AAC Nuts and Bolts
AAC Nuts and Bolts
AAC Nuts and Bolts
Introduction
This module is number 3 in the package “Supporting Communication through AAC” published
by SCOPE. It provides information on the “nitty gritty” of introducing and using AAC. It is
divided into several sections and appendices in the hope that readers can dip into it to find those
aspects that they want to know about now, but can return to it later when the next issue arises.
Section 1 is a Communication Bill of Rights which we hope everyone will subscribe to and
follow when talking to or working with a person who uses AAC to help them communicate.
Section 2 provides some guidance on Do’s and Don’ts when communicating with people who
use AAC.
Section 3 aims to emphasise the importance of having an AAC Policy. Each school, college,
and adult environment should have a policy to guide their implementation of AAC. The AAC
Policy given here is used at Redway School and has supported and encouraged
communication throughout the school.
Section 4 discusses the issues involved in selecting the communication system the child is to
use, and provides lots of pointers to guide and inform your choice.
Section 5 looks at the issues involved in organising and integrating a communication system –
such as selecting vocabulary and what to do to ensure success.
Section 6 provides information on making communication boards and books, and questions to
consider before starting. There are lots of examples on how charts and books can be laid out
assisting speedy access and communication.
Section 7 tells you about the software that will help you to make the charts and books quickly
and easily yet with a professional looking end result.
Section 8 leads you through the maze of Voice Output Communication Aids (VOCAs) which
are available from simple one-message devices to complex systems, both dedicated aids and
computer-based systems that can provide a full range of vocabulary.
Section 1 Section 2
5. request information 5. Do ask me to expand/explain, rather than always asking questions to which I can
only answer yes or no.
6. have access to information 6. Do check that I mean to say what I said, (check it wasn’t a mis-hit) and also
that you have not misunderstood. Just ask “Did you mean ...”
7. be communicated with in a dignified manner
7. Do make sure that I can access my Talker:
8. aids, services and resources ■ is it switched on?
■ is my switch plugged fully in?
■ is the light reflecting on my screen?
9. be listened to ■ is the light shining directly on the screen
■ is my head-pointer upside down!?
10. be included in social interaction ■ is the screen at a good angle?
8. Do talk to me at my eye-level.
11. learn about yourself
9. Do tell me things, it’s boring just to be asked questions.
12. learn about life
10. Do tell me when you want to move my chair – I’m not a sack of potatoes.
1. Don’t ask a question and then answer it yourself, or immediately turn to It is important to have an AAC Policy related to your environment so everyone knows what is
someone else for the answer. expected. It makes the environment’s standards clear for all. The Redway School has kindly
allowed us to include their AAC Policy here as an example of an actual policy in use in a
2. Don’t talk about me in front of me without acknowledging that you are school.
being rather rude – and apologizing.
The Redway School Alternative and Augmentative Communication Policy (AAC Policy)
3. Don’t lean on my device or my wheelchair without my permission. It is important to note at the outset that learning to use any form of alternative and
augmentative communication is difficult. Sophisticated users claim that familiarity with their
4. Don’t anticipate what I’m going to say without asking “Can I have a guess at communication aids can take a number of years.
what you mean?”
Children progress through a number of stages, including accessing the aid, developing
5. Don’t switch off my device because I’m being a pain or you disagree with me. familiarity with the aid, learning the available vocabulary and accepting the aid as an essential
form of communication. Once this point is reached the aid enables the child to take part fully
6. Don’t laugh at my mistakes, it gets disheartening. When you did your best to speak French, in educational and social life.
would you like it if someone laughed at you?
INTRODUCTION
7. Don’t just ask me questions, tell me about yourself or talk about music, television, This policy has been written by the AAC team, consisting of teaching staff and speech and
football, etc. language therapist. It is the result of the training and experience of the AAC team. The
policy details the way alternative augmentative communication enables children to access the
8 Don’t put me on the spot by asking me to demonstrate my Talker unless I whole curriculum in the Redway School.
have agreed in private.
THE NATURE OF ALTERNATIVE, AUGMENTATIVE COMMUNCATION (AAC)
9 Don’t stand behind me when I’m talking to you. Alternative refers to a means of communication other than speech. Augmentative means the
quality of increasing the power of communication. Communication is described as success in
conveying one’s meaning to others. Therefore Alternative, Augmentative Communication can
be defined as any means which replaces speech and/or enhances an individual’s ability to
successfully convey meaning to others.
The Redway School policy is TOTAL COMMUNICATION. This means that pupils are
encouraged to use every available form of communication. This includes the informal
methods of facial expression, body language, gesture and vocalisation, together with formal
communicative methods of words, signs, symbols and electronically aided speech. Pupils are
encouraged to use whatever system they feel is most effective for each given situation.
■ Modules are currently in use for speech output devices and symbol resources. Modules to The information recorded will be used to inform:
teach signing will be developed. ■ teachers about the level of skills achieved by the child in different social situations.
■ After assessment pupils are withdrawn either individually or in small groups to complete the ■ parents of their child’s progress, and show activities that have been covered.
appropriate module with a member of the AAC team. ■ all staff who may be involved in programmes of work.
■ Progress is reviewed at the completion of each module and the pupil either moves to a more
advanced module or experiences a period of consolidation either in class or in a small group. ASSESSMENT
Assessment takes place yearly on the Redway School’s communication assessment. This
CROSS CURRICULAR ISSUES allows progress in the use of AAC to be reviewed in context of the pupil’s functional
All AAC is cross curricular and integrated into pupils’ individual programmes at the communication skills. The assessment leads to the formulation of future plans for AAC
appropriate level. together with general communication skill work.
EVALUATION
This policy will be presented to the governors at the discretion of the head teacher. It will be
reviewed at regular intervals by the AAC team as new information and research becomes
available.
8 Supporting Communication through AAC | Module 3 | Section 4 Supporting Communication through AAC | Module 3 | Section 4 9
2.1 Points to consider when selecting a sign system: For further information see “A Voice and a Choice” by Keith Park, in Special Children Issue
■ Are the signs easy to understand? 153 Feb/March 2003.
■ Ease of making signs, i.e. can the user make the necessary hand shapes?
■ Are one or two hands necessary? See Appendix 3 for a sample Objects of Reference Policy.
■ Are signs symmetrical (both hands doing the same thing) or asymmetrical (one hand in one
position and the other making a different movement in a different position) in relation to the
user? Either of these would be difficult for many children.
■ Which system will meet the user's communication needs in the foreseeable future?
■ Can additional vocabulary be obtained from a similar sign vocabulary? For example, for an
individual using Signalong, additional vocabulary can be taken from BSL.
2.4 Points to consider when using Facilitated Communication Training (FCT): Section 5
■ Does the person have a functional communication system currently in place?
■ Can the person make his/her needs / wants known to others?
ORGANISING/INTEGRATING A COMMUNICATION SYSTEM
■ Do others understand messages communicated?
■ Can the person control his movements? ‘The purpose of a communication display is to arrange language in space so individuals can ...
■ Can the individual tolerate physical contact and support? say what they wish to say as quickly as possible, and can do so with a minimal amount of
■ Can the individual initiate communication? effort’ (Blackstone 1993).
■ Does the individual have any independent access to control technology?
■ Can the individual make choices? Vocabulary Selection
■ Can the person pick up something or point to something spontaneously? Choosing vocabulary for a child who cannot speak is difficult. A child who uses augmentative
■ If you ask the person to pick something up or point to something, is it difficult? communication needs to have:
■ reason for talking
See Appendix 4 for further information. ■ method of talking
■ a sensitive listener.
2.5 Points to consider when using the Picture Exchange Communication Without a large flexible vocabulary, the child who uses AAC will be restricted in what s/he can
System (PECS): say. A small vocabulary:
■ Does the person have a functional communication system currently in place? ■ limits what the child can say
■ Can the person make his/her needs / wants known to others? ■ changes the way the child might talk
■ Do others understand messages communicated? ■ gives responsibility to the communication partner rather than the child.
■ When does the person communicate – spontaneously, responsive or imitative?
