Staying Sane while Staying Home

By: Kelly Nesbitt, MOT, OTR/L, Occupational Therapist

Response to Coronavirus (COVID-19) 

Kids are finishing up the school year, you are still going to work/working remotely, running your home, and keeping your kids entertained during their summer! All this change can be very disorienting and stressful for everyone.  I wanted to put together a list of some suggestions that are “occupational therapist-approved” to help you navigate staying sane, keeping a good routine, carving out “family time”, and receiving therapy services remotely while being stuck inside the house! 

Routines

Probably the largest disruption to all of us at this time is that all of our daily routines are completely changed! Daily routines help provide structure to our lives, whether you are a child or an adult. Research by Ruth Segal, OTD and Assistant Professor in the Department of Occupational Therapy at New York University, reports that daily routines give families as sense of identity, organization, and provide socialization opportunities (Segal, 2004). Our kids are used to having a predictable day involving school, extra curriculars, play dates, and therapy appointments which help them organize their days and have meaningful interactions with family and friends. With this change to e-learning and staying home, it’s completely understandable that kids may feel stressed, anxious, and aimless without their routines. This stress may be more exacerbated for children with Autism Spectrum Disorder (ASD). Children with ASD can be heavily reliant upon predictability and routine, which have been thrown off because of the Coronavirus. For both neurotypical and children with ASD alike, using visual schedules, timers, and social stories may be good techniques to help your child cope with a new routine. 

Visual Schedules

Visual schedules can be as complex or simple as you need; they can be simple drawings on a piece of paper, an excel spreadsheet, or printed words/pictures from an online generator. For some of my clients, they are comforted and reassured when I draw 3 pictures of activities we are going to do in OT.

Honestly, whatever works for your kid and helps them feel organized is correct.  Whatever way you decide to create a visual schedule, it’s important to build in both structured and unstructured time for your children. They should have time built in for their academic work for school as well as a few hours for play time that is completely unstructured. Some kids may want to put a sticker next to an activity they completed, erase it on the whiteboard, cross it out, or just put a checkmark next to it. The sky’s the limit! Below are some examples of visual schedules and who it may be appropriate for:  

(Written schedule with times, appropriate for older elementary children who can tell time) 

(visual picture or words, as they are able to read. You can draw your own pictures or just print some off for younger children who cannot read.)  

More resources at: Free Templates for Daily Visual Schedules 

Timers

In conjunction with visual schedules, it can be helpful to utilize timers (sandtimers, timer on the microwave, on your iPhone, etc.) to help your children keep organized. The timer you use will have to be dependent upon your own child’s level of development as well as what they personally need to feel supported. Apps you can use: 

1. Children’s Countdown App: Great, free time app on smart phones that shows a picture countdown on the screen. The coundtown clock can be set for any amount of time and children do not need to understand how to tell time or have understanding of numbers to comprehend it.
2. Timed It! App: App for older children in which you can put in personalized tasks in minute increments and the app will help the child count down until they need to move on to the next task.
3. Timer on smart phone: just about all smart phones have a “clock” application in which there are capabilities for setting a timer. This would be good for older children who have a better sense of what an hour, minute, second is. Although, some younger children will understand the concept that they are only “all done” when the timer makes a sound.

Social Stories

For some children with ASD, social stories are a good way to help explain why their routine has changed or what the “story” of their day. Social stories are third person stories in which the child is the main character and different themes can be explored. Ask an Occupational or Speech therapists for help creating a social story, if needed. 

Here’s a link to example social stories and one of the final links on this page has a social story template: https://www.andnextcomesl.com/2018/07/free-social-stories-about-transitions.html.  

Reducing Stress Activities

 In this uncertain time, it’s important to have some outlets for both you and your children to decompress and still have fun together. Building in sensory activities into your daily routine will help your child remain calm and regulated throughout the day.  

