:33:01.460]to provide support for students
[00:33:03.490]to create positive relationships
[00:33:07.470]in a positive environment for students.
[00:33:09.600]So in the tiered approach, that first tier is supports
[00:33:15.620]that you are providing to all students in your classroom.
[00:33:17.960]So in my classroom I have a visual schedule
[00:33:21.130]that we use every day for every activity
[00:33:24.230]that is for the whole class.
[00:33:26.310]So then the next tier is tier two,
[00:33:28.610]where you can provide targeted services
[00:33:30.730]to those students who need a little bit more support.
[00:33:32.600]So in my classroom that might mean
[00:33:35.740]that I have a student who has a broken down version
[00:33:39.450]of our big schedule.
[00:33:40.320]So they know that when we go to do our opening,
[00:33:44.980]that means that we're going to come in,
[00:33:48.760]we're gonna sing our song,
[00:33:50.110]we're gonna do our feelings check-in.
[00:33:52.210]We listen to our announcements,
[00:33:53.410]we say the pledge of allegiance.
[00:33:56.450]But they need those targets steps,
[00:33:57.870]so they know when are we done with this activity?
[00:34:02.710]And you can use some more intensive services
[00:34:06.040]for those kiddos who need them.
[00:34:09.660]The Pyramid Intervention Center,
[00:34:12.420]this is a link for the website.
[00:34:14.340]They have tons of resources, social stories,
[00:34:17.240]they have posters that you can put up in your classroom
[00:34:20.470]to use as cue cards.
[00:34:22.450]They're a great resource for supports in your classroom.
[00:34:26.620]There again is the website for the Pyramid Model
[00:34:30.090]and the SEFEL's website.
[00:34:32.110]They have a myriad of resources for (keyboard clicking),
[00:34:37.100]they have a myriad of resources
[00:34:38.540]for families and for teachers.
[00:34:42.900]So Tucker the Turtle
[00:34:44.510]is something that I use in my classroom.
[00:34:48.120]They have a little song and a finger play
[00:34:49.690]that you can do with students.
[00:34:50.920]There's a social story,
[00:34:53.760]they have little reminder cards
[00:34:55.720]that you can put in your calming area.
[00:34:59.510]It's just a really great resource and website
[00:35:02.320]for you to use in your classroom
[00:35:03.480]and to share it with family.
[00:35:04.550]They have a tucker,
[00:35:06.210]the turtle takes time to tuck and think at school,
[00:35:09.200]they also have a home version,
[00:35:10.520]they come in English and Spanish.
[00:35:12.930]There's just some really great resources
[00:35:14.520]for helping families manage with some of those behaviors
[00:35:17.140]and to manage some of those behaviors in our classrooms.
[00:35:21.920]These are some of the visuals that are available
[00:35:24.230]on the SEFEL's website and the Pyramid website.
[00:35:28.930]This one down here in the corner
[00:35:30.950]is all the steps for calming down
[00:35:32.770]that "Tucker the Turtle" uses,
[00:35:33.860]it goes with the social story that's available.
[00:35:37.280]There's a social story
[00:35:38.340]for using your words and taking turns.
[00:35:41.680]And that's a great one to read for a student
[00:35:43.670]that's having a hard time expressing themselves.
[00:35:46.810]Here are steps for solving problems in a solution kit.
[00:35:51.037]The solution kit is something that I use in my classroom
[00:35:53.840]for all of my students.
[00:35:54.910]It's posted in all of my centers.
[00:35:57.210]There's just a bunch of different little pictures
[00:35:58.690]that we talk about how they can solve some of the problems
[00:36:01.710]that they might encounter in the classroom.
[00:36:05.120]So I would encourage you to check those out.
[00:36:08.140]One other thing that I wanna touch on
[00:36:11.443]before I turn this back over to Diane, are social stories.
[00:36:15.890]Social stories are a great way
[00:36:18.330]students identify social situations
[00:36:21.340]and how to respond appropriately.
[00:36:23.750]They're very structured, they're consistent.
[00:36:27.703]It helps to predict the actions and assumptions
[00:36:31.160]of other people and how you can respond to those situations.
[00:36:35.295]There is a prescribed format for these social stories.
[00:36:39.460]They use descriptive sentences,
[00:36:41.340]they are written from the perspective
[00:36:42.810]of the person reading them.
[00:36:45.480]They give students directions on what to do
[00:36:49.920]and then they use some control sentences.
[00:36:52.010]So this one says, "When I'm polite,
[00:36:53.800]I know people wanna help me and I'll be happy."
[00:36:58.350]You can use symbols or you can use pictures or drawings
[00:37:04.740]to help facilitate those situations as well.
[00:37:08.840]I'm gonna turn that back over to Diane.