■ Does the person have severe physical impairments? Obviously, a child will start with a few signs or symbols that are immediately useful and
■ Does the person have the motor skills to exchange a picture? Can he/she pick up and hold a motivating to her. (These are unlikely to include the basics such as ‘toilet’, ‘drink’ and ‘biscuit’,
picture on his/her own? although choices of drinks e.g. water, juice, milk etc and snacks e.g. biscuit, banana etc, might
■ Does the person have preferred activities and/or toys/objects? be motivating.) The child’s vocabulary should be developed as quickly as possible to provide
■ Are there sufficient staff available to start working with PECS? as wide a vocabulary as s/he can cope with cognitively.
See Appendix 5 for further information. Without a functional vocabulary (i.e. the words the child needs rather than the words we think
the child needs) it is impossible for a child to say what s/he wants to say. Although the child
may not always have access to the exact word s/he wants, with some graphic symbol systems
s/he can use symbols very flexibly. The child who signs has access to personalised gestures.
A useful way to gather vocabulary is to jot down the words the child might need throughout the
day. For example, you may write down the names of favourite toys, people and activities,
favourite drinks, snacks and other food, places to go and things you see when you go out. It is
important to take time to do this so the child has the vocabulary s/he really needs.
In order for a child to learn to communicate and develop vocabulary, learning to use an AAC
system must be fun and functional. Vocabulary must be directed, at least initially, at activities
the child is interested in and motivated by. New vocabulary should be introduced as part of the
activity so that the child sees others using signs and/or symbols and sees the outcomes from
that use. This may make the difference between an AAC system being used functionally or
simply as a teaching tool.
There are lots of games and activities you can play to teach the child what photographs, pictures,
graphic symbols and signs mean. For some ideas, see Module 4 “Games and Activities”.
■ Discuss the child’s communication skills and needs with the relevant people e.g. SLT,
carers, nursery staff.
Aim: to ensure that there is a co-ordinated approach to developing a communication system
for the child. In the Early Years, parents will often take the initiative regarding communication.
12 Supporting Communication through AAC | Module 3 | Section 5 Supporting Communication through AAC | Module 3 | Section 5 13
■ Discuss roles and responsibilities with those involved with the child’s communication ■ Add vocabulary in context and use functionally immediately.
system. Aim: to help the user learn the new vocabulary and use it appropriately.
– Who will co-ordinate the development of the child’s communication system?
– Who will add new vocabulary? ■ Demonstrate the usefulness of signs or symbols.
– Who will create new charts/books? Aim: Each communicative interaction should be rewarded by demonstrating that the
– Who will take the lead on teaching others about the child’s communication system? environment can be controlled through communication.
Aim: to ensure everyone knows who will do what!
■ Include vocabulary from all syntactic categories.
■ Include all those involved with the child in any communication and/or AAC training. Aim: to provide the user with a flexible, usable vocabulary so the user can create
Aim: to make sure everyone involved have an understanding of the communication needs of grammatically correct utterances, if the situation requires it.
the child and how their input can help the child to become an effective communicator. See Appendix 6 for further information
■ Have the child’s communication system available at all times.
Aim: to make sure the child has access to the most appropriate means of communication. ■ Include vocabulary for a range of communicative functions e.g. requesting,
questioning, giving information, initiating conversation.
■ Make sure the child is positioned well in order to use the most appropriate Aim: to give the child as many possibilities for engaging in conversation as possible and to
communication system for the situation. give the child a shared responsibility for conversation and communication.
Aim: to make communication as easy as possible for the child regardless of position. See Appendix 7 for further information
■ Initially, keep language simple.
■ Expand the child’s utterances by using signs, symbols and speech.
Aim: Use simple clear sentences when speaking to the child and repeat the sentences if
Aim: to show the child how she can expand her utterances. All children learn speech this way
necessary, but do not bombard the child with lots of rapid questions. Silence works too!
and children using AAC need to see others using their communication systems.
■ Attract the child’s attention.
Aim: to make sure the child is watching and listening to what is happening. ■ Use additional charts for specific occasions.
Aim: to provide relevant vocabulary for specific situations and topics which would not need to
■ Take time.
be readily available all the time.
Aim: to give the child time to pay attention and to respond. It may take the child time to
organise herself to look and listen and respond. ■ Demonstrate and teach the potential of creating new words by combining symbols.
■ Give choices. Aim: to develop the user abilities to manipulate language effectively.
Aim: to encourage the user to be an active communicator and to have a positive effect on their
environment. Don’t ask lots of questions that require a ‘yes/no’ response. Give the child time. ■ Provide the opportunity to develop self-image.
Aim: To provide an opportunity for the individual to talk about their feelings of being disabled.
■ Provide signs and symbols in the AAC user’s environment i.e. label activities/toys/rooms. This may just be a single comment or may develop into a lengthy and detailed discussion
Aim: to encourage and develop the AAC user’s awareness of her communication system i.e. involving other people.
seeing others using her symbols.
■ Teach the communication partners about the user’s system and how it is accessed.
■ Create a well organised attractive communication system (chart or book) that reflects Aim: to promote efficient, effective communication. It is essential to provide clear instructions
the personality of the user. as to how the AAC user accesses her communication system.
Aim: to create something the child will be proud to use.
■ Teach the child what to do if she is not understood by her communication partner (this
NB: This will include using commercially available tools such as Boardmaker, Writing with
is also described as developing strategies for coping with communication breakdown).
Symbols, Clicker4 or Paper Chart Maker, as well as photographs and pictures. See section 7
Aim: to enable the child to begin to take some responsibility for conversation. This will
for further information.
increase the child’s conversational skills as she realises that her attempts at communication
■ Put the most frequently used vocabulary in the easiest to reach/see locations. are valued as the adult/communication partner responds.
Aim: to make communication as quick and easy as possible for the child.
■ If you cannot understand the child’s message, ask structured questions.
■ Make the print large enough for everyone to read easily, (but not bigger than the symbols!).
Aim: by asking a set of structured questions starting with
Aim: to introduce, from the beginning, the idea that print is important and part of the child’s
‘who’ was/will be involved
communication system.
‘what was it about’
■ Use symbols for things the user cannot already indicate. ‘where’ was it/did it happen
Aim: to expand, not duplicate, the user’s expressive language e.g. allow imaginative use of etc
language, e.g. interesting vocabulary such as ghosts, monsters, doll's names and the use of
colloquial language. ■ Encourage initiation: watch wait
■ Use vocabulary that is highly motivating for the user. ■ Expect signals: look listen
Aim: to promote the user’s interest in the augmentative system. The first sign/symbols
introduced should be those which are highly motivating for the user. ■ Respond.
■ Have fun!!!!!
14 Supporting Communication through AAC | Module 3 | Section 6 Supporting Communication through AAC | Module 3 | Section 6 15
Section 6 ■ Include details about how the child uses the communication book.
Why?: so the communication partner understands how the child access his/her
MAKING COMMUNICATION BOARDS AND BOOKS communication board/book.
“Symbols are useful in helping a child to make sense of routines, to understand what is going ■ Use durable materials e.g. plastic wallets, laminate charts/pages
to happen next, or to make choices and express preferences. If you use symbols to back up Why? Each communication board/book will last longer!
your language, you are giving children two chances to understand – they can hear your words
and see the symbols. The symbols stay there – spoken words disappear!” (Claire Craig, Early ■ Save each chart/page created with chart making software (e.g. Boardmaker, Paper
Years Advisor, East Sussex LEA 2003) Chart Maker, Writing with Symbols 2000, Clicker4).
Why?: Having a backup to the paper based communication board/book is always a good
idea. Creating boards and book on the computer with chart making software will save time
Communication boards/books can be used almost anywhere. They don’t go wrong (and even when the vocabulary is expanded.
if one gets lost, you WILL have a backup, won’t you?)
■ Keep a paper copy – just in case!
Basic Principles Why? Because computers go wrong and we all forget to backup sometimes!
You need to think about the physical skills of the child who will be using the communication
display, such as:
What is a communication chart?
■ Where will the child be sitting when he/she is using a communication chart book?
Will it need to be available in lots of different seats and positions?
Why?: because the child needs to be able to communicate in whatever position or seating
s/he is in. This may mean a communication book to be used when the child is sitting in
supportive seating, but s/he might need a much simpler board to access when lying on the
floor or sitting on the sofa with Mum.
