Speech Generating Devices

EFFECTS OF ACCESS TO A SPEECH GENERATING DEVICE, A VIDEO MODEL AND DIRECT TEACHER TRAINING ON COMMUNICATION ATTEMPTS BY STUDENTS WITH SIGNIFICANT DISABILITIES

Patricia Wright National Director, Autism Services

Definition of Terms • Augmentative and Alternative Communication (AAC) – Systems – Support

• Speech Generating Device (SGD) • Significant Disability • Communication Attempts

Statement of the Problem • Statement of the Problem – Professional development in special education has not kept pace with best practice in augmentative and alternative communication intervention – Methods to encourage professionals to utilize speech generating devices with individuals with significant disabilities needs to be investigated

Purpose • To determine which of three levels of intervention intensity is needed to get teachers to provide their students with an SGD – Provision of an SGD – Video observation of successful users of SGD – Direct instruction on the use of an SGD

Brief Literature Review

Success with Speech Generating Devices • Obtain preferred items • Obtain access to preferred activities • Functional communication training • More interaction/turns during a conversational exchange

Speech Generating Devices in Comparison with Other AAC Methods • More successful than pictographic communication for gaining attention in community • User preference • More effective than sign-language alone

Professional Development • Training of educational personnel is prerequisite to AAC use • Lack of time for training is an identified barrier • Outcome Management is an effective approach • Use of video for training • Milieu teaching/incidental teaching is effective for AAC instruction

Methods

Participants • Criteria for Students – Age 3-21 – Receiving services under an IDEA eligibility category – No meaningful verbalizations – Sufficient motor skills to use a simple switch – No access to speech generating device for expressive communication

Ag e

Doug

3

Ge nder

Ethnicity

IDEA Eligibility

Language Spoken at Home

Langua ge Spoken at School

M

Micronesian

Developmental Disability

Micronesian (actual language withheld to protect confidentiality)

English

Speech and Languag e Services on 30 IEP minutes per week

Sam

5

M

Japanese/ AfricanAmerican

Autism

Japanese

English

60 minutes per week

Mary

9

F

Micronesian

Multiple Disability

English

English

None

Tom

19

M

Vietnamese

Autism

Vietnamese

English

None

Participants • Criteria for Teachers – Licensed in special education

Teache r

Education Level

Darlene BA Education Professional Diploma in Education

Number of Years of Experienc e 3

# of Students with Significant Disabilities Taught 11-20

Kelly

BA Speech Pathology Professional Diploma in Education

27

>50

Joan

BA Education Professional Diploma in Education

5

11-20

Sally

BA Music Professional Diploma in Education

7

11-20

Settings • Criteria for Selection – Public School

Student

Grade Levels on Campus

Enrollment

% of Enrollment Receiving Free and Reduced Lunch

Doug

Preschool – Grade 5

531

56%

Sam

Preschool – Grade 5

531

56%

Mary

Kindergarten – Grade 5

288

81%

Tom

Grade 9 – Grade 12

1574

19%

Research Design • Multiple Probe • Replication across subjects

Dependent Variables • Teacher provision of the SGD – – – –

Physical placement Message recorded Symbol on-top Prompted (if needed)

• Communication attempts – Unique challenge. . .

Procedures • Prior to Baseline – Consent – Activity identification – 1 hour observation for current communication

• Baseline

Procedures • Intervention I: provision of device • Intervention II: teacher observation of video • Intervention III: Didactic instruction / Outcome Management 1. List desired outcome for student 2. Specify what staff must do to support student in obtaining desired outcome 3. Describe, for staff, their expected responsibilities 4. Provide a written, concise description of duties 5. Demonstrate how to perform expected duties

Procedures • Generalization • Social Validity/Teacher Interview

Results

Communication Attempts Baseline

Interventio n I

Interventio n II

Interventio n III

Generalization

Sam

1.3 (.21) 1.86(.21)

1.87(.22) 3.07(.85)

Mary

.02(.03 )

.01(.02)

.02(.03)

.74(.01)

.18

Tom

.55(.22 )

.51(.24)

.66(.09)

3.1(.85)

1.4

Doug

.03(.02 )

.01(.02)

.02(.03)

.75(.20)

2.4

2

Teacher Provision of SGD Student Doug

Interventio Interventio Interventio n n II n III I 0%(4) 0% (3) 100% (3)

Generalizatio n 100% (1)

Sam

0% (3)

0% (3)

75% (4)

100% (1)

Mary

0% (4)

0% (3)

100% (3)

100% (1)

Tom

0% (5)

0% (3)

100% (3)

100% (1)

Discussion

Discussion • When an SGD was provided communication attempts increased • Direct instruction is required for use of SGD • Generalization – Untrained setting – Higher rates for Doug

Teacher Interview • Beliefs: – Student capable of more communication – SGD is an appropriate method • Sam and Tom (higher level device) • Mary and Doug (infused throughout the day)

• Intervention I – Fear of breakage

• Intervention II – Impressed by users, hoped same success for their student

Teacher Interview • Intervention III – Direct instruction was needed prior to use – Message selection • Social message, a novel concept

– Barriers • Determining message selection • Time to record

Limitations • Multiple baseline • Limited generalization data • Device selection – Single message – Lack of feature matching

• Unable to assess cumulative effect

Future Research • Communication attempts vs. communication • Generalization of SGD use across settings • Home/School language • Longevity of SGD use

EFFECTS OF ACCESS TO A SPEECH GENERATING DEVICE, A VIDEO MODEL AND DIRECT TEACHER TRAINING ON COMMUNICATION ATTEMPTS BY STUDENTS WITH SIGNIFICANT DISABILITIES

Patricia Wright National Director, Autism Services