[00:37:12.530]So far, we have covered some ways to use visuals
[00:37:15.510]for a variety of communicating functions,
[00:37:18.350]starting with some beginning expressive skills
[00:37:20.570]and receptive skills beyond requesting.
[00:37:24.000]Then Sarah continued moving on
[00:37:25.780]to social and behavior skills, which affect communication.
[00:37:30.980]And she talked about how using visuals
[00:37:32.670]can help support those areas of development.
[00:37:36.860]Now, we want to continue to move beyond requesting,
[00:37:39.450]to how to use what we know about visuals
[00:37:43.030]to encourage cooperation, participation and engagement.
[00:37:48.770]Visuals can be used to help children learn
[00:37:50.810]to initiate greetings and maintain conversations.
[00:37:54.710]Simple visual scripts using pictures or words
[00:37:58.060]can help a child navigate the perplexing social world.
[00:38:02.480]Students with autism may need to utilize
[00:38:04.790]some conversational scripts, communication systems
[00:38:08.550]and behavior supports in order to maintain a conversation.
[00:38:12.870]As we discuss some simple ideas
[00:38:16.490]to encourage engagement and participation,
[00:38:19.350]it is important to include visuals
[00:38:21.560]that will support a child's ability to read and use
[00:38:25.350]nonverbal communication skills.
[00:38:27.910]Often children with autism will have difficulty reading
[00:38:31.320]these social cues and can misread situations.
[00:38:35.670]Instruction on communication and behavior skills
[00:38:38.680]must include recognition
[00:38:40.360]of a child's non-verbal skills and abilities.
[00:38:44.680]Here are a couple examples
[00:38:46.130]of how to use visuals to support conversations.
[00:38:50.000]It is possible to purchase
[00:38:51.350]a commercial conversations scripts or create your own.
[00:38:56.410]This top picture shows an example of one program
[00:38:59.280]that may be useful to you, as you begin to implement
[00:39:02.040]some visual strategies in your classroom
[00:39:05.080]and provide some visual scripts.
[00:39:08.190]The one on the bottom is a teacher-made visual support
[00:39:11.220]that goes through three simple steps
[00:39:13.520]for a brief conversation.
[00:39:16.150]Often children will need multiple times
[00:39:18.460]to practice these skills across environments,
[00:39:21.400]people and situations.
[00:39:23.920]One of the difficulties with supporting a student
[00:39:26.120]during conversational interactions
[00:39:28.500]it's in knowing how the other person
[00:39:31.550]or the communicated partner will respond to your student.
[00:39:35.870]That is why these kinds of supports
[00:39:37.570]may need to be somewhat open-ended.
[00:39:40.080]And initially you would want to script
[00:39:42.230]the responses of the conversational partner.
[00:39:45.440]Embedded in these scripts should be visual supports
[00:39:48.320]to remind students is some of the pragmatic language skills,
[00:39:52.080]including taking turns in a conversation
[00:39:54.680]and staying on topic.
[00:39:58.500]Here's some other examples
[00:39:59.720]of how to build visuals into a child's routine.
[00:40:03.160]The first is a placement from a Susan Berkowitz,
[00:40:06.600]that you can use as a visual support
[00:40:08.540]to encourage conversations during mealtimes.
[00:40:11.700]The pictures for communication
[00:40:13.140]are arranged around the outside of the placement,
[00:40:15.610]so they are available as a child eats
[00:40:18.520]and will encourage them to interact with others.
[00:40:21.860]We also have visual cues to help organize the plate
[00:40:24.590]and utensils that promotes a child's independence.
[00:40:28.650]The other picture is an activity binder
[00:40:30.510]developed by the Pyramid Educational Consultants,
[00:40:33.460]to use with their PECS program.
[00:40:35.520]This binder is available at the different centers
[00:40:38.530]or during the specific learning activities
[00:40:40.760]to support a child's use of communication
[00:40:44.160]to interact during these routines.
[00:40:46.890]Teachers can make their own activity binders or boards
[00:40:49.990]to use in their classroom or with a specific child.
[00:40:53.970]It's extremely important for a child to have access
[00:40:57.320]to communication supports during their entire day
[00:41:01.320]including interactions with peers without an adult present.
[00:41:07.090]It is vital to include peers in any intervention.
[00:41:10.630]When you are working on interactions,
[00:41:12.520]engagement and participation.
[00:41:14.930]Developing a social group of peers
[00:41:16.870]to support a child with autism,
[00:41:19.110]can be the most effective way
[00:41:21.050]to support and include him in the activities.
[00:41:26.620]One way to do this is training peers
[00:41:29.370]and actually using visuals to help cue the peer
[00:41:32.940]on what their response should be.
[00:41:36.150]The teacher may use the peer visuals to cue the peer
[00:41:39.610]to use the appropriate visual prompt
[00:41:41.500]for the students with autism.