■ How will the child access the symbols? Will he use his hands and point with a finger or
part of his hand? Will he use his eyes and look directly at symbols? Will you need to point to
all the symbols for the child and wait for him to indicate that you have pointed to and said the
word/phrase he wants?
Why?: Access to a communication board/book needs to be as easy as possible with the child
using the minimum of physical effort to indicate the symbols s/he wants.
I use my left thumb to point to the symbols I need to talk to you. Please read the words
above each symbol as I point to it. I also use some gestures.
I will point to one or more symbols and look at you when I have finished. Please repeat
what you think I have said. If you are right I will nod my head. If you are wrong I will shake
my head and I will try again.
I do understand what you say, although sometimes I may not answer immediately!
This is just to tell you a little bit more about how I can talk to you.
I will find the page I want. I will point to the symbols with the middle finger of my right hand.
Please read the words above each symbol as I point to it. I also use some gestures:
please read the page called “ My Signs and Gestures”.
When I have finished, I will look at you. Please repeat what you think I have said. If you
are right I will nod my head and smile. If you are wrong I will shake my head and frown and
I will try again.
■ should contain an index page, so topics can be chosen quickly and easily e.g.
■ should leave space for new vocabulary e.g. ■ will the symbols be arranged? This may depend on how the child will indicate symbols.
blocks columns
pages
Arrangement of symbols
How do we know where to put symbols on a communication chart or book?
There are several things to consider when you plan a communication chart or book, but
remember, the communication chart or book will grow and change as the child learns and
experiments with language.
Section 7 Writing with Symbols and Boardmaker will allow you to remove cell walls, e.g. for worksheets
or for irregular communication board/book layouts:
CHART MAKING SOFTWARE
There are several programs that can be used to make communication boards/books. Some
contain the symbols you may need, but with other programs the symbols have to be
purchased separately.
The most commonly used programs for making communication boards/books are:
■ Boardmaker (Picture Communication Symbols)
■ Writing with Symbols (Rebus, Widgit Rebus, Picture Communication Symbols, Makaton
Symbols)
■ Paper Chart Maker – part of Symbols for Windows suite (Picture Communication Symbols,
Rebus, Blissymbols, and others)
■ Clicker 4 (Picture Communication Symbols)
It is possible to import symbols into any of these four programs; for example, importing Rebus
symbols into Boardmaker even through you cannot purchase Rebus for Boardmaker. You will
need to purchase these additional symbol sets if you need to use them.
PaperChart Maker, Writing with Symbols 2000 and Boardmaker will let you have more than
one symbol in a cell (shown with a pale yellow background):
24 Supporting Communication through AAC | Module 3 | Section 7 Supporting Communication through AAC | Module 3 | Section 8 25
You can scan in pictures to all the programs e.g. the Digivox overlay containing the names of Section 8
all the dogs in the story “Hairy Maclary from Donaldson’s Dairy” (by Lynley Dodds)
VOICE OUTPUT COMMUNICATION AIDS
There is a wide range of electronic communication aids available. To help readers get to grips
with the range available they have been classified as:
■ Simple message devices (digitised speech)
■ Multi-message/multi-level message device (digitised speech)
■ Complex devices (synthesised speech) and the vocabularies available for them.
Digitised speech refers to the use of human recorded speech which can be changed at any
point.
Synthesised speech refers to artificial, machine generated speech. The quality of this is
improving all the time.
Choosing a VOCA
The choice of a VOCA is not a simple decision. It is essential that both professionals and
parents are involved with the individual in the decision making process and if required, further
advice should be sought from a centre specialising in the assessment and use of VOCAs (e.g.
See the ACE Centre website (www.ace-centre.org.uk) for the Comparison of Chart Making communication aids centres, ACE Centres).
Software for further information.
When choosing a VOCA, consider:
■ What is the device to be used for? e.g. is it to be used as a main or additional means of
communication, for attracting attention, all of these functions as well as writing and accessing
the curriculum?
■ Who will take responsibility for co-ordinating the use of the device?
■ Who will take responsibility for programming the device? e.g. adding new vocabulary -
■ Is the individual ambulant or does s/he use a wheelchair or variety of seats? This affects the
weight of the communication aid that will be possible – heavy communication aids are difficult
to carry around but can be attached to a wheelchair – as well as raising the issues of
mounting the device.
■ What is the individual’s level of language and cognitive ability?
■ Is auditory scanning required to support the individual’s visual skills?
■ How is the individual going to access the device (keyboard, optical head-pointer, switches,
joystick etc.)?
■ Which type of speech output (digitised or synthesised) will be most easily understood by the
user?
■ Are languages other than English spoken in the individual’s environment? If so, this may
affect choice of device as digitised speech may be required in order to record speech in the
user’s first language.
■ Should graphic symbols or text be used on the VOCA? If graphic symbols are to be used,
should these be the same as the user’s existing graphic symbol system or should other
graphic symbols available with devices be used (e.g. Minsymbols, Dynasyms)?
■ Is the individual at the stage of pressing one location for a single message or will he be able to
select several symbols to produce more complex and spontaneous messages? Can he/she
combine icons and use a Minspeak based system or does he/she need a hierarchical system
e.g. Dynavox, Personal Communicator (Symbols for Windows), MindExpress?
■ Where is training and support going to be available from?
26 Supporting Communication through AAC | Module 3 | Section 8 Supporting Communication through AAC | Module 3 | Section 8 27
8 – 10 message devices A few years ago a choice of any one of the above components would have fixed all the rest.
e.g. MiniMessage Mate, TechTalk 8, TechScan 8, TechScan 8 Plus, Tash Ultimate, GoTalk 9, Nowadays we are very close to the stage where each component of the system may be
VoicePal Max. chosen independently. This makes it possible to choose each component to suit the individual
and therefore to put together a system which will best meet the needs of each individual user
16 – 20 message display devices – e.g. to hit the jackpot on the fruit machine! This is exciting but also demanding as we have to
e.g.Chatbox, VocaFlex, adVOCAte, Message Mate 20. get to grips with all the separate possibilities of hardware, software, symbol system and
vocabulary. These are discussed in turn below or in other modules as indicated.
32 message display devices
e.g.TechSpeak 32, TechScan 32, TechScan 32 Plus, Macaw 3, Macaw 3+. NB. There is one big caution which must be highlighted to anyone thinking of putting together
these separate components. Do not get into the position where if something goes wrong the
40 – 64 message display devices person selling you the hardware says it’s the fault of the software and the person selling you
e.g. MessageMate 40, Portacom, Springboard, Digivox, Eclipse. the software says it’s a hardware fault! Try to get the hardware retailer to load the software
and take responsibility for it even if you need to get support from the software company in how
(For Sources see Appendix 9) to use features of the software.
COMPLEX VOCAS It is helpful to further categorise these high-tech devices in two ways:
■ whether they are devised to be mainly accessed by letters and words or whether the user will
These are the most powerful devices which can offer a full (or at least an extensive range of) mainly be using symbols (with the option to use letters and words).
vocabulary. ■ dedicated communication aids (just talking boxes) versus computers which can also run any
other software such as word processing or curriculum programs, as well as running their
You will need to make lots of decisions when you go down this path! special communication program.
Will you want to use a dedicated communication aid? If you use a computer it can run any The choice between a dedicated communication aid and a computer is not a simple one.
other software such as word processing or curriculum programs, as well as running a special
communication program Advantages of using a dedicated communication aid
■ Simple to use.
You will also need to decide whether the device will be accessed by letters and words or by ■ Less vulnerable to damage and software crashing. Repair warranties are available for 3 years
symbols (with the option to use letters and words). and longer.
Advantages of using a dedicated communication aid Advantages of using a computer as a communication aid
■ Longer battery life ■ Can run additional software.
■ Quicker to start up ■ The individual has the opportunity to swap between programs (dependent on access method).
■ Less vulnerable to damage and software crashing.
See Hardware for Complex VOCAs for further information. Hardware for complex VOCAs
Advantages of using a computer as a communication aid Hardware can be divided into four groups:
■ Can run additional software. ■ High-Tech Dedicated Communication Aids with dynamic displays – Symbols and text
■ The individual has the opportunity to swap between programs (dependent on access e.g. MT4, DV4,
method). For further information see below.
