Meet Libby: Why are we concerned about this student?
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Libby is a 4 year 1 month old Hispanic child. She is being raised by adoptive parents who both speak English. She is of a short stature. Libby was tested in February at a chronological age of 44 months. Her developmental levels are: Cognitive – 24 months, Expressive – 24 months, Receptive – 23 months, Personal Social – 28 months, Fine Motor – 24 months, Gross Motor – 24 months, and Adaptive – 24 months. She enjoys playing in the housekeeping area or the play area, but prefers solitary play. She will sit by herself with one or two toys and try to engage an adult. She uses a limited amount of words in the classroom which include Ah Oh, please, and I got it. The volume on her voice is low and she is, therefore, difficult to hear when she does speak. She can point to objects in her environment and will make choices at circle on request. She is working on toileting and will use the toilet or potty char when placed. She resists taking her clothing down to use the toilet.
Libby currently gets special instruction, physical therapy, and motor development. She is in a 3 day per week half day preschool class with 4 to 5 other peers who are non-categorical special education students. The preschool classroom is broken down into 5 areas which include circle, housekeeping, art/snack, play, and library areas. Each area has about 8-9 square feet with an open area in the center of the room for movement between centers. Picture communication symbols are present at circle, and throughout the room for area labels. Libby is able to walk to each area, but prefers to sit alone in the play area. She will hide in the house when it is time to transition to another activity.
The schedule in the classroom starts with arrival. Once the students are in the classroom they remove their coats and backpacks. They take their snack and notebooks out of their backpacks and put these onto the shelf by the door. They then put their coats and backpacks into their individual cubbies. At bathroom times Libby is able to walk down the hall with the other students. She needs help to get up and down from the child sized toilet seat. Circle lasts for 15-20 minutes depending on the schedule for the day. During Play Time the students are allowed to move between areas. There is a clean up time at the end of each play session where materials and toys are put back into their labeled places. Snack time follows hand washing, and Libby needs help in reaching the adult sized sink, even with a two step stair. She will use pointing and guttural sounds to request snack items.
Libby needs to be able to communicate what she wants to do, and then follow through. She needs to be able to tell adults around her when she has to go to the bathroom. She needs to be able to communicate her snack preferences, and who she wants to sit beside at circle. She needs to be able to use her own name, and to name her peers. Libby needs to be able to remove her coat and backpack, and remove the items from her backpack. She then needs to put them in the appropriate place. Libby needs to be encouraged with hand over hand to put toys and materials away. She will pick up her trash from snack, as well as her cup and placemat and put them into the trash can. Libby needs to be able to request snack items.
Consider and Trial AT
Goals: Where are we going?
At Libby’s most recent IEP meeting, the school team, including Libby’s parents, agreed that Libby would likely benefit from the use of Augmentative Communication strategies and the possible use of a voice output device in order to help her reach her IEP goals and objectives. The school team needs to evaluate exactly what device would be best for Libby to use, and therefore a trial with voice output device was added to her IEP. Libby has IEP goals and objectives across all areas of development, but some of the goals that the team is most concerned about accomplishing are those in the area of Personal/Social. Objectives in this are are for Libby to use her own name, put toys away, manipulate toys to interact, request activities, and communicate play intentions.
Strategies and Tools: How do we get there?
In the classroom, there has been limited use of AAC tools and strategies, but Libby has had exposure to song boards which consist of picture communication symbols for the main ideas of songs. These boards are used at circle and the students are encouraged to point to the symbols as they sing through the songs. Libby will occasionally point to an object on the board indiscriminately. The team would like to allow Libby more choices for songs and other activities including play and snack. Using the Choose and Trial AT Planning Form, the school team has decided to trial the use of an 8 cell voice output device, the TechTalk with Libby, as they have it available in the classroom. The school SLP and the classroom teacher will collect data on its use during play time and snack daily over a period of 2 weeks.
Implement AT: What needs to happen so that the tools and strategies are used effectively? Using the Implement AT Planning Form, the school team has decided to have the Speech/Language Pathologist create overlays for different activities using Boardmaker software. The overlay would be changed based on the activity. The team decided that snack choices would be: more please, no thanks, crackers, fish, pudding, spoon, milk, and juice. Pretend play choices would include: baby, sleep, eat, cry, bottle, night-night, shh, more. The SLP will train the special educator and the para educator in the classroom how to change the overlays on the voice output device and on strategies including Aided Language Stimulation, to facilitate Libby’s successful use of the VOD. Data on Libby’s use of the VOD, including prompted and spontaneous use will be tracked as specified in the AT Trial Plan. At the conclusion of the 2 week trial the team planned to meet again to discuss the data collected and next steps for implementing AT and monitoring progress.
Monitor Progress
How do we know we are on track?
Following the 2 week trial, the school team was very pleased with the progress Libby has made using the voice oupt device. With prompts, she is starting to select a prefered food at snack and has spontaneously asked for more. In the housekeeping center, Libby will select baby on the voice output device when it is presented to her. The school team feels that Libby is on track using the voice output device and they will continue to implement its use and provide appropriate modelling during snack and play. They are also going to introduce the use of the voice output device for bubble play with the following vocabualry: bubbles, blow, pop, messy, uh oh, my turn, more, all done. They will explore strategies, including use of a prompt heirarchy to increase Libby’s spontaneous use of the device
Implications
By following the AT Cycle of Consider, Choose and Trial, Implement and Monitor, Libby’s school team was able to make appropriate decisions regarding the use of AT (specifically an AAC device) to support Libby in her attainment of IEP goals and objectives.