[00:41:43.980]The goal is to fade the need for teacher
[00:41:46.590]to be part of the interaction
[00:41:48.610]in order to avoid altering that peer dynamic.
[00:41:54.150]There are many considerations involved in choosing a peer.
[00:41:57.680]Most important, the peer needs to be able and willing
[00:42:01.320]to interact with a student with autism.
[00:42:04.230]I have found this doesn't necessarily mean
[00:42:06.470]that it's the star student in the classroom.
[00:42:09.870]Sometimes other students may be more accepting
[00:42:12.770]of the behavior responses
[00:42:14.270]the student with autism may display.
[00:42:17.935]OPS and Bellevue public schools,
[00:42:19.640]collaborate to offer a summer peers on training
[00:42:23.030]with using visuals.
[00:42:25.050]We recruit peers who are willing to spend a morning meeting
[00:42:28.060]and interacting with one of the students
[00:42:29.920]in the training during the summer.
[00:42:32.280]It's amazing to see how many of our peers
[00:42:35.160]look forward to this every year.
[00:42:37.610]I've seen the same outcome when working with students
[00:42:40.440]in an upper elementary grade using circle friends process
[00:42:43.830]to build peer interactions,
[00:42:45.860]they want to be able to interact
[00:42:47.710]with their friends who have autism.
[00:42:50.490]If you can get these interactions
[00:42:51.700]happening early in a child's life,
[00:42:53.940]these friendships have a better chance
[00:42:55.860]of a long-term success.
[00:43:00.470]These examples of visual cues,
[00:43:02.700]could be for the student with autism to use
[00:43:05.910]or actually could be the visual cues
[00:43:08.280]this teacher will use with a peer to help them learn
[00:43:11.830]how to use the student with autism visual supports.
[00:43:17.000]A teacher may hold a visual cue up to the peer
[00:43:19.240]that prompts the peer to point the students visual prompt
[00:43:23.670]for taking turns or to ask a question.
[00:43:26.610]Once the peer is comfortable
[00:43:28.290]using the student with autism visual supports,
[00:43:31.920]the teacher can fade themselves from the interaction.
[00:43:35.170]The ultimate goal is to have interaction
[00:43:37.340]be independent of an adult.
[00:43:43.740]Literacy skills are important for all students to develop
[00:43:46.710]so they can engage in learning in the school setting.
[00:43:49.770]Finding ways to support a student with autism's engagement
[00:43:53.010]in literacy activities is key.
[00:43:56.650]One way to make language and literacy visible
[00:44:00.080]by using pull off symbols as prompts in the story,
[00:44:03.870]and adding symbol-supported text.
[00:44:07.810]As the teacher reads the story in a group,
[00:44:10.360]holding off the story prop
[00:44:12.130]can help bring a student's attention back to the story.
[00:44:16.010]The prompts and symbol supported texts
[00:44:18.640]can also be used to engage the student
[00:44:21.010]in telling or reading the story.
[00:44:24.990]The prompts and simple supportive texts can be used
[00:44:27.750]to engage the student in telling or reading the story.
[00:44:31.770]The visual prompts and simple supportive texts
[00:44:34.160]helps the student internalize the story
[00:44:36.720]and stay engaged in the activity.
[00:44:42.210]Adaptive books with visual props and symbol supported texts
[00:44:45.730]can be commercially bought or teacher-made.
[00:44:48.920]In this topic sample, symbol supportive text
[00:44:51.860]has been added to the story, "Polar Bear, Polar Bear".
[00:44:55.540]As the teacher reads the book, she can point to each symbol,
[00:44:59.320]have this student pointing to the symbol,
[00:45:01.490]or pull off the symbols to bring to the student,
[00:45:04.310]to re-engage them in the activity.
[00:45:07.950]Below that is a teacher-made story prompt
[00:45:10.150]for the book, "The Very Hungry Caterpillar".
[00:45:12.770]Young and early learners often needs hands on activities
[00:45:16.830]to engage them in the reading activity.
[00:45:19.220]These prompts can be used later
[00:45:20.870]for the student to learn to retell the story
[00:45:23.150]or put the story in sequence.
[00:45:26.450]The one on the right
[00:45:27.300]is a commercially purchased storyboard from pecs.com.
[00:45:31.320]This can be used for students who are on a basics of PECS
[00:45:34.900]as they begin to learn how to comment.
[00:45:37.637]"Brown bear, Brown bear" and other repetitive books
[00:45:40.530]are great for teaching a skill
[00:45:42.460]and engaging children in the story.
[00:45:45.620]With these supports the student can answer questions
[00:45:48.260]or comment on the story by using the symbols
[00:45:50.890]and sentence strip.