■ Can have access to e-mail and the Internet
■ High-Tech Dedicated Communication Aids with static displays – Text
By thinking of the comparison with a fruit machine, it is possible to look at each e.g. Lightwriter, Dynawrite.
component that makes up these devices. All communication aids are made up of four parts For further information contact see below NB WRITE SOMETHING
which can be likened to the four wheels of a fruit machine:
■ Windows Computers specifically prepared for use as communication aids (Symbols or Words)
■ Hardware – the expensive box with all the electronics inside it. e.g. Cameleon, Tellus.
■ Software – the brains of the system which controls (amongst other things) the access For further information see below.
options, flexibility of the display (range of colours, number of symbols or words that can be
displayed on the screen) ease of programming. ■ Windows CE Computers (Symbols or Words)
■ Symbol system – letters & words, Picture Communication Symbols (PCS), Rebus Symbols, e.g. Palmtops running ChatPC, Portable Impact, Say-IT-Sam, The Grid Pocket version.
Bliss Symbols, Makaton Symbols, (or others which are more typically used in other countries). For further information see below.
■ Vocabulary – The structure of the language available to the user which affects how easy it is
for users to find the words or phrases that they are looking for, and if well designed, can speed (For Sources see Appendix 9)
the process of putting together what they want to say.
30 Supporting Communication through AAC | Module 3 | Section 8 Supporting Communication through AAC | Module 3 | Section 8 31
Symbols Section 9
The person for whom you are thinking about a VOCA will probably already be using symbols if
they need them, and it will normally be unwise to change the symbol system that they are VOCABULARIES FOR VOCAS
already using. Some of the symbol systems – Beta, Beeldezen, Picto – are used in Europe
but not generally in the UK. Rebus is seldom used outside the UK. Blissymbols and Picture When VOCAs were first available, each device was programmed with a vocabulary specifically
Communication Symbols (PCS) are used throughout the world, PCC tend to be the more for each individual. Sadly there is rarely anyone available who has both the time and expertise
popular graphic symbol system because it is available in both colour and in black and white. to program a device for each specific individual. What typically happens is an existing
vocabulary package, which most closely matches the needs of the intended user, is selected
Symbol Systems available for each communication software package and then personalised to the specific language needs of that user – the user’s family and
friend’s names; the things they like and dislike doing and eating; places they enjoy going to,
Software Symbol Systems available etc. More time is then spent with the user helping them to learn what vocabulary is available to
them and how to use the device as effectively and efficiently as possible rather than the
Windows therapist, teacher or parent being shut away in a darkened room programming the device!
Clicker4 PCS, Rebus Purchasing an established vocabulary is generally agreed to produce a VOCA which most
closely meets the needs of the user in the shortest possible time.
Dynavox 3100 / Series 4 Dynasyms, PCS / Dynasyms, PCS, Rebus
MindExpress Beta, Bliss, PCS, Picto, Rebus Some vocabularies are designed with levels or stages so that the user can start with a simple
screen but progress to increasingly wide vocabularies without having to start from scratch
Personal Communicator Beta, Beeldezen, Bliss, PCS, Picto each time (ExpressTalk, Gateway, IDV/Quickfire).
Speaking Dynamically Pro PCS
So when choosing a vocabulary package you first need to identify the package that is most
Talking Screen Bliss, PCS, Rebus suitable for your user. The table below, shows the type of people each vocabulary package
was originally written for. Secondly you need to check that the vocabulary is available in the
The Grid Bliss, PCS, Rebus
symbol system with which the user is familiar and then finally check that it is available for the
ViP Libsyms, PCS software and hardware you wish to use. Many people who are knowledgeable in this field will
argue that the vocabulary is more important than the hardware or software.
Windows CE
Chat PC PCS If your user has difficulty accessing the cells then the number of cells that need to be selected
in order to make a sentence will be an important consideration. Subsequent charts identify the
Icon Speak PCS, Rebus
number of item selections and new pages that need to be selected in order to produce one of
Portable Impact PCS the two test sentences used for the purposes of illustration. This information may provide
further pointers as to which vocabulary may be most beneficial for the user you are trying to
The Grid PCS
help. (Note that communication software for Windows CE usually has only sample
Touch Speak PCS vocabularies provided with it.)
Say-IT-Sam PCS
What sort of people were the vocabularies, which are available, written for? What ages of user are the various vocabularies suitable for?
People vary enormously in their abilities and needs and therefore the chart below can
obviously be only a guide. It may appear odd that some options appear in all/many age
Vocabulary Target Users groups. This indicates that it is still appropriate to start an older user on the basic level of the
Adult SS Adult users with extensive vocabularies 48 cells, 990 pages vocabulary – hopefully they will progress more quickly to higher levels than would a younger
user. In many instances the basic level teaches patterns and approaches that it is simplest to
CALLtalk Children with good literacy potential in mainstream schools, 35 cells per learn before proceeding to higher levels.
page, 217 pages
Vocabularies available for each symbol set widely used in the UK
Chailey CS Children with physical difficulties, designed for auditory scanning and
has a rigid organisation. 24 cells per page, 280 pages
Vocabulary 3-5 Years 4-7 Years 6-9 Years 8-11 10 to less able
Chataway Community based vocabulary for children’s social interaction 30 cells per Years adult teen/adult
page, 154 pages
Adult SS – – – ? Yes ?
Communicate Adults requiring access to a large community based vocabulary 63 cells
per page, 350 pages CALLtalk – – Yes Yes Yes –
EDL Teenagers with some learning difficulties and a curriculum based Chataway – – Yes Yes Yes Yes
vocabulary. 48/55 cells and 251 pages
Chailey CS – – Yes Yes Yes Yes
ExpressTalk Able people requiring speedy access to a large vocabulary. 3 levels of
complexity. Junior with 8 cells 17 pages; Intermediate with 32 cells, 33 Chataway – – Yes Yes Yes Yes
pages; Senior with 72 cells, 45 pages, each with 3 levels
Communicate – – – – Yes –
Gateway Children with conversational ability 4-12 years with good access. 7 levels
EDL – – – – Yes Yes
of complexity, 12-75 cells and 37-90 pages
ExpressTalk Junior Junior, Intermediate Intermediate, Intermediate, Intermediate
IDV Children with physical difficulties in a conductive education
environment, KS 1&2. 4 levels of complexity (A to D), 24-63 cells, 16- Intermediate Senior Senior
Quickfire
71 pages (levels C and D are likely to be too have too many cells for
Say-IT-Sam Gateway 12 12, 20 20, 36 36, 40 ,54 54, 75 30
the Say-It-Sam display)
IDV/Quickfire A A, B A, B, C A, B, C, D Yes C
Language Learning and From 3 years of age (expressive vocabulary). 4, 8, 15, 45, 84 cell
Living (LLL) (dedicated grids available. Early stages focus on teaching Minspeak which is
LLL Yes Yes Yes Yes
transferable to larger grids. Uses mainly two icon selections to
device)
access a word/phrase PragTalk Yes Yes Yes – – –
PragTalk Pre-schoolers – designed on pragmatic rather than topic features 18
Mamba45 – Yes Yes – – Yes
cells per page with 12 pages
Rattler – Yes Yes Yes Yes Yes
Copperhead From 6 years of age, 16x8 symbolic keyboard remains unaltered allowing
the learner the continue making selections without losing sight of a Sidewinder – – Yes Yes Yes –
familiar page using cycling. Access to over a 1000 words and phrases.
Unity – Yes Yes Yes Yes –
Mamba 45 From 4 – 9 and less able adult. 9x5 symbolic keyboard adapts
automatically to allow the learner to continue making selections. Other WP + KB – – – Yes Yes –
pages available for a greater range of verbs, prepositions and adjectives.
WP – KB – – Yes Yes Yes Yes
Rattler From 4 years and for the less able adult. 16x8 symbolic keyboard
adapts automatically with a limited number of cells changing when a WP scanning – – – Yes Yes –
‘topic’ cell is selected.
Unity (dedicated device) From 3 years of age (expressive vocabulary). 4, 8, 15, 45, 84 cell
grids available. Over 3,000 word vocabulary at upper levels. Early
stages focus on teaching Minspeak which is transferable to larger
grids. Uses mainly three icon selections to access a word/phrase.