Physical Activities and Heavy Work

Taking movement breaks throughout your day will help both you and your child stay sane while you are cooped up at the house.  Occupational therapists often discuss the benefits of heavy work and how this push, pull, or carry input (or proprioceptive input) to the muscles and joints has a regulating and calming affect. There are a multitude of heavy work activities you can do indoors. Such as:

1. Build a pillow fort with blankets, pillows & stuffed animals
2. Pull siblings on the hardwood floor while they are sitting or laying on a blanket
3. Do animal walk races across the room (bear walk, frog hop, crab walk, etc. Make up your own silly walk!)
4. Jumping Jacks or jump on a trampoline
5. Pull siblings in the wagon around the block
6. Have a wall push-up competition and find out who is the strongest in your house
7. Play towel tug-of-war
8. Plant flowers in the backyard or help with yard work (using little shovel, pull weeds, dig in the dirt)

My helpful tip to parents is, if the activity includes pushing, pulling, or carrying something; that’s heavy work! Get creative and come up with your own ideas!

Family Game Night/Nightly Mealtime Tradition

Keeping special family routines will be important to make sure kids feel safe and supported when everyone is kind of stressed. Set aside time in your routine where you can all sit down and have a meal together with the television off. A family tradition at my house growing up was to play “Pot Boils Over” where one member of the family starts a silly story and after a few sentences says “pot boils over” and “passes” the story-telling to another family member to add on as they please. It’s a simple game that gets all family members involved, laughing, and thinking creatively.

Another mealtime routine I have heard of, is going around and saying one thing each family member is thankful for, what the best part of their day was, share a good joke, etc. This is also a great time for families to all sit down together and have game nights. You are going to be all home together, why not build some special memories and encourage social learning. Here are a few favorite games that can be played with multiple people, for different ages:

1. Games for younger children: Shoots and Ladders, Simon Says, Twister (help them with right and left), Follow the Leader, Go fish, Memory (match pictures by turning over cards), Jenga, Kerplunk
2. Games for Older children: Twister, Uno (each color you play can correspond to a fun activity such as “Make up your Own Dance Move” or “Do 2 Pushups”), Clue, Scrabble and Scrabble Junior, Telestrations (like telephone, but with drawing pictures), Apples to Apples, do a 200+ piece puzzle as a family, Guess Who?

Here’s another resource with more games: Our Favorite Board Games for Kids

Unplug

I am personally feeling inundated by COVID-19 news and I can get overwhelmed quickly, so I can imagine you and your children are feeling the same. I think it’s healthy to be aware of the evolving situation and current precautions, however it’s beneficial to “unplug” every once and a while when you are at home with your kids. Your children are very perceptive and can pick up on your stress and anxiety as they read your non-verbal cues and affect. Young children especially need their parents to “co regulate,” meaning they read your affect, mood, facial expressions and adjust their own regulation accordingly. If you exude a calm, cool, collected attitude when they are anxious, this will help them calm down and feel secure.

Therefore it’s important to turn off the news at some point and focus on having quality and uninterrupted play time with your kids. Do finger painting, make a fort out of blankets, play board games, read stories by flashlight, sit together and do a puzzle or color! Even just being available to your children, not distracted by technology or work, can be extremely beneficial to your kids.

As May is Mental Health Awareness Month, the CDC also recommends to take time to pause and breath during stress. Notice How you Feel. Take Breaks. Make time to sleep and exercise. Reach out and stay connected. Seek help if you are feeling overwhelmed or feeling unsafe. If you or your child needs help, our social work team can help.

Tele-Therapy Services

COVID-19 does not have to stop your child’s progress toward their goals! Your child can still receive therapy services remotely via tele-therapy.  Tele-therapy is a unique service delivery method in which your friendly Easterseals therapist will arrange a time and will send you a link via the Microsoft Teams app. From there, you just click on the link at your pre-arranged appointment time and you can have a video call with your therapist. Your therapist can then work on therapy goals with your child with you, the parent, being the therapist’s “hands” in the session. An occupational therapist will help coach you through appropriate handling techniques, sensory strategies, exercises, fine motor activities, feeding session and more remotely!  

All our therapists adopted this technology so your child will continually receive services with minimal interruption. It is our hope to keep providing exceptional therapy services to all of our clients during this difficult time. If you have any questions or concerns regarding tele-therapy, please reach out to one of your therapists or contact us at 630.620.4433.

Also stay tuned to our blog for more resources and tips from our therapists on helping families cope with increased time at home during COVID especially during the summer.

Sources:

• Segal, R. (2004). Family routines and rituals: A context for occupational therapy interventions. American Journal of Occupational Therapy, 58, 499–508.
• And Next Comes L Website link: https://www.andnextcomesl.com/2018/07/free-social-stories-about-transitions.html
• The Many Little Joys Website link: https://www.themanylittlejoys.com/gift-guide-our-favorite-board-games-for-kids/
• A Day in Our Shoes website link: https://adayinourshoes.com/free-printable-visual-schedules-for-home-and-daily-routines/

Tele-therapy at Easterseals

By: Valerie Heneghan, M.A., CCC-SLP/L, Director of Speech-Language, Feeding, and Assistive Technology

Tele-therapy for All! 

Easterseals DuPage & Fox Valley has been at the forefront of serving children and their families in a way that meets their current needs through clinical expertise, a team-based approach and integrating technology to ensure maximum independence. As an organization, we have been offering tele-therapy opportunities for the past 10 years as a service delivery model to those it would serve optimally (i.e., a generalization of skills to home environment, transportation issues, medically fragile or at-risk health, to accommodate busy schedules, etc.). 

In response to COVID-19, all 87 therapists were trained to transition to tele-therapy services within two days with support from experienced tele-therapists within the agency.  

How Does Tele-Therapy Work? 

Once evaluated to determine eligibility for skilled therapy services, your therapist would follow up to plan your child’s tele-therapy session and schedule a time to meet. They will work with you to review treatment plans and establish your priorities. 

Laptops or desktop computers are preferred for best overall experience. But tablets, iPhones and Android phones can work too as long as the device has a working microphone and camera. A stable internet connection is needed via a hard-line/Ethernet cord, WiFi or using your cellular plan (your standard data rates may apply). Screen sharing is available to increase participation, engagement and utilization of resources throughout the session. 

Tips for Making the Most out of Online Therapy

1. Get comfortable with the technology: Immerse yourself in the platform you are using. There are often a lot of features available such as audio adjustments and visual displays, screen sharing, chat features, etc. The more comfortable you are with these features the easier it may be to modify or troubleshoot if a technical problem occurs.
   
2. Make a plan: Plan out a time and a designated space in your home that would work best for your child. Have the computer, phone or other device propped up on books or a stand that has a wide view of the room. If possible, the therapy time should be away from other family members or pets. Work with your therapist ahead of time to prepare a few materials or resources like balls, pillows, mats, or games. 
   • Ex: For a young child, find a space where the child can sit comfortably to view the screen but also has space nearby for movement breaks. Bring your child’s favorite toy to show to their therapist and board game to keep their engagement with the parent between exercises. 
3. Be flexible: When plan A doesn’t go accordingly, be willing to change course.  
   • Take the child’s lead and adapt as necessary. Let the therapist guide you in facilitating therapy strategies through real-life reactions and experiences. 
   • Use items in your home to replicate therapy equipment. Ex: Use couch cushions and pillows to create new surfaces for climbing and crashing. 
4. Make it fun: Be creative and try new things! You may be surprised by new interests and breaking from the same routines. See how much your child can do! 
   
5. Make it matter: Use this as an opportunity for your therapist to see your child in your home to incorporate therapy strategies and techniques in your daily routine. Let your therapist see what is important to your child and how to motivate them to achieve their treatment goals. 
   • Ex: A child is experiencing difficulty with mealtime; let the therapist observe seating and position at the table, mealtime structure, and how you communicate to your child during a typical mealtime. Pick a food that is important to your family and ask about strategies to incorporate it into your child’s diet. 
6. Give your therapist feedback: It may be more difficult to pick up on social cues, be direct about what went well and what could be improved. Share ideas and problem-solve together to plan for the next session.   

COVID Response

As we try to be one step ahead of the COVID-19 crisis and care of your child, we are committed to keeping our programs running. Our tele-therapy services are available to maintain your child’s therapy schedule, help your family navigate this new routine and manage the difficult emotions that may come with it.  We can also help parents that have a concern about their infant or toddler’s development now. There is no need to wait, as the early stages of a child’s life are the most important in their development.

We are pleased that tele-therapy has already helped many children eat a new food, stay active, and improve their regulation and play skills while building a stronger relationship with their caregiver. 

We understand the immense stress of balancing your child’s needs with the demands of work and school while also keeping your family healthy. We are here to ensure that each child and their caregivers have the support they need to adopt this technology and continue therapy progress. 

While much has changed, our commitment to you remains. If you have any needs, we are actively monitoring our main phone number, 630.620.4433 and info@eastersealsdfvr.org. Contact us at any time (please include your full name, child’s name, phone number and email) and a member of our team will return the response within one business day. 

What is an Augmentative and Alternative Communication Evaluation?

By: Laura Van Zandt, MS, OTR/L

Did you know October was National Augmentative and Alternative Communication (AAC) month? AAC is a specialized area of clinical services. Here at Easterseals DuPage & Fox Valley, we are very lucky to have several therapists who specialize in helping individuals find their voice through AAC. We have both Occupational Therapists (OT)  and Speech-Language Pathologists (SLPs) involved in a multidisciplinary team evaluation to determine the best strategies and/or communication systems to help a child learn to communicate.

As an OT, I first became interested in AAC when I was working with a little boy with autism who received a high tech speech output device. It was amazing to see how having his new voice provided so many new opportunities for him. It helped with his overall regulation as he now had a system to share his wants, desires, and needs.

AAC looks different from person to person and varies from low tech options, light/mid tech and high tech systems. If you think your child might benefit from AAC, our team evaluative approach may be helpful. Below is more information on what each team member does to best help your child.

1. Many parents often have questions about whether or not a device will hinder their children’s ability to speak. This is absolutely not the case. Research demonstrates that AAC does not keep children from learning to speak.  In fact, users will make gains in language AND speech because AAC helps a child connect with others, produce successful communication, and provides consistent speech models. The child I described above, went on to learn a ton of new words after he got his device! When we begin to use AAC with toddlers, it doesn’t mean we believe they are never going to talk; instead, it often means, we believe they need a way to have a meaningful connection to others through a common language which helps serve as a bridge to spoken language.
2.  Do try and introduce forms of AAC early. Using AAC can be very helpful for a toddler who is beginning to make gestures, eye contact or sounds to communicate messages, but isn’t yet using spoken language. Often these toddlers are frustrated they can’t communicate certain thoughts and messages. Once they start to see and learn the power of communication through signs, pictures, or more formal AAC apps/devices, they begin to feel a little less frustrated.

3. Model, model, model. When using any type of AAC, we can never model enough. This means that everyone in a child’s life should use AAC too! As with all language learning, AAC is learned because those around the child speak the same language. If you think about it, early communication development (between birth – 12 months) is only modeling – caregivers communicating without any expectation while being connected with their baby using a common language. I love it when my clients bring their devices to therapy. If your child is already receiving therapy services, ask the therapist to use your child’s communication system during sessions to connect and engage with your child. When using AAC, continue to use verbal speech to model and help children understand the pictorial representation of language and develop the words.

4. When you schedule an evaluation, you will see both an occupational therapist and a speech therapist trained in AAC. Both therapists are knowledgeable in a variety of access methods such as hand access, switch scanning, and eye gaze technology. The occupational therapist will specifically look at:

• the child’s overall posture and strength to allow for upper extremity (or any other extremity) use while accessing the communication system
• determine optimal positioning of both the child and the device to ensure the most efficient method of access
• the child’s vision, auditory, and sensory processing needs
• the child’s visual and/or auditory scanning ability
• the child’s visual/auditory tolerance
• any adaptations to engage different sensory systems, as well as monitor for sensory overload and/or assist in sensory regulation for device access.

The speech therapist is extremely knowledgeable in the vast array of AAC communication systems and AAC strategies available. They will help determine the communication system and language page best suited to bridge the gap between the child’s receptive and expressive communication skills. The evaluations are done in a play based manner to help the child feel comfortable. And play is how children learn!

Here at Easterseals we offer a team approach for evaluating children for AAC needs. For children that could additionally benefit from AAC, we will see them for co-treats to help expand their language within play based therapy sessions.

When the child’s specific goal is to assist in overall regulation and play to support device access, then a co-treat can be extremely valuable between Occupational Therapy and Speech Therapy. OTs are trained in setting up sensory rich environments to support regulation and drive play. These activities can be very motivating for your child’s communication. There are endless opportunities to model language depending on your child’s unique development.

To learn more about Assistive Technology at Easterseals DuPage & Fox Valley, click here. 

 

Additional resources: www.speechscience.org

The Amazon Echo as an Accessibility Support

By: Judy Gardner, MA, CCC-SLP, Speech Pathologist/Feeding Therapist

Amazon describes the Echo as a hands-free, voice-controlled device that uses Alexa (Amazon’s answer to Siri, Cortana and Google) to play music, control smart home devices, provide information, read the news, set alarms, and more.  It is exciting that people’s interactions with a computer device is much easier with no buttons to find and press.  The speech recognition still has some limitations but devices like the Echo show what the future may be around the corner.  The Echo works by constantly listening to a trigger word, by default, the trigger word is “Alexa” but you can change it in the Alexa app on your mobile device.    The communication devices we use in assistive technology allow a non-verbal child, or the child with some difficulty in oral speech to use the Echo independently.

Relationship Coordinator, Amy Liss, really enjoys this new device. “This is the most beneficial piece of technology I have ever received that can help me be completely independent.” Her favorite feature is playing daily Jeopardy trivia.

Some of these many uses:

Get quick answers for simple Web searches:  The most basic use of the Echo is to ask it questions it can answer by searching on the Web.  This ranges from simple math (Alexa what is 125 times 33?”) or spelling and definitions, etc.  The Echo is unique in that it will say the answers out loud  rather than requiring the user to read the responses.

Set alarms and timers:  So children with executive functioning is ability to self-regulate, including the ability to stay on task and manage and keep time.  For example, you can set a timer for someone to do an activity for one hour (“Alexa set a timer for one hour”) then set a second timer for each separate step that needs to be completed to accomplish the assigned task during that hour.  Just say “Alexa set a second timer for 25 minutes.  So you can have a 5 minute break.

Manage a to do list:  Just say “Alexa, add (name of to do item) to my to do list, or remind me to (name of task).”

Update your calendar:  “Alexa, add (event name) to my calendar.”  Gives the ability to stay organized.

Get your daily news fix:  (“Alexa, give me my Flash Briefing”)

Listen to Audible and Kindle books:  The Echo is a great way to listen to your books read aloud.  This can be a great way to use the Echo in the classroom setting.

Control your lights:  Echo can be great way to control your home lighting using just your voice.  This can be especially helpful for those who have motor difficulties.  By installing the Hue Skill, you can get basic voice control of the lights in your home.

Control your appliances:  With a Wemo switch you can add voice control to any small appliance with an on/off switch (fans, lamps, etc.)

Listen to music and podcasts:  Echo supports a number of music services.

There are many more thing you can do with the Echo.  For more details go to www.luisperezonline.com for full details.  If you have a voice that is difficult to understand, have no fear- Alexa can use many speech generating devices to the rescue.

The Assistive Technology department at Easterseals DuPage & Fox Valley has received a grant to install Amazon Echo in their department.  Once it is installed we hope that you all will come down and give it a try.  Learn more about our assistive technology department by clicking here.

Screen Time: What is too much?

By: Cassidy McCoy, PT

Over the past few years, computers, tablets, phones, and TV seem to have taken over. Technology has begun to change the way our children interact with each other and us. However, how much time spent on these devices is considered too much?

The American Academy of Pediatrics recently released new recommendation for children’s media use.

The recommendations include:

• <18 months: Avoid use of screen media other than video-chatting.
• 18 to 24 months: If you want to introduce digital media, choose high-quality programming. Also, watch it with your children to help them understand what they’re seeing.
• 2 to 5 years: Limit your children’s screen use to 1 hour per day of high-quality programs. You should watch it with them to help them understand what they are seeing and apply it to the world around them.
• 6 and older: Place consistent limits on the time spent using media, the types of media, and make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.

What are the potential effects of too much screen time?

• Obesity: Too much screen time equates to more time spent in sedentary positioning resulting in decreased physical activity and weight gain. The American Academy of Pediatrics recommend for children to get at least 60 minutes of active play daily.
• Sleep: Devices emit a blue light that mimics daylight, which stimulates you, leading to irregular sleep schedules and shorter duration of sleep with use of a device before bedtime.
• Behavioral problems and violence: Screen time can be an effective way to calm down, but it should not be the only way they learn to calm down. Children should learn how to identify and handle strong emotions and come up with ways to manage them (such as deep breathing or problem solving)
• Loss of social skills: Face-to-face communication or “talk time” is critical for language development. Research has shown that it’s that “back-and-forth conversation” that improves language skills—much more so than “passive” listening or one-way interaction with a screen.

What can you to to help?

• Set time limits and expectations
• Create “tech free zones” such a dinner table or bedrooms
• Use screen time to promote education and development by utilizing appropriate programming.

For more information on Easter Seals DuPage & Fox Valley visit, eastersealsdfvr.org.

My Child is Stuttering; Will He or She Grow out of it?

By: Valerie Heneghan, M.A., CCC-SLP/L

You may have noticed that your child appears to be getting stuck on words or repeating words and sounds recently, what do you do?  Your friends and/or family may have told you not to worry about it as they will likely grow out of the problem, is this true?  How can you tell if my child is stuttering?  When do I seek help for this problem?

In this post, you will be provided with a brief summary addressing questions related to childhood stuttering.

Prevalence

According to the American Speech-Language-Hearing Association (ASHA), in preschool age the prevalence of stuttering can be as great as eleven percent. The prevalence of stuttering is also greater in boys than girls up to 4:1 as the stuttering progresses.

Characteristics of Stuttering

Disfluency is anything that interrupts the forward flow of speech. Stuttering occurs when this disruption occurs within a word.

There are two forms of stuttering:

1) Sound/Syllable Repetition: repeating a single sound or syllable (e.g., g-g-g-going, bi-bi-cycle, etc.) and 2) Sound Prolongations; pausing or stretching out single sound (e.g, g__oing, ____bicycle).

Associated and/or secondary characteristics may also be present for a child who stutters.  These are described as movements as a reaction to the stuttering including but not limited to: distracting sounds, facial grimaces, head movements, movement of the extremities, etc.

Risk Factors

Stuttering is a disorder of childhood with typically emerges between the ages of two and a half and five years old. While genetics and neurophysiology appear to be related to the underlying causes of stuttering, environmental factors, temperament, and speaking demands may influence a child’s reactions to stuttering.

Recovery

80% of children will outgrow stuttering within four years.  During the first year however, 12% recover spontaneously.  Indicators that your child may continue to stutter includes but not limited to: no changes in frequency of stuttering, changes in stuttering type, persistence of associated behaviors six months post onset, family history of stuttering, increased communication demands, etc.

When therapy is recommended

If you notice that your child is stuttering, mark when you first noticed the problem begin.  Initially, do not draw attention to the stuttering, decrease the communication demands and model slow and smooth speech when speaking to or near your child.

If you are concerned about your child’s stuttering, have them evaluated by a Speech-Language Pathologist who specializes in assessing and treating children who stutter.

Top Five Blog Posts of 2015

Thank you for being a reader this year. Review the top five most read blog posts from this year.

5. Self Regulation: The Secret to Success: Speech-Language Pathologist Jessica Drake-Simmons shares methods to help children filter out distractions, handle emotions, delay gratification and inhibit impulses in order to be able to focus their attention on learning.

4. Myths and Realities of Augmentative Communication  As the title suggests, Speech-Language Pathologist Amanda Nagle dispels the most common concerns (myths) regarding augmentative communication.

Physical Therapist Bridget has the top posts helping parents and caregivers prevent flat head, correct sitting position and babies crawl.

3. How to Prevent Your Baby From Getting a Flat Head

2. What’s Wrong with W-Sitting? By: Bridget Hobbs, PT, DPT

1. Yes!  We Want Your Baby to Crawl! By: Bridget Hobbs, PT, DPT

Wishing you a happy new year!

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

One Step

Jamie Bodden Austin, M.S. CCC/SLP-L- Assistive Technology Speech and Language Pathologist
Learning a language is a journey – be it a a first language, a foreign language, a light tech symbols systems (e.g. PODD Communication Books) or a high technology voice output system (e.g. Proloquo2Go on an iPad, NOVA chat 10 or Tobii Dynavox). It begins with one step. A baby hears words for the first year said by all of their family members. The family members repeat these words, use gestures, point to things, say single words over and over words such as “Daddy”, “Up”, “Uh oh”. They focus on favorite words (e.g. “doggie” and ‘Swing”), familiar words (e.g. “bottle”, “night-night”), greetings (e.g. “Hello”) and comments (e.g. “uh oh”). After one year, the first word, a single word is spoken by the baby. When learning a foreign language, the teacher speaks single words, uses gestures and points to items. She focuses on favorite words, greetings, comments and familiar vocabulary first.
The same is applied when learning any AAC system. It is another language. Did you know that baby hears 4,000-6,000 words per day for the first year, before they say their first word? This repetition of modeling of language is just as important through a Augmentative and Alternative communication (ACC) device. This can be formally called: Aided Language Stimulation, Partner–Augmented Input, Natural Aided Language or Aided Language Modeling. This means that all of the people in a child’s environment communicate using the AAC communication system. When we support someone to learn to use an AAC device, we talk with the device throughout the day ourselves. We can think about saying favorite words, familiar words, greetings and comments. While doing this we can use gestures, point to things and say single words with the AAC system. By having all of your family/friends involved in saying messages using the AAC system you create a language rich environment, in your child’s language. This language becomes another language in your home that you all speak.

The trick is that you and your family are also learning the AAC system. However, every journey begins with a single step. Like a baby learning to speak and like a person learning a foreign language, focus only on one word or one page of vocabulary at a time. The more you talk with the device with this one page or one word, the more your child will hear, see and follow your lead. You can start with a favorite activity, a greeting or with a few favorite actions. Next, find another page to focus on, such as position words, names, questions or places. You can’t learn the device in one day, but the more single words you find, you will see your own AAC vocabulary grow. Your one step is going to be the biggest step of your child’s AAC journey.

“A journey of a thousand miles begins with one step.” Lao-tzu

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

SMART Technology

By: Valerie Heneghan, M.A., CCC-SLP/L

SMARTBoards are now available at Easter Seals DuPage & Fox Valley! This new technology will be utilized for individual therapy sessions, community based therapy programs and classroom based learning in the pre-Kindergarten classroom at The Lily Garden Child Care Center. While SMARTBoards are widely used in schools and have been proven to be innovative in the classroom setting, we know there are numerous applications in the therapeutic setting.

There are 4 major advantages of bringing this technology to children of all ages in a therapeutic setting.

 1. Enriched Teaching and Learning Experience

The SMARTBoard provides a multi-modal learning experience for children. With typical instruction, educators can be limited to mostly auditory learning with supplemental visual supports. Using the SMARTBoard, children have access to auditory, visual, kinesthetic, and tactile learning by being able to physically interact and conceptualize topics in new exciting ways.

Photo by Molly Gardner

Studies have revealed higher learning outcomes as educators are given a platform to prepare and execute their ideas and materials more efficiently. With increased efficiency of materials presented and engagement from children, studies have shown improved performance outcomes and efficacy for achieving treatment goals.

2. Unlimited Access to Online Information and Resources

The SMARTBoard gives you flexibility to utilize many forms of media. Using articles, pictures, and videos creates exceptional involvement with a child using applications that are of deep interest and captivation. Many SMARTBoard users have created their own materials and have shared them for others to download for free use. The SMARTBoard software also provides a variety of materials which saves preparation time for therapists.

3. Universal Design – User Friendly

With a variety of products available, the SMARTBoard hardware is suitable for a variety of abilities and assists in bridging the gap for those who have motor, visual, hearing, attention deficits, etc. It also encourages companies to go green, as this is a web-based medium. Therapy materials are available online and can be shared or stored without producing physical materials.

4. Communication

Unlike Apps, the SMART software is completely adaptable to meet the needs of specific individuals and their learning needs. Using technology is innately engaging for children of this generation while still providing targeted hands-on learning. Additionally, by having the ability to touch and change the sessions as you go, sessions can be stripped down to the most functional level for children of all abilities, simplifying the learning process.

The SMARTBoards have four touch points, allowing a therapist and client or multiple clients in a community based therapy program to touch and learn together. The games are so fun, the child doesn’t realize they are practicing new speech patterns or movements as part of their therapy goals.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.

Myths and Realities of Augmentative Communication

By:  Amanda Nagle, MA, CCC-SLP/L

Two-year-old Frank vocalizes the word “duck” while playing with a computer laptop and recorder. Frank attends weekly speech pathology sessions at Easter Seals DuPage & Fox Valley to help with issues that stemmed from food allergies and delayed truck core strength. After a year of therapy, Frank is now quite a talkative young boy!
Photo by: Nancy Kerner

Parents understandably worry when they hear the words “speech generating device”, “AAC” and  “augmentative communication”. Concerns are voiced such as:

• The Speech Language Pathologist (SLP) doesn’t think she will talk and is giving up on her speech
• My son talks, why is the SLP recommending a speech generating device? My son doesn’t fit this profile!
• Won’t that device stop her talking and make her too lazy to talk?

That is just not the case. The American Speech Language Hearing Association (ASHA) defines augmentative and alternative communication (AAC) as “all forms of communication (other than oral speech) that are used to express thoughts, needs, wants and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.”

There are many myths around the use of augmentative and alternative communication (AAC) in individuals of all ages but these myths are particularly prevalent with our young children. Below are the most common concerns (myths) that I continue to hear from families and professionals, especially those working with young children.  I want to dispel the myths with the realities surrounding the concerns.

MYTH:  The AAC system will become a crutch for my child.  Parents are frequently concerned that their child will use the device instead of learning to communicate verbally.

REALITY:  Many children’s verbalizations increase when they begin using a voice output AAC device.  Research and clinical practice continue to indicate that AAC does not interfere with verbal speech and actually encourages spoken language.   We frequently see increased imitation and spontaneous verbalizations when children use augmentative communication systems.  Children will communicate with the easiest and most flexible means available to them.  It is easier to use verbal speech when possible than it is to create a message on a communication device.

MYTH:  The term ‘augmentative communication’ refers only to devices with voice output.

REALITY:  There are many different types of augmentative communication with and without voice output.  Some types include using objects, photographs, picture symbols such as Boardmaker or SymbolStix, gestures and manual signs.  Other types are low tech battery operated single message voice output devices with as few as one message.  Mid tech devices are available with multiple message selections.  High tech devices are also available with robust language organization that can be modified for various stages in a child’s receptive and expressive language development. 

Tablet systems such as iPads have a variety of communication apps from single messages to full robust language organizations.  Frequently, children’s full communication systems include a combination of no tech, low-tech and high-tech AAC, in addition to their unaided communication including verbalizations.

MYTH:  Individuals must progress through a specific hierarchy of skills before they are ready to use augmentative communication or before moving to the ‘next level’ of augmentative communication.

REALITY:  There are no prerequisites for communication.  A child does not need to understand cause-effect before he/she can use AAC.  A child may actually learn cause-effect skills through the use of augmentative communication while she is learning new forms of communication.  A child does not need to know that a picture represents an object.  When a picture is attached to a voice output device or to a low tech surface, the child will begin to associate meaning between the picture and the object she receives when she selects the symbol.

For example, if you attach a picture symbol of ‘bubbles’ to a single message device, your child touches the picture and hears the message ‘bubbles’, then you blow bubbles for her, in time she will begin to associate the picture of bubbles with the actual bubbles.

MYTH:  AAC is a last resort and we are giving up on my child’s speech.

REALITY:  A child’s use of AAC can enhance speech, language and communication development while reducing frustration at the same time. Ideally, augmentative communication strategies should be introduced and implemented prior to communication failure in order to prevent communication failure.  When AAC is introduced early, before increased frustration and communication failure occur, a child may naturally incorporate the system into their typical communication repertoire.  Receptive and expressive language skills can be modeled using an AAC system.  It is never too early to begin to incorporate AAC strategies into a child’s communication development.  When introduced early, AAC can provide a strong foundation for a child’s receptive and expressive speech and language development.

MYTH:  My child speaks and AAC is only for people who are completely nonverbal.

REALITY:  AAC systems and strategies may be used as primary communication systems or as supplemental/augmentative systems for individuals.  Many children are verbal and have trouble being understood by unfamiliar listeners or become frustrated when a familiar listener doesn’t understand a spoken message when the context is not known.

The following are some, but not all of the additional ways that AAC can be used with children who are verbal but may be difficult to understand:

• repair communication breakdowns
• set topics
• word retrieval
• receptive language development
• expressive language development
• expansion

It is important to remember that individuals with complex communication needs should have the opportunity to use augmentative communication strategies if they are not able to say what they want or need, share an idea or story, offer their thoughts, ask questions, tell you that they are afraid and what they are afraid of, and tell you if they are in pain.  Augmentative communication can provide a means for them to share these types of messages to more people in more places more often.It is never too early to introduce AAC into communication intervention.  There are no prerequisites for communication.

For more information about Easter Seals DuPage & Fox Valley please visit EasterSealsDFVR.org.