[00:45:55.300]Here are a couple of examples of how storyboards
[00:45:57.600]can be made to help a student retell the story.
[00:46:01.280]On the left is a storyboard for "The Three Little Pigs".
[00:46:04.300]And include some prompts for the student to use.
[00:46:07.170]On the right is another example of how a storyboard
[00:46:09.780]can be set up to provide visual supports to a student
[00:46:13.360]who retelling the story, "The Little Red Hen".
[00:46:17.030]Both of these examples are teacher-made,
[00:46:19.900]but again, there are commercially prepared boards available,
[00:46:23.490]such as the "Brown bear Brown bear" one
[00:46:25.450]I shared on the last slide.
[00:46:27.960]It could be used to retell that story.
[00:46:34.170]Music is a great way to engage children in learning,
[00:46:37.050]and again, visual strategies are a way
[00:46:40.600]to support their participation for a child with autism.
[00:46:45.140]Similar to the adaptive books,
[00:46:46.840]visual prompts and symbol-supporting texts
[00:46:49.410]can help a child engage and participate in songs
[00:46:52.610]and retelling the stories.
[00:46:54.960]The one on the left is a favorite
[00:46:56.540]of most preschool children, "The Wheels on the Bus".
[00:47:00.910]The one on the right is a commercially prepared song board
[00:47:03.870]for several familiar early childhood finger plays.
[00:47:07.390]It includes puppets as well as the pictures
[00:47:10.110]and a sentence strip.
[00:47:11.890]It is available at pecs.com
[00:47:13.900]but it teacher could make a similar one,
[00:47:16.500]and make or use other props instead of the finger puppets.
[00:47:24.870]A teacher and team should work together
[00:47:27.200]to plan how to use visual supports throughout a child's day,
[00:47:31.560]in order to support their interactions,
[00:47:33.800]engagement, and participation.
[00:47:36.755]The first step is to look at each routine or activity
[00:47:39.570]and then do a task analysis.
[00:47:41.850]Write the tasks down into smaller steps if needed.
[00:47:45.300]The routine must be something that a student can do
[00:47:48.260]or complete in order to avoid a high level of frustration
[00:47:52.230]or overwhelming them if it is difficult task.
[00:47:56.860]Next determine the vocabulary and skills needed
[00:48:00.130]within that routine.
[00:48:01.960]One way to determine vocabulary,
[00:48:04.100]is to look at the routine itself
[00:48:06.030]and what items or activities are needed and relevant
[00:48:09.730]from the student's perspective.
[00:48:12.980]After that you determine what visuals
[00:48:14.980]or symbol supports might be needed for the student.
[00:48:19.140]Then you are able to engineer the environment
[00:48:21.410]and determine if reinforcement may be needed.
[00:48:24.290]For some students,
[00:48:25.670]completing the routine itself is reinforcing,
[00:48:28.670]but those who do not find that reinforcing in and of itself,
[00:48:33.000]will need to have alternate reinforcement set up for them.
[00:48:37.690]Remember, this should be from the student's perspective,
[00:48:41.620]then you sabotage the routine,
[00:48:43.610]if needed to help motivate the student to interact.
[00:48:46.900]Remove a piece of puzzle, give snack without a spoon,
[00:48:50.720]and other strategies, where it will motivate them to engage.
[00:48:59.100]Here's an example
[00:48:59.950]for the Picture Exchange Communication System or PECS,
[00:49:03.310]of how to build communication throughout the day.
[00:49:06.300]We have listed the activity routine
[00:49:09.300]and started a list of skills, communication skills.
[00:49:13.210]When we break you into groups,
[00:49:14.560]what we want you to do is to look at each activity
[00:49:17.330]and see you can identify what visual supports you could use
[00:49:20.690]for students for your classroom.
[00:49:23.230]I encourage you to consider additional communication skills
[00:49:26.630]not listed and how visuals can support the student
[00:49:29.850]for that routine or skill.
[00:49:32.580]On the next slide,
[00:49:33.430]I will discuss the plan for our breakout groups
[00:49:35.530]and how we'll use this form
[00:49:37.220]that you should have received in the handout
[00:49:39.210]or with the PowerPoint.
[00:49:42.610]For our group activity, hopefully you have a copy
[00:49:45.080]of the "Communication Throughout the Day" worksheet.
[00:49:47.640]But if no one in your group has one,
[00:49:49.780]one of us will be joining you.
[00:49:51.830]Don't forget to remember to plan
[00:49:53.610]for pragmatic or social language,
[00:49:56.260]as you look at communication.
[00:49:58.820]When done, we hope has some time
[00:50:01.067]for you to share any ideas that your group identified.
[00:50:04.310]You will pause the presentation at this time,
[00:50:08.970]so that we can break into that group.

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