An increasing number of families and professionals are involved with severely communication-impaired children, adolescents and adults who use alternative communication systems to compensate for delayed systems and strategies that can be used to increase the communicative possibilities of people with limited spoken language. The authors discuss factors that are important when choosing communication systems, assessment strategies, environmental adaptation, and the principles for teaching comprehension and use of such communication systems to individuals with different disabilities; including motor impairments, learning disability and autism. This book is unique within the field of augmentative and alternative communication with its basis in modern developmental theories of language and communication, its practical approach with many examples and focus on every-day situations, and its coherent and readable text. It may serve as an introductory text book for speech and language therapists, teachers in school and preschool, psychologists and care nurses, as well as a source of information for families with members who have severe developmental speech and language disorders.

Edited by Stephen von Tetzchner, University of Oslo, Norway.

Preface

v

Introduction

1

(6)

Terminology

4

(1)

Notation

5

(2)

Augmentative and alternative communication

7

(27)

Manual signs

9

(1)

Graphic signs

10

(12)

Blissymbols

10

(7)

Pictogram Ideogram Communication

17

(1)

Picture Communication Symbols

18

(1)

Rebus

18

(2)

Lexigrams

20

(1)

Sigsymbols

21

(1)

Pictures

22

(2)

Orthographic script

24

(1)

Tangible signs

24

(3)

Premack's word bricks

24

(2)

Tactile signs

26

(1)

Choosing a sign system

27

(7)

Manual, graphic or tangible signs

27

(2)

Use of the systems

29

(1)

Manual signs

30

(1)

Graphic signs

31

(2)

Tangible signs

33

(1)

Communication aids

34

(28)

Traditional aids

35

(2)

High-technology aids

37

(9)

Artificial speech

43

(2)

Telecommunication aids

45

(1)

Pointing

46

(2)

Keyboards

48

(2)

Switches

50

(1)

Choosing a communication aid

51

(6)

Mobility

53

(1)

Direct selection and scanning

53

(2)

Manual and electronic aids

55

(2)

Some characteristics of aided communication

57

(5)

Articulation

57

(1)

Time

57

(3)

The role of the conversational partner

60

(2)

Children, adolescents and adults in need of augmentative and alternative communication

62

(28)

Three functional groups

62

(4)

The expressive language group

63

(1)

The supportive language group

63

(2)

The alternative language group

65

(1)

Distinguishing between the groups

66

(1)

The most common groups in need of augmentative and alternative communication

66

(21)

Motor impairment

67

(3)

Developmental language disorders

70

(3)

Learning disability

73

(4)

Autism

77

(5)

Rett's syndrome

82

(5)

Some common problems

87

(3)

Learning takes time

87

(1)

Generalisation

88

(1)

Learned passivity and dependency on others

88

(1)

Behavioral disorders

89

(1)

Assessment

90

(32)

The need for total intervention

90

(1)

Assessment methods

91

(5)

Tests

91

(3)

Checklists

94

(1)

Information from those in contact with the individual

95

(1)

Systematic observation

95

(1)

Experimental teaching

95

(1)

Basic information

96

(3)

Overview of the day

97

(2)

General skills

99

(2)

Interest in objects, activities and events

99

(1)

Attention and initiation of communicative contact with others

99

(1)

Self-help skills

100

(1)

Self-occupancy

101

(1)

Motor skills

101

(3)

Vision and hearing

104

(1)

Diagnosis

104

(1)

The family's need for support, relief and help

105

(1)

Language and communication

106

(7)

Use

106

(3)

Comprehension

109

(4)

Evaluating the language intervention

113

(3)

Specific goals

114

(1)

Generalized effects

115

(1)

Information transfer when changing school, work and home

116

(3)

Defining areas of responsibility

119

(3)

The teaching situation

122

(13)

Joint attention

123

(1)

Desiging the teaching situation

124

(3)

Planning for generalization

127

(2)

Duration and location of teaching sessions

129

(1)

Structuring

130

(3)

Frame structure

130

(1)

Situational structure

131

(1)

Cues

132

(1)

Initiating the intervention

133

(1)

The effect of sign teaching on speech acquisition

133

(2)

Teaching strategies

135

(43)

Structured overinterpretation and total communication

136

(1)

Implicit and explicit teaching

136

(2)

Comprehension and use of signs

138

(2)

Teaching comprehension

140

(6)

Natural situations

140

(5)

Special training

145

(1)

Teaching sign use

146

(9)

Watch, wait and react

146

(3)

Reacting to habitual behaviour

149

(1)

Build-and-break chains

149

(1)

Reaching to signal-triggered anticipatory behaviour

150

(1)

Fulfilling wants

151

(4)

Focusing on expression and comprehension

155

(3)

Incidental teaching

158

(2)

Structured waiting

160

(2)

Naming

162

(1)

Structured and unstructured situations

163

(2)

Preparatory training

165

(8)

Eye contact

167

(1)

Gaze direction and attentiveness

168

(1)

Sitting still

169

(1)

Behaviour chains

170

(1)

Initation

171

(2)

Motor skills

173

(1)

Facilitating techniques

173

(5)

Choosing the first signs

178

(29)

Existing communication

181

(1)

General and specific signs

182

(3)

Repetitions

185

(1)

Motor skills

186

(3)

Perception

189

(2)

Iconicity

191

(7)

Manual signs

192

(2)

Graphic signs

194

(4)

Tangible signs

198

(1)

Simple and complex concepts

198

(6)

What to expect

204

(3)

Further vocabulary development

207

(33)

Alternative and supportive language groups

207

(10)

Contrasts between signs

211

(2)

Signs for proper names

213

(1)

Expanding use

214

(2)

Individual sign dictionaries

216

(1)

The expressive language group

217

(11)

Use involvement

217

(1)

Expanding the situations in which signs may be used

218

(5)

Increased access to signs

223

(38)

Expanding the vocabulary by using sign combinations

261

(33)

Ready-made vocabularies

228

(8)

From graphic signs to orthographic script

236

(4)

Multi-sign utterances

240

(26)

Vocabulary

244

(6)

Pivots

245

(2)

Verb island constructs

247

(2)

New sign categories

249

(1)

Inflections

249

(1)

Sentences

250

(10)

Horizontal and vertical structures

250

(2)

Topic-comment

252

(1)

Semantic roles

253

(3)

Negation

256

(1)

Fill-in

256

(1)

Chaining

257

(2)

Ready-made sentences

259

(1)

Cognitive effort

260

(2)

Comprehension

262

(2)

Bootstrapping

263

(1)

Perspective

263

(1)

Comprehension of spoken language

264

(1)

Variation

264

(2)

Conversational skills

266

(31)

Alternative language group

267

(6)

Routines, plans and scripts

268

(5)

Supportive language group

273

(3)

Expressive language group

276

(18)

Environmental strategies

278

(4)

Partner strategies

282

(5)

Conversational strategies

287

(7)

Narratives

294

(3)

The language environment

297

(15)

Adapting the environment

298

(4)

The simultaneous use of speech and signs

299

(1)

Simplified language

300

(1)

Models

301

(1)

Teaching families

302

(4)

Teaching peers and friends

306

(2)

Teaching staff

308

(3)

Cost and benefit

311

(1)

Overview of case studies

312

(7)

List of sign illustrations

319

(4)

References and citation index

323

(29)

Index

352

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