Areas Augmentative and alternative communication Should Evaluate Summary Part 1: Assessment Summary
In 500-750-words, summarize the following:
What areas should an AAC assessment evaluate?
What areas of communication do AAC assessments address?
How do assessment results inform AAC strategies/techniques?
Identify AAC assessments used within your school or district and explain when each assessment would most appropriately be used.
Support your assessment summary with 1-3 scholarly resources.
Part 2: Case Studies
Read the following case studies to inform Part 2 of the assignment.
Case Study 1: Mandy
Mandy is a 3-year-old preschool student who has been diagnosed with ASD and is nonverbal. She is sensitive to loud noises and certain textures. She was recently referred to a child study team by the family physician. Her family doctor described her as having low muscle tone, delayed communication, and delayed motor skills. She uses her behavior and physicality for communicating needs. Mandy does point and reach for desired items, but she has not been able to reproduce any signs, despite her parents’ attempts to teach her sign language for the past year. She often appears to be disengaged when playing or when her parents are encouraging her to sign. Her eye contact is minimal, tantrums are common, crying happens daily, and change is very difficult for her.
Case Study 2: Wilson
Wilson is an 11-year-old boy who was diagnosed with ASD as a toddler. He is physically healthy, but he is very sensitive to hot, cold, noises, and pain. He does not like crowds or lines and struggles with class assemblies, lunch time periods, and recesses. He is in a self-contained special education classroom on a public school campus and attends general education class for music only. He is capable of doing some general education class work, but his behavior is far too unpredictable to make further placement in a general education classroom feasible at this time. He can be impulsive and destructive when frustrated or overwhelmed. He is quite social and enjoys interacting with his peers in both settings; however, it can be difficult to discern when he will have a meltdown. He has tantrums and destroys property, and his participation in some aspects of school is limited. When changes in the schedule occur, such as school assemblies or fire drills, Wilson has a hard time adjusting and oftentimes tips over desks or kicks. He has not been able to attend the last two field trips due to his parents’ concerns for his safety.
Case Study 3: Cole
Cole is a 16-year-old boy with ASD and cognitive delays. He was born three weeks premature and required intensive neonatal care for six weeks after birth, but he is currently in good health. He passed all hearing and vision screenings. Cole uses gestures and a few verbal words to express his needs and wants; for example yes/no and hungry. He uses a few sign language gestures and some picture symbols, but mostly relies on a communication device in order to communicate with teachers, peers, and parents. When stressed or uncomfortable, Cole bites his finger and bangs his head. He generally will only use his device when a teacher or other caregiver asks him to, often relying on others to show him how to use the device. He is not independently able to communicate his needs in a meaningful way.
Select and analyze two of the case studies. Compose a 250-500 word summary per case study that addresses the following:
Identify an appropriate AAC assessment
Rationalize your assessment choice.
Detail how the assessment results will aid in designing or modifying instruction to meet student needs.
Make the case for ongoing evaluation of abilities, strengths, and needs as it pertains to the case study student.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
http://www.asha.org/uploadedFiles/Communication-Services-Severe-Disabilities.pdf
http://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/FCT_Steps_0.pdf National Professional Development Center on
Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Steps for Implementation: Functional Communication
Training
Franzone, E. (2009). Steps for implementation: Functional communication training. Madison,
WI: The National Professional Development Center on Autism Spectrum Disorders,
Waisman Center, University of Wisconsin.
Functional communication training (FCT) is most frequently used to replace interfering
behaviors (e.g., disruptive, repetitive/stereotypical) or subtle, less clear communicative forms
(e.g., reaching, leading) with more conventional communicative forms (e.g., pointing, picture
exchange, signing, verbalizations).
Step 1. Identifying the Interfering Behavior
In Step 1, teachers/practitioners identify (a) an inappropriate behavior (e.g., hitting,
grunting, falling to the floor) that is serving some type of communicative function and
that is being reinforced (perhaps unknowingly) so that it continues to occur on a regular
basis or (b) a subtle communicative attempt that can be replaced with a more
conventional form of communication.
1. Teachers/practitioners (e.g., speech/language pathologist, paraprofessional)
identify an interfering behavior or a subtle communicative form to be the
interfering behavior.
Potential interfering behaviors that are serving some type of communicative function
and are being reinforced (perhaps unknowingly) include:
interfering behaviors that may be repetitive, disruptive, and/or self-injurious
and
subtle forms of communications such as grunting, reaching, leading.
