Thursday, July 27, 2017

Strategies from a SLP/BCBA about how to Help Nonverbal Students Find their Voice

Today we have a special guest blogger, Rosemarie Griffin, a Speech-Language Pathologist and BCBA, sharing with us steps to help nonverbal students find their voices! 

Have you encountered students who are non verbal or limited verbally and are in the initial stages of acquiring a way to communicate with the world? Working with students at this stage of communication can be overwhelming and exhilarating all at the same time. By following the strategies that I will outline below, you will be able to help your clients increase their overall spontaneous language.

The first thing that you want to do when you work with an early learner, is to pair the environment and yourself with the delivery of reinforcing items and activities. You want to have many fun items and activities ready to present the student. At this point, we do not demand anything from the client, we are merely having fun, building rapport and learning about what they like.  The process of pairing yourself and the environment may take just one session or it may take more sessions, depending on the learner.

After we have an idea of what the learner enjoys, we want to start work on teaching the student to request specific items and activities. This can be referred to as requesting or manding. The term manding was described in the book Verbal Behavior written by B.F. Skinner (1957).

Manding is how we all start communicating: for babies, crying functions as a way to gain access to desired items, like a diaper change or food or cuddles. As a child grows and develops, crying is replaced with other ways to communicate (i.e. sign, gestures, word approximations).  Mands are first in the language repertoire learned by all children, and are very important for the early development of language and for day-to-day verbal interactions of children and adults (Cooper, Heron, & Heward, 2007). It is important to focus on manding first; in its absence, it is unlikely that you will be able to teach other verbal behavior repertoires. 

Following these strategies outlined below will help your student increase their ability to spontaneously communicate:

Strategy 1: Prompt mands initially to teach the child that it’s easy to get things with verbal behavior, so as to not turn the child off to communicating.

For most students starting work on manding, this may be the first time they are learning how to use a functional response form, whether it is sign, pictures, augmentative communication, verbalizations or a combination of these. We will use a variety of prompts based on their level of need and the way in which they are communicating. We need to make certain that they realize that communication is powerful and fun!

Strategy 2: Always start work with the student requesting their most powerful reinforcers.

Strategy 3: Always teach specific mands.

We should always start with manding for specific and powerful reinforcers, targeting 3-5 initial mands if possible. If you have a student with a limited amount of reinforcers, remember to use a preference assessment.

Strategy 4: Be a giver not a taker.

This is such a key strategy! Please do not take things from students who are nonverbal. Sometimes the only way they know how to communicate is with their behavior, which may be falling on the floor or having a tantrum. If a student wants a pretzel, give them a couple and not the whole bag. Once they eat the pretzels you gave them, they will be motivated to ask for more pretzels on their own. If a student requests a movie, show a short clip on your computer and control the buttons yourself. If you let the student watch a ten minute movie clip or give them their iPad to watch the movie, it may be very difficult to transfer to working on manding for other items or activities.

Strategy 5: Use a rotating array of reinforcement.

This strategy goes with Strategy 4. Instead of taking away an item, present another item or activity that is also motivating. If the student wants to engage with the item or activity they will request it. It is important to have this array of reinforcement in your possession, so that students need to request to gain access to the item or activity. This will help to increase the amount of practice they get with manding.

Following the above guidelines will help you build rapport and a cooperative therapeutic relationship with your student. It will also allow them to communicate more effectively with the world!

Rosemarie Griffin, MA, CCC-SLP, BCBA, serves students in public and private school settings. She created the website and gives presentations on professional collaboration and on using evidence-based practices. She is also the creator of the action builder cards and can be reached on facebook at @abaspeech.
Skinner, B.F. ( 1957). Verbal Behavior. New York: Appleton-Century-Crofts.

Sundberg, M.L. (2014) The verbal behavior milestones assessment and placement program: The VB-MAPP guide ( 2nd ed.) Concord, CA:AVB Press.

Tuesday, July 11, 2017

How to Turn Making S'mores Into a Speech and Language Lesson!

It's officially summer, SLP friends!  If you are like me and working summer school, you might be looking for some super fun activities for your students.  I wanted to blog today about making s'mores, since I have found that this can be adapted and differentiated for your special education students as young as kindergarten or as old as high school.

First, I like to include an interactive vocabulary book in my lesson prior to actually making the s'mores.  This allows your students to be exposed to the necessary vocabulary, includes a literacy piece to the lesson, and prepares them for the later part of the lesson where they will actually be making the s'mores!  I love this freebie from Speech Bonanza: Free Making S'mores Interactive Book.  Here's a picture of my book, laminated and bound together to increase the chances of it not being destroyed from week to week.  (There's no guarantee, people!)

Are you working with a 6:1:1 class and are going to be doing a group lesson? Here are the jobs/ directions I suggest using.  Of course, remember that you know your students best, so differentiate however is necessary for your kids to be successful.  If some of the directions seem too challenging for your students, remember there is nothing wrong with starting with hand over hand prompting and then slowly fading your prompt level. 

1. Place six graham crackers on tray/plate
2. Place one or two pieces of chocolate on each graham cracker
3. Place a marshmallow on top of each piece of chocolate
4. Cook the tray/plate in the microwave for 30 seconds
5. Place a graham cracker on top of the marshmallow and push down
6. Pass S'mores out to your friends

 My coworker used Boardmaker Plus to create these visual sentence strips for students, and graciously shared them with me!

This year I don't have any, but if you're working with a 12:1:1 class, I would suggest using these jobs/directions:

1. Take out all of the ingredients and place on table (graham crackers, marshmallows, chocolate)
2. Place three graham crackers on tray/plate
3. Place three graham crackers on tray/plate
4. Place one piece of chocolate on six graham crackers
5. Place one piece of chocolate on six graham crackers
6. Place a marshmallow on top of the chocolate on six of the crackers
7. Place a marshmallow on top of the chocolate on six of the crackers
8. Cook the tray/plate in the microwave for 30 seconds
9. Place a graham cracker on top of the marshmallow and push down
10. Get out six napkins and lay them out on the table
11. Place one s'more on each napkin
12. Pass s'mores out to your friends

We always want to make sure that we aren't just working on requesting with our students.  They should be able to comment also!  This visual sentence strip allows students to comment on what ingredients they see.  I leave all of the options on a laminated piece of computer paper that has a long strip of velcro on it.  My student can then select the correct one and place it on the commenting sentence strip (I see + noun).  This is also a great way to target/assess your students' matching skills.

Again, props to my colleague for creating the sentence strip with Boardmaker Plus!

-Do this activity repetitively with your students.  I see my 6:1:1 classes for a collaborative lesson one time a week, for an hour, and I typically will do the same activity for at least four weeks in a row.  This allows students to learn the routine and learn what is expected of them, before you change it up on them with a new activity.

-Don't assign jobs all willy-nilly!  Think ahead and plan which of your students would be best for each step.  We always want to challenge our students, but we do not want to frustrate them.  If you have a student who does not have great fine motor skills, don't assign them the job of placing a tiny piece of chocolate on each graham cracker.  If you have a student who has sensory challenges, they probably won't want to be the one to place the marshmallow on the chocolate, BUT they may be great at pushing down on the marshmallow using the graham cracker.  Do you have a student who has an IEP goal of learning their peers' names? They may be perfect for handing out the finished s'mores to their friends!

-I also recommend writing down which "job" each of your students has on week one, and assigning them the exact same job for the next four weeks.  They will be able to start completing their job with independence, allowing for them also to feel pride in being able to complete their step.

-Don't be discouraged at how