Word Power People, with some literacy skills, needing rapid communication with
(90 cells, 85 pages) and without (71 cells, 39 pages) a keyboard and
specifically designed for efficient scanning.
36 Supporting Communication through AAC | Module 3 | Section 9 Supporting Communication through AAC | Module 3 | Section 9 37
NB. It is not a good idea to change a user’s symbol system without a great deal of thought Vocabularies available for each Windows communication software package
and discussion between the user themselves (if they are old enough), teachers, therapists
and parents.
Software
Vocabulary PCS Rebus Bliss Dynasym Minsyms Libsyms Vocabulary Clicker4 Dynavox Mind Personal Talking The Grid VIP
(classic / 3100 Express Communicator Screen
new)
Adult SS – – – – – Yes –
Adult SS – Yes – – – –
CALLtalk – Yes – – – Yes –
CALLtalk Yes – – – – –
Chailey CS – Yes – – – – –
Chailey CS – Yes – – – –
Chataway – Yes – – – – –
Chataway Yes – – – – –
Communicate – Yes – – – – –
Communicate Yes – – – – –
Copperhead – – – – – – Yes
Copperhead Yes – – – – Yes
EDL – Yes – – – – –
EDL – – – Yes – –
ExpressTalk – – Yes – – – –
ExpressTalk Yes Yes Yes – – –
Gateway – Yes – – – – –
Gateway Yes – – Yes – –
IDV/Quickfire Yes Yes Yes Yes Yes Yes –
IDV/Quickfire Yes Yes – Yes – –
Mamba45 – – – – – – –
LLL Yes – – – Yes –
PragTalk – – – – – Yes –
Mamba45 Yes – – – – Yes
Rattler – – – – – – Yes
PragTalk Yes – – – – –
Sidewinder – – – – – – Yes
Rattler Yes – – – – Yes
Word Power – Yes Yes – – Yes –
Sidewinder Yes – – – – Yes
Chailey CS 28 21 Rigid structure: 4 selections and WordPower 15 6 Need to start to spell “dead”, completed
3 page turns per word Pictures + by prediction
keyboard & direct
Chataway 21 10 No “dead”, needed to spell access
Communicate 22 12 Scrolled to “cat”. Need to start to spell WordPower 14 3 Need to start to spell “dead” completed
“dead”, completed by prediction Pictures – by prediction
keyboard &
Copperhead 13 0 Uses static dynamic display – screen scanning
doesn’t change. Needed to use ‘cycle’ to
find “because” (1), “cat” (3) and “dead” (2)
Test Sentence: Can you come to tea at my house tonight? Wordcore 84 18 8 NB NB 8 page changes by setting text and
white out of un-needed icons. 10 Activity
Vocabulary Select icons Page changes Comments row/prediction changes. Needed to
spell/begin to spell the following come,
Adult SS 25 15 No “tonight” – “today” used tea, house, tonight. Frequency of
prediction will change.
CALLtalk 22 14 No “tonight” – “today” used
Copperhead 18 0 Uses static dynamic display – screen WordPower 15 6 Need to start to spell “tea”, start to spell
doesn’t change. Needed to use ‘cycle’ to Pictures – “house” and completed by prediction
find “tea” (1), “my” (1), “house” (1) and keyboard &
“tonight” (5) scanning
Passports are particularly important for vulnerable people who are facing a transition from a
setting where people know them well to a new setting and new people. The concept of
making and using Personal Communication Passports was introduced in 1992 by Sally Millar,
from the CALL Centre in Edinburgh. Since then, the idea has taken off in a big way and
Passports are now very widely used in many settings (2), especially with children and adults
with complex needs and those who use augmentative communication.
Sally Millar has recently (2003) published a comprehensive book on Passports (1). The book
provides guidance not only on the practicalities of how to set about making and using
Passports, but also guidelines to ensure that an ethical approach is followed, quality
assurance is carried out, and appropriate policy and management procedures are put in
place. The book is in full colour and includes many illustrations and example pages from
different Passports that should help to provide ideas to get others started.
Passport Ownership
A Passport belongs to the person it is made for (and/or their family), not to the professionals.
The more a person has been involved in creating – or at least being made aware of – their
own Passport, the more likely they are to see it as ‘theirs’, to view it positively and for it to be
used positively. At the very least, this might involve choosing colours or pictures for a booklet.
For some people, it can mean determining page topics and content; creating the Passport can
become a central focus of curriculum work (personal and social development) and/or
communication work (“This is how I communicate; Things I like to talk about”) or part of the
process of preparing for a transition.
Teamwork
Passports are coordinated by one person but created by a team (which should include the
child and parents / family) so that all the pieces of the jigsaw are put in place, not just one
perspective.
44 Supporting Communication through AAC | Module 3 | Section 10 Supporting Communication through AAC | Module 3 | Section 10 45
■ Date each page separately so it can be seen at a glance when the information was last Section 11 Appendices
updated.
■ Leave out information that is short-term and is bound to change rapidly (this can go in home Appendix 1
or school diary).
■ Leave space for addition of new material. MANUAL SIGN SYSTEMS
If you have any further queries or wish to discuss Passports, please make contact. British Sign Language
The Royal National Institute for Deaf People
Sally Millar 1. BSL is the sign system used by the hearing impaired community.
Joint Coordinator 2. It is a living language in that it grows and changes as spoken languages do.
Communication Aids for Language and Learning (CALL) Centre 3. BSL has its own language structure which is different to spoken and written English, so users
University of Edinburgh may find it difficult to transfer to reading and written English.
Paterson’s Land 4. BSL contains a limited number of constituents, i.e. components of a sign, such as location,
Holyrood Road hand shape, movement and orientation and facial expression, body positions and postures, all
Edinburgh EH8 8AQ of which can occur simultaneously in a signed utterance.
Email: [email protected] 5. BSL signs can be adapted for single-handed use.
Web: www.callcentrescotland.org.uk 6. Finger spelling is an intrinsic part of BSL.
Makaton Vocabulary
Makaton Vocabulary Development Project
1. There are symbols to accompany all the signs within the Makaton Vocabulary.
2. The Makaton Vocabulary consists of:
– a core vocabulary (approximately 350 items)
– the national curriculum (approximately 600 items)
– Animals, Transport and Vehicles (approximately 400 items)
– People, Buildings and Places (approximately 700 items)
– Growth and Development, Emotions, Feelings and Relationships (approximately 1200
items)
3. The signs are based on BSL, but are used to support spoken English, so only key words are
signed.
4. The Makaton Vocabulary has grammatical markers (from Signed English).
5. There are no strategies for expanding symbol use without creating new signs for each lexical
item.
6. It is possible to use one-handed signs.
Signalong
The Signalong Group
1. There are approximately 1600 signs currently available in the core vocabulary.
2. Additional vocabularies include:
Signalong at the Table (approximately 256 items)
Signalong by the Sea (approximately 233 items)
We’re Going to the Zoo (approximately 400 items)
48 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 1 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 1 49
What Shall I Wear Today? (approximately 300 items) The following chart is taken from:
Learning Through Exploring and Creating Hazell G. & Cockerill H. (2002) “Communication Resources” In: Cockerill H. & Carroll-Few C.
Learning through the Senses (Eds) “Communicating Without Speech: Practical Augmentative and Alternative
Science Key Stage 1: Signs for Life Processes and Living Things (approximately 1500 items) Communication”; Mac Keith Press
National Literacy Strategy
Personal and Social Education (approximately 161 items) British Sign Signed Makaton Signalong Communication
Language English Vocabulary Link
Dental Care (approximately 140 items)
Signalong at Work: An Introduction to the Workplace (approximately 229 items)
Hotel and Catering (approximately 600 items)
General Retail (approximately 400 items)
Home As BSL
Horticulture and Animal Husbandry (approximately 600 items)
It’s My Life (approximately 870 items)
3. The signs are based on BSL, but are used to support spoken English, so only key words are
signed.
4. There are no strategies for expanding symbol use without creating new signs for each lexical
item. To go,
advance
Communication Link
Beverley School For The Deaf
1. Approximately 1700 signs.
2. BSL signs are used.
3. Alphabetically organised book. Pic Needed
4. Stress the variability of signs depending on the individual, the context and the region. To want As BSL
here
Because As BSL
But As BSL
50 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 2 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 2 51
Appendix 2 Blissymbols
Blissymbol Communication UK
GRAPHIC SYMBOLS 1. Blissymbols uses nine basic shapes to represent 3,500 vocabulary items.
2. New vocabulary is constantly being developed throughout the world.
Picture Sets 3. Many symbols are highly abstract, in order to sustain as consistent an inherent logic as
Colour Communication Stickers (Imaginart) possible.
Imaginart or Winslow Press 4. The size orientation and position of the shapes determines the meaning.
1. There are 840 stickers available. 5. There are symbols to mark all parts of speech.
2. Categories cover a wide range of vocabulary. 6. “Special Symbols” enable users to create novel words and utterances without substantially
3. There is no text accompanying the pictures. adding to the total number of items in a user’s communication system.
4. They are quite clear and simple to understand. 7. Blissymbols are visually and cognitively more demanding, but less ‘visually busy’ than more
pictographic systems when displayed on a chart.
Picture Communication Symbols
Don Johnston Special Needs, Winslow Press The following chart is taken from:
1. There are approximately 5,000 symbols. Hazell G. & Cockerill H. (2002) “Communication Resources” In: Cockerill H. & Carroll-Few C.
2. PCS consist of simple drawings. (Eds) “Communicating Without Speech: Practical Augmentative and Alternative
3. There are no symbols for grammatical markers. Communication”; Mac Keith Press
4. There is an excellent selection of vocabulary for all ages.
Pick ‘N’ Pic Picture Rebus Makaton Blissymbol
PIC/Pictograms Stick Communication Vocabulary
The Lodden School, Symbols
1. There are approximately 700 Pics (UK) / Pictograms (Norway)
2. They are white outlines on black backgrounds which is supposed to be easier to perceive than
Home
the traditional black on white.
Symbol Systems
Widget Rebus Symbols
Widget Software To go,
advance
1. There are about 7,000 Rebus symbols available now.
2. Rebus symbols have been recently redesigned to give a much clearer grammatical foundation
3. Rebus symbols were devised originally to help develop reading skills.
4. A combination of symbols and letters was used historically.
To want
Makaton Vocabulary
Makaton Vocabulary Development Project,
1. There are symbols to accompany all the signs within the Makaton Vocabulary.
2. The Makaton Vocabulary consists of: To tease
– a core vocabulary (approximately 350 items)
– the national curriculum (approximately 600 items)
– Animals, Transport and Vehicles (approximately 400 items)
– People, Buildings and Places (approximately 700 items)
Tired
– Growth and Development, Emotions, Feelings and Relationships (approximately 1200 items)
3. The Makaton Vocabulary now provides grammatical markers (taken from Signed English),
although these are visually complex and arbitrary.
4. There are no strategies for expanding symbol use without creating new signs for each lexical
item. Noisy
Picsyms
Winslow Press
1. There are about 800 Picsyms, with approximately 2000 available as Dynasyms in the DynaVox.
Because
2. The symbols can be pictographic or as abstract as needed.
3. The shape or manner of representation of a symbol provides a clue to the semantic category
that item belongs to, e.g. action is represented by an arrow indicating the direction of the action.
4. There are guidelines for creating new vocabulary.
5. As yet the system is not widely used in this country. but
6. Many of the symbols look very visually 'busy'.
52 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 3 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 3 53
Appendix 3 – OOR of reference are self-contained entities. As such, all multi-sensory elements must be
contained within the OOR itself: the cup must have a particular smell, taste, feel, shape,
OBJECTS OF REFERENCE POLICY & PROCEDURE colour. Sensory cues provided at the POLE, however, may come from a variety of different
sources: music may be played from one source and a particular smell may be provided
INTRODUCTION from another.
THIS DOCUMENT IS a statement of the aims, principles and strategies for the – A single unique OOR is provided to represent the POLE. Multiple sensory cues may be
implementation of Objects of Reference at Dame Hannah Rogers School. provided at/within the POLE itself.
■ Individual students have individual sets of OOR.
IT WAS DEVELOPED during the Summer Term of 2003, through a process of consultation ■ Initially the student’s OOR set will be limited in number. Ideally, this number will not exceed
between teaching staff and speech and language therapists. five, (Toilet, Drink, Meal, Physio, Hydro) although three is the typical Dame Hannah Rogers
School number.
IT WAS APPROVED by the Governing Body. ■ As students become more familiar with OOR, so more OOR may be included in their OOR
bag.
THIS POLICY WILL BE REVIEWED in Spring 2006. ■ The more frequently the OOR can be reinforced, the greater the chance of individual
understanding. Early choices of OOR should, therefore, represent frequently occurring
THIS POLICY WILL BE REVIEWED every two years. A schedule for the review of all policy events (preferably more than once per day).
documents is set out in the School Development Plan. ■ OOR should be present immediately prior to a change of POLE.
■ On presentation of the OOR, staff should move with the student to the POLE. No delay is
AIMS acceptable. If there is a need to open doors to allow for the movement of wheelchair, for
■ To ensure that all Staff know what is considered good practice in the use of Dame Hannah example, then the door should be opened prior to the presentation of the OOR.
Rogers School ’s Objects of Reference (OOR) system. ■ The student should be encouraged to take the OOR directly from the OOR bag. The bag
should be presented with the appropriate OOR at the fore. If the student is physically
■ To provide a consistent and uniform experience for all students in the use of OOR. incapable of taking the OOR, the staff member should assist the student.
■ Students may be reluctant to acknowledge the OOR (Stage One development). This typically
■ To help provide an inclusive environment for students experiencing Profound and Multiple takes one of two forms: The student ignores the OOR or the student drops or throws the OOR.
Learning Difficulties (as well as for other students for whom OOR is deemed to be suitable). If the latter occurs, staff should pick up the OOR and repeat the activity. This should happen
approximately three times. At this point, the staff member should carry the OOR him/herself
PROCEDURES and accompany the student to the new POLE occasionally displaying the OOR for the student
■ There are no prerequisites for the Dame Hannah Rogers School OOR scheme. All individuals to see. Where students ignore the OOR (typically this may occur with a few students who are
on the scheme will benefit from a consistent caring approach. not ambulant), staff should attempt to get the student to acknowledge the presence of the
■ The Objects of Reference are kept within an OOR bag. Students new to the scheme will be OOR and then place it (preferably) in line of vision (on the student’s knee for example) before
provided with their own OOR bag containing a suitable set of OOR. moving to the POLE.
■ OOR should be safe for unsupervised use. ■ Staff should always accompany the presentation of an OOR with simple language and
■ There are at least three ‘types’ of OOR schemes: shared, differentiated and individualised. sign where applicable. Encourage the student to interact with the OOR’s sensory aspects. If
Shared scheme – all students use exactly the same OOR to represent a particular the student has physical problems in interacting, staff may assist with this process by, for
POLE (Person, Object, Location or Event) within the curriculum (for example, all students use example, gently rubbing the OOR on the student’s skin (where the tactile aspect of the OOR is
an identical cup to represent drink time). seen as important).
Differentiated scheme – all students use the same object but the object itself may vary ■ Where possible, especially with ambulant students, staff should allow the student to lead the
(for example, all students use a cup to represent a drink period but each student has his or her way to the POLE on presentation of the OOR. Does the student demonstrate an
own particular cup – different styles, colours, shapes, textures are allowed). understanding of where s/he is going? If the student is obviously ‘lost’ then the staff member
Individualised scheme – all students have an individualised OOR to represent the should guide the student to the POLE allowing the student to lead taking the final few
POLE (for example, one student may use a cup, another a straw, and yet another any item steps into the room.
utilised specifically at this time). ■ At the POLE entrance (where the POLE has a marked entrance) staff should encourage the
■ Dame Hannah Rogers School operates a shared OOR scheme. For example, all students on student to match the OOR with the OOR on the door. This is best achieved by removing the
the scheme use an identical blue plastic cup as the OOR to represent a drink. Shared door marker from its housing and holding it next to the OOR together in a position that the
schemes are seen as easier to maintain and to manage. Furthermore, communication, by student can easily see.
definition, is shared. In order for individuals to communicate with each other they have to ■ When the POLE is reached, the student should return the OOR of reference to the bag.
share symbol sets. Communication between peers would be impossible with individualised Sensory cues may be utilised within the POLE to further reference the forthcoming activity.
symbol sets. Students must never return from a POLE clutching the OOR for the POLE as this
■ OOR are complimented by the use of sensory cues to particular POLEs. A sensory cue presents a very confusing message.
differs to an OOR in a number of key elements: ■ Staff should present the OOR consistently at every appropriate opportunity. Staff should
– OOR are presented in the session prior to the movement to the POLE. Sensory cues are never declare unilaterally that they consider the OOR to be inappropriate and decide
part of the POLE experience. not to go ahead with the presentation. Should staff feel strongly that a particular student’s
needs are not being properly met with any OOR then it is the individual staff member’s
responsibility to raise this matter and a meeting can be held to discuss whether a change
should be made.
54 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 3 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 3 55
■ It should be realised that it may only be after many thousands of presentations that a student EDUCATIONAL COMPONENTS OF THE DAME HANNAH
may begin to make an association between the OOR and the POLE. Therefore, it is ROGERS SCHOOL OBJECTS OF REFERENCE SYSTEM
essential that staff are consistent and diligent in their efforts with the OOR scheme.
■ Where possible, the OOR may itself be labelled with the symbol for the POLE. While there ■ To develop anticipatory skills.
should be no focus on the symbol when presenting the OOR to the student, the fact that ■ To reduce confusion and apprehension.
the two are paired allows every opportunity for future progression. ■ To promote inclusion for individuals experiencing Profound and Multiple Learning Difficulties.
■ When students indicate a need for their OOR bag or present an OOR to a member of staff, ■ To develop early ‘emergent’ communication skills.
staff should immediately react to this presentation as if it were intentional. That is, they ■ To develop cognitive/early thinking skills.
should move to the POLE or provide the requested object or event. The OOR should then be ■ To work towards the student being able to express preferences, communicate needs, make
returned to the bag, as is normal procedure. choices, make decisions and choose options that other people act on and respect.
■ While Stages of Development are outlined in the table below, it is expected that: ■ To promote self-advocacy or the use of a range of systems of supported advocacy.
– development will not be commensurate for each object in the set. That is, development may ■ To prepare students for an adult life in which they have the greatest possible degree of
be faster on some objects than on others. autonomy.
– not all students will enter at Stage One and leave at Stage Five. Some students may enter ■ To increase the student’s awareness and understanding of his/her environment and of the
the scheme at Stage Two or even Stage Three. Some students may never reach Stage world.
Five. Some students may leave the scheme before they reach Stage Five because they are
ready for symbol use and OOR is no longer seen as appropriate. EVALUATION
– students will develop at different rates. ■ All students experiencing Profound and Multiple Learning Difficulties have an Objects of
■ Quality assurance of the OOR scheme is provided by Learning Support Staff and by the Speech Reference bag with appropriate OOR.
and Language Therapy Department. At the beginning of each day a designated member of the ■ Students carry OOR to POLE.
team should check the contents of the OOR bag before presenting it to the student to ensure ■ Students match OOR to symbol on door on reaching specific POLEs.
that the appropriate items are present (a list should be contained in each bag). If an item is ■ Student’s IEP targets make specific reference to OOR.
missing or damaged, the team member should seek a replacement from the Speech and ■ Occasionally, a student reaches developmental Level Five with a specific object.
Language Therapy Assistant. Likewise, if ‘alien’ OOR have somehow found their way into the
OOR bag, these should be returned to the Speech and Language Therapy Assistant.
■ At the end of the day, the staff member designated to check OOR bags should ensure that the
bag is removed before the student leaves for home. While, ideally, the OOR set should be in Stage Descriptors Characterised by
use at home, it is the experience of other establishments that too many have not returned and
Stage 1 Intolerant Individual shows little tolerance of OOR.
the scheme becomes very difficult to manage. Duplicate sets of OOR are to be made
Difficult to reach Ignores, drops, or throws it
available to families in at cost.
Dependent
■ Staff may wish to develop their own OOR for use to reference POLEs within a specific
Meaningless
session. This should always be done in close liaison with the Speech and Language
Therapist. Stage 2 Tolerant Holds/carries OOR but demonstrates little
■ Staff may wish to use OOR developed (as in the above point) to provide choices within the Hard to reach understanding
session. In this instance, two objects of reference are used to provide a choice: the student Dependent
indicating a preference. This should not be undertaken with students operating at Stage One Meaningless
and Stage Two levels of development (see chart below). If in doubt consult the Speech and
Language Therapist. Stage 3 Tolerant Individual begins to show understanding of
■ Students will take their OOR sets with them when they move on from Dame Hannah Rogers Receptive meaning of one or more OOR
School. Dependent
More Meaningful
Appendix 4 Appendix 5
Children with disabilities affecting communication and movement benefit from a range of The following information is taken from Frost & Bondy (1994) ‘PECS Training Manual’.
approaches and techniques. Facilitated Communication Training (FCT) is one of the
techniques, within a wide range of Alternative and Augmentative Communication (AAC) PECS “…is a unique AAC training package developed for use with young children with autism
strategies, that may benefit some children with a wide range of disabilities where they are and other social-communication deficits.” (p1)
having difficulty with movement as well as with speech. FCT provides physical and emotional
support to those who need to access communication aids but do not have the motor skills to PECS was initially developed for use with early years children who had autism. Frost and
successfully do so independently. Bondy describe these children as those who do not speak, who are echolalic or speak in a
‘self-stimulatory’ manner. They continue by describing the communicative disabilities of these
Within the technique a range of specific Neuro motor issues are identified each of which children as being “socially-related in that they do not routinely approach others to
require specific physical strategies to compensate for the access difficulties that result. The communicate, actively avoid interaction with others or only communicate in response to a
aim of FCT is to support the communication aid user in developing their motor skills gradually direct verbal cue to do so.” (p2).
over time so that they can eventually learn to independently access an aid. Not everyone is
able to achieve independence but they should not be excluded from FCT on this account nor There are six phases in a PECS programme and it is recommended by Frost and Bondy that
should efforts to help them achieve the goal of independence be abandoned. the child should progress through all six phases.
Phase 5
Objective: the student can spontaneously request a variety of items and can answer the
questions “What do you want?”
58 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 5 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 6 59
Phase 6 Appendix 6
Objective: The student appropriately answers the above questions and similar questions
when these questions are asked randomly. VOCABULARY FOR SENTENCE STRUCTURING
Introducing Additional Language Concepts The aim of communication is to transfer information from a speaker to a listener. This can be
Objective: The student uses a wide range of vocabulary concepts in a variety of achieved by using facial expression, body movement, gesture, sign, graphic symbols, and
communicative functions. speech. For the listener to understand an AAC utterance easily and quickly, it is necessary for
the person using AAC to be able to create utterances that have an internal structure i.e.
The important points in PECS include: grammar.
■ Working from the individual’s motivators i.e. favourite toys/objects. You need to assess which
are the most to least motivating items for the individual. When we speak, words follow each other in a set order e.g. “I saw the boy” or “I am going to
■ Teach the staff, parents and child how to use the system before expecting any symbol the shops” are examples of simple sentences. People using AAC may be able to create
discrimination utterances in the word order appropriate to the language spoken around them. Others may
■ You will need to engineer situations to encourage the child to request not have access to the vocabulary to do so. It may be that the child is using language at a
■ You should work through the PECS stages. simpler level and is linking key words together e.g. “boy look” or “me shop” at an earlier
developmental level.
The challenge is to provide the opportunity for all those using AAC to have access to the
vocabulary they need to develop language. Children need to see us using their
communication systems to speak to them, particularly when repeating back and elaborating
what the child has just said.
The ideas below may help you to think of many other opportunities to teach vocabulary to
develop sentence structure.
■ People
■ Objects
■ Verbs to enable children to acquire language through action. Verbs should be included in the
early stages so that symbols are not merely 'labels' for items but vehicles for expression e.g.
go, come, swim, play
jump, run.
■ Adjectives will allow the AAC user to express themselves more fully and understand the world
around them more clearly. e.g.
– expressing emotion:
angry, bored, excited
– physical state:
ok, tired, sleepy
– surroundings:
noisy, quiet, light, dark
– size:
big, little
The Blissymbol strategy of “opposite meaning” can be a useful tool when teaching and using
adjectives.
■ Prepositions, by actively involving the AAC user, spatial concepts can be more easily
understood. For example, the child can be encouraged to hide in a box/cupboard. She can
then be asked to hide an object in a box/cupboard. The next step would involve telling
someone else to hide in something. A user may enjoy hiding something that belongs to
another person for that person to then find.
60 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 6 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 7 61
■ Questions are asked by children about the world around them. In order to learn they need to Appendix 7
be able to ask questions. The AAC user needs to have the opportunity to ask questions as
e.g. USE OF LANGUAGE
what?
where? When developing a communication system for a child who will be using AAC, it is important
why? not only to choose vocabulary carefully to ensure it meets the child’s needs, but equally to
when? ensure the child has access to a range of ‘communicative functions’. This very grand term
who? simply refers to the way in which we actually put the words (the vocabulary) together to
how? express ourselves in sentences. We are able to reply to questions, ask for information,
express our feelings and desires, describe events past, present and future, ask for clarification
■ Negation. It is important to remember to include negative words, e.g. not/no, don't/won't, to and repair any misunderstandings. We take all this for granted, but the non-speaking
enable the AAC user to refuse something in a socially acceptable manner; e.g. spitting one’s individual who uses AAC, who uses telegrammatic utterances, may find many of these things
food out is socially unacceptable, but if the AAC user has no other way of refusing food, it is extremely difficult.
the only effective means of communication open to her.
The following are necessary for fluent two-way conversation:
■ Social vocabulary should include some colloquial language, e.g. how are you, get lost, chill ■ Social exchange (e.g. greetings, farewells, insults):
out, as well as the more conventional language hello, thank you, sorry. hello; good-bye; please; thanks; how are you?; sorry; get lost.
■ Attention directing:
look at me; see that horse over there.
■ Asking questions:
for information, for personal needs, actions or objects: ‘wh’ words.
■ Transferring information:
about nouns; people, places; time; verbs; feelings.
■ Responding:
yes; no; lots of nouns.
■ Self-expression / assertion
expressions of emotion e.g. I’m fed up; asserting independence e.g. Me.
■ Negation:
no; not; don’t want; don’t like; can’t; won’t; wrong; didn't.
■ Self-expression:
feelings, humour.
Cameleon, Symbols for Windows (including Personal Communicator and Paper Chart
British Sign Language
Maker), Talking Screen for Windows, Say-IT SAM, EZ Keys
The Royal National Institute for Deaf People, 105 Gower Street, London, WC1E 6AH.
MiniMessageMate, Message 20, MessageMate40
Telephone: 0207-387-8033
Cambridge Adaptive Communication,
Signed English
Mr Derek Baker, Treasurer and Information Officer, 20 Magdalen Road, Exeter EX2 4TD. 8 Farmborough Close, Stocklake Park Industrial Estate, Aylesbury, Bucks, HP20 1DQ
Courses: Margaret Down, 9 the Mede, Ashford Road, Topsham, Exeter, EX3 0LD Telephone: 01296-461002 Fax: 01296-461107
email: [email protected] website: www.cameleon-web.com
Makaton Vocabulary
Makaton Vocabulary Development Project, 31 Firwood Drive, Camberley, Surrey. BigMack, Little Mack, One Step, step-by-Step, iTalk2
Telephone: 01276-61390 Partner 1, Partner 2, Partner 4, One Talker, 1 by 4 Talker, Talktrack, 4Talk4, 4Scan4
e-mail: [email protected] Web site: www.makaton.org Pocket GoTalk, GoTalk4, Go Talk9,
Signalong TechTalk8, TechScan8, TechScan 8+, TechSpeak 32, TechScan32, TechScan 32+
Signalong, Communication and Language Centre, All Saints’ Hospital, Magpie Hall Road, Inclusive Technology,
Chatham, Kent, ME4 5NG.
Gatehead Business Park, Delph New Road, Delph, Oldham. OL3 5BX
Telephone: 01634-819915
Telephone: 01457 819790 Fax: 01457 819799
e-mail: [email protected] Web site: www.signalong.org.uk
e-mail: [email protected] website: www.inclusive.co.uk
Paget-Gorman Signed Speech
Mr Bob Newey, 3 Gipsy Lane, Headington, Oxford, Oxon. BigMack, Little Mack, One Step, step-by-Step, iTalk2, Partner 1, Partner 2, Partner 4
Supervoca, Lexicon, ChatPC, Mercury, Mini-Merc, TalkOut, Vocabulary applications,
Cued Speech
Copperhead, Mamba, Rattler, SideWinder, ViP:
National Centre for Cued Speech, 29-30 Watling Street, Canterbury, Kent, CT1 2UD.
Telephone: 01227-450757 Liberator Ltd,
Colour Communication Stickers (Imaginart) Whitegates, Swinstead, Lincolnshire, NG33 4PA
Imaginart, 307 Arizona Street, Bisbee, AZ 85603 U.S.A. Freephone: 0800-622457 Telephone: 0476-550391 Fax: 0476-550357
Fax: (800)737-1376 email: [email protected] website: www.liberator.co.uk
Winslow Press, Telford Road, Bicester, Oxon, OX6 0TS.
Telephone: 01869-244733 BigMack, Little Mack, One Step, step-by-Step, Chipper, Talking Buddy Button, 4Talk4,
4Scan4, Pocket Go Talk, GoTalk4, GoTalk9, Tash Ultimate, VoicePal Max, Macaw 3,
Picture Communication Symbols Portacom, Digivox:
Don Johnston Special Needs, 18/19 Clarendon Court, Calver Road, Winwick Quay,
QED,
Warrington, WA2 8QP
Tel: 01223-264244 Fax: 01223-264254 (Quality Enabling Devices Ltd), 1 Prince Alfred Street, Gosport, Hampshire, PO12 1QH
Web site: www.donjohnston.com Telephone: 0870 787 8850 Fax: 0870 787 8860
Winslow Press, Telford Road, Bicester, Oxon, OX6 0TS. e-mail: [email protected] website: www.qedltd.com
Telephone: 01869-244733
Clicker 5
PIC/Pictograms Vocabulary applications: Quickfire grids:
The Lodden School, Wildmoor, Sherfield on Lodden, Hook, RG27 0JD
Telephone: 01256-882394 Crick Software Ltd,
Crick House, Boarden Close, Moulton Park, Northampton NN3 6LF
Blissymbols,
Telephone: 01604-671691 Fax : 01604-671692
Blissymbol Communication UK, C/o 92 Windmill Road, Headington, Oxford, OX3 7DR.
e-mail: [email protected] website: www.cricksoft.com/uk
Telephone: 01608-676455
Web site: www.blissymbols.org
Dynamo, MightyMo and MiniMo, DV4, MT4, Dynawrite, Enkidu devices
Picsyms Vocabulary applications: CallTalk, Communicate , Expressions to Daily Living,
Winslow Press, Telford Road, Bicester, Oxon, OX6 0TS. Gateway, Ingfield Vocabularies, WordPower:
Telephone: 01869-244733 DynaVox Ltd,
Wigit Rebus Symbols Sunrise Medical Ltd, High Street, Wollaston, West Midlands, DY8 4PS
Widget Software, 124 Cambridge Science Park, Milton Road, Cambridge, CB4 0ZS. Telephone: 01384-446688 Fax: 01384-446568
Telephone: 01223-425558 x773 e-mail: [email protected] website: www.dynavox.co.uk
e-mail: [email protected] Web site: www.widgit.com
66 Supporting Communication through AAC | Module 3 | Section 11 | Appendix 9
IconSpeak:
Bostock Software Development & Consultancy Ltd,
31 The Old Convent, East Grinstead, West Sussex, RH19 3RS, United Kingdom
Telephone: 0870 744 1521,
e-mail: [email protected]. Website: www.bostock.com/IconSpeakInternational
The Grid,
Vocabulary applications: Adult Dynamic Vocabularies, Chailey Communication
System (CCS), Communication Overlays for Engineering Training Environments,
Ingfield Dynamic Vocabularies (IDV):
Sensory Software,
26 Abbey Rd, Malvern WR14 3HD
Telephone & Fax: 01684 578868
e-mail: [email protected] website: www.sensorysoftware.com