Step 2. Completing a Functional Behavioral Assessment (FBA)
In Step 2, two components of the FBA process are implemented by
teachers/practitioners. These components serve as reminders to those who are
experienced with the FBA process. For teachers/practitioners who are not as familiar
with FBA, please refer to the FBA Steps for Implementation. A high-quality FBA has
many discrete steps related to identifying the interfering behavior, collecting baseline
data, developing a hypothesis statement, and testing the hypothesis that are helpful
when implementing FCT. Therefore, if you are not familiar with the complete FBA
process, please refer to Steps 1 through 5 of the FBA brief.
Functional Communication Training: Steps for Implementation
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10/2010
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Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
1. Teachers/practitioners complete a high-quality FBA .
With FBA, teachers/practitioners use (a) indirect (e.g., interviews, record review,
questionnaires) and (b) direct assessment (e.g., A-B-C observation) to create a
hypothesis about the function of the interfering behavior and to determine what might be
causing and reinforcing the behavior. An FBA provides teachers/practitioners with a
clear understanding of why learners engage in the interfering behavior.
2. Teachers/practitioners identify the function of the interfering behavior.
Data collection is a key part of a high-quality FBA and is essential for determining the
function of the interfering behavior. The function of the interfering behavior will most
likely include one of the following:
gaining attention (e.g., a teenager screams to get attention from staff);
escape (e.g., a boy bites his hand so that he is removed from math class);
gaining access to tangible/edible items (e.g., a girl grabs cookies from her
friend’s hand); or
acquiring automatic sensory stimuli (e.g., a learner flaps his hands during
language arts).
Data also provide baseline information that is critical for planning effective interventions.
Considerations for planning interventions include identifying:
antecedents of the interfering behavior (i.e., what happens to precipitate the
behavior) and consequences (i.e., what happens after the behavior that
might be maintaining it);
environments where the interfering behavior occurs;
people involved with the learner when the interfering behavior occurs; and
the frequency and intensity of the interfering behavior.
Step 3. Identifying a Replacement Behavior as a Substitute for the Interfering
Behavior
In Step 3, teachers/practitioners identify a replacement behavior that serves the same
function as the interfering behavior and that will serve as a substitute.
In general, a replacement behavior should still allow the learner to get what he wants
just as easily, or more easily, than the interfering behavior. If it doesn’t, then the learner
has little incentive to use the replacement behavior that is less efficient than the
interfering behavior.
Functional Communication Training: Steps for Implementation
National Professional Development Center on ASD
10/2010
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National Professional Development Center on
Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
1. Teachers/practitioners select a form of communication (e.g., signing,
verbalizations, pictures) that is appropriate for the learner.
Depending on the learner, the replacement behavior may be delivered through
verbalizations (e.g., words), signs, gestures, pointing, the use of a picture exchange
system, or a speech generating device.
2. Teachers/practitioners choose a replacement behavior that is efficient.
The replacement behavior should be simple enough (a) to be taught in a short amount
of time and (b) allow the learner to quickly acquire the behavior and gain access to the
reinforcement. If learners are asked to produce a complicated replacement behavior,
they may revert back to the undesirable interfering behavior.
3. Teachers/practitioners identify a replacement behavior that is acceptable and
appropriate for both the environment and the learner.
The replacement behavior should be appropriate for the learner’s environment and be a
task or activity that the learner can or will do. For example, teaching a seventh-grade
student to hold up a large picture of a toilet to request a bathroom break is not
acceptable in an inclusive middle school setting because it may invite unnecessary
teasing from classmates. In this situation, it may be more appropriate to teach the
student the sign for toilet.
4. Teachers/practitioners choose a replacement behavior that is recognized by
multiple communicative partners.
If the replacement behavior is not recognizable to others, communication partners may
not respond, and the interfering behavior may not be reduced. Teaching a learner with
severely reduced intelligibility (i.e., difficult to understand) to say, “I need help with this,”
may not be an appropriate use of FCT. If the sentence is difficult to understand,
communicative partners may not provide the reinforcement (assistance) consistently,
and the interfering behavior will not decrease. However, if the same learner is taught to
sign, “Help,” communicative partners could more quickly recognize the communication
and provide reinforcement.
One caveat is worth noting. With sign language, it may be that the communicative act is
recognizable to a limited group: either to people who understand sign language or, even
more limiting, a select group of people who have learned an individual learner’s version
of signed words. Other forms of communication, including pictures and speech
generating devices, may be easier to generalize to multiple environments.
Functional Communication Training: Steps for Implementation
National Professional Development Center on ASD
10/2010
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Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
5. Teachers/practitioners incorporate attention-getting into the replacement
behavior if necessary.
Teachers/practitioners should recognize that learners using nonverbal communicative
forms (e.g., signing, pointing to pictures) may need to gain the attention of the
communicative partner prior to making requests. Gaining the attention of others before
making a request is particularly relevant if initial instruction in FCT occurs in an
environment in which the learner already has the communicative partner’s attention
(e.g., traditional one-on-one therapy at a table). In other environments, the learner may
be unable to use the replacement behavior successfully if the communicative partner is
not attending. For example, a learner may be signing, “Help,” while his assistant is
attending to another student. The replacement behavior could be to first touch the
communicative partner’s shoulder and then produce the sign.
In summary, the replacement behavior should be one that is easily taught, is agreed to
be appropriate by all team members (including classroom teachers, assistants, special
education staff, parents, and, potentially, the learner), and is easily understood by
communicative partners. Most importantly, the replacement behavior should always
result in access to the reinforcer.
Step 4. Designing and Implementing Data Collection Procedures
In Step 4, teachers/practitioners design and then implement data collection procedures
that are functional, meaningful, and useful for the team. When designing data collection
procedures, teachers/practitioners collect data (in the same fashion as they were
collected during the FBA) to monitor learner progress, to determine the effectiveness of
FCT, and to identify ways in which the intervention needs to be modified if the learner is
still using the interfering behavior more often then the replacement behavior.
1. Teachers/practitioners implement data collection procedures that are functional,
meaningful, and available to team members responsible for data collection.
2. Data are collected:
a. before FCT is implemented (typically during the FBA process) and
b. during the implementation of FCT (e.g., weekly).
Baseline data are gathered during the FBA process. For more detailed information on
collecting baseline data, please review the FBA Steps for Implementation, Step 3.
Data collected during the implementation of FCT will be used to monitor its
effectiveness. Typically, data are collected on the same variables during the FBA, the
pre-intervention phase (or baseline), and intervention.
Functional Communication Training: Steps for Implementation
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10/2010
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Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
3. Data collection focuses on:
antecedents,
prompts required to produce the replacement behavior,
frequency of the replacement behaviors,
frequency of the target interfering behaviors, and
consequences of the behavior.
The following chart provides an example of a data collection process.
Interfering Behavior (IB): Running from room
Replacement Behavior (RB): Sign for break
Date
Location
Antecedent
IB or
RB
IB
Prompts
required
Consequence
Notes
I P G V
On
phone…missed
early indicators
7-30
Resource
Room
Math
flashcards
7-30
Classroom
Ind. reading
RB
I P G V
Avoided task,
quickly brought
back to room
Break given
7-31
Classroom
Ind. reading
RB
I P G V
Break given
Data collection allows teachers/practitioners to determine if the replacement behavior is
decreasing the incidence of the interfering behavior. Data also may be compared to
baseline data to determine overall progress and to provide information on the
consistency or changing functions of behaviors. In addition, data allow team members
to monitor the level of prompting required to use the replacement behavior.
4. Teachers/practitioners use data to monitor FCT effectiveness and whether
aspects of FCT need adjustment.
If learners continue to (a) use the interfering behavior rather than the replacement
behavior, (b) require intrusive prompting to use the replacement behavior, or (c) have
difficulty generalizing the use of the replacement behavior, then certain aspects of the
intervention may need to be altered. The following questions may be helpful during this
problem-solving process (more details on these issues are discussed later in this
guide):
Has the function of the behavior been identified correctly?
Functional Communication Training: Steps for Implementation
National Professional Development Center on ASD
10/2010
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National Professional Development Center on
Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Did the communicative act serve as a replacement for the behavior?
Was the replacement behavior efficient, appropriate, and recognizable?
Was instruction provided in environments where the interfering behavior
typically occurs?
Was the instruction provided in multiple environments and with multiple
people?
Were the prompting procedures appropriate for the learner?
Did the communicative partner provide reinforcement quickly and
consistently?
Was the interfering behavior, if produced, not reinforced/made less efficient?
Step 5. Manipulating the Environment to Elicit the Interfering Behavior
In Step 5, teachers/practitioners manipulate the environment, materials, and/or activities
to elicit the interfering behavior and provide numerous opportunities for learners to
practice using replacement behaviors instead.
1. Teachers/practitioners teach the replacement behavior in the environments
where the interfering behavior occurs.
The FBA process gives teachers/practitioners information about the situations and
environments in which the interfering behavior is likely to occur. For example, if the FBA
documents that a learner bangs his head on the table to reject any painting activity, the
replacement behavior (e.g., pushing a Big Mac ® switch that is programmed to say,
“No, thank you,”) should be taught in the context of the art class in which the interfering
behavior occurs.
2. Teachers/practitioners manipulate materials or activities to provide opportunities
for the repeated practice of the replacement behavior.
For example, a teacher/practitioner could plan more painting activities so that a learner
can practice using the Big Mac ®. Other examples might include serving very small
portions at snack time so the learner must present a picture of “more” multiple times
(instead of leading someone to the food/drink) or having an adult engage in another
activity so that the learner has to gain attention by waving her hand (rather than
screaming).
Please refer to Naturalistic Teaching: Steps for Implementation (National
Professional Development Center on ASD, 2009) for more information about
manipulating an environment in order to elicit specific skills.
Functional Communication Training: Steps for Implementation
National Professional Development Center on ASD
10/2010
Page 6 of 13
National Professional Development Center on
Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Step 6. Planning Opportunities for Generalization
The primary component of Step 6 is to plan opportunities for generalization so that
learners can practice replacement behaviors in multiple settings and with multiple
individuals.
1. Teachers/practitioners teach the replacement behavior with multiple
communication partners.
A key factor in the generalization of replacement behaviors is to include multiple people
as communicative partners so that learners become accustomed to interacting with
various people.
2. Teachers/practitioners teach the replacement behavior across multiple
environments.
Another factor in generalization is to teach the use of the replacement behavior in
multiple environments. These environments may include different areas in the school,
job sites, before and after school care facilities, and the home. Home programs as well
as environments that encourage choice-making tend to result in more successful FCT
programs and generalization of skills.
3. Teachers/practitioners train communicative partners to respond to the learner’s
use of the replacement behavior.
For example, if a learner is taught to say, “Leave me alone” rather than biting peers, the
peers are taught to move away from the learner when they hear this request. Similarly,
all communicative partners (e.g., assistants, teachers, parents, peers) should be taught
to provide reinforcement quickly and consistently.
4. Teachers/practitioners introduce varied vocabulary for requesting, if appropriate
for the learner’s developmental level.
Generalizing requests for tangibles may be improved by teaching learners ways to
request varied tangibles. For example, teach learners how to request bubbles, sandbox,
rice bin, and Legos rather than always practicing a request for bubbles. Make certain
that the vocabulary chosen is reinforcing to learners as well as appropriate for their
developmental levels.
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National Professional Development Center on ASD
10/2010
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National Professional Development Center on
Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
Step 7. Prompting Learners to Use Replacement Behavior
In Step 7, teachers/practitioners use prompting procedures to help learners use
replacement behavior when appropriate. Prompts will vary depending on the individual
learner’s abilities.
1. Teachers/practitioners prompt the learner to use the replacement behavior,
beginning with a prompt that ensures errorless learning (i.e.,using a prompt
intrusive enough to guarantee use of the replacement behavior ).
With all prompting procedures, errorless teaching is the goal. That is, the
teacher/practitioner may use a higher level of prompting in order to guarantee that the
learner produces the replacement behavior rather than the interfering behavior. This
may require a more-intrusive prompt (with a goal of moving toward a less intrusive
prompt; see Step 11) to ensure use of the replacement behavior
The correct prompting level will vary depending on the learner. Some learners may be
able to use the replacement behavior when prompted subtly. For example, a seventh
grader who is high-functioning but minimally verbal may start humming loudly while
doing seat work so that he is sent out of the room. A teacher may be able to explain to
him that he will be provided with a card with an X on it, and that he is to hand it to the
teacher when he wants a break. It may then take prompts as subtle as the teacher
touching the card to prompt him to use the strategy. However, other learners may
require a more intrusive prompt such as hand-over-hand to help them activate the
speech generating device that voices their request, “I want a break.”
Please refer to the prompting module (National Professional Development Center
on ASD, 2009) for more information about prompting.
Step 8. Not Reinforcing the Interfering Behavior
In Step 8, reinforcement is not provided for the interfering behavior. In the case of
dangerous behaviors and subtle communicative acts, teachers/practitioners alter their
reactions to decrease the effectiveness and efficiency of the interfering behavior.
1. Teachers/practitioners must not reinforce any instance of the interfering behavior,
if possible.
In the process of teaching the replacement behavior, teachers/practitioners do not
reinforce any instance of the interfering behavior.
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National Professional Development Center on ASD
10/2010
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Autism Spectrum Disorders
Module: Functional Communication Training (FCT)
2. Teachers/practitioners intervene as minimally as possible if the interfering
behavior is potentially dangerous.
If learners engage in behaviors that are potentially dangerous to themselves or others,
teachers/practitioners intervene as minimally as possible to protect the safety of all
involved.
3. For subtle communicative acts (e.g., leading), teachers/practitioners make the
interfering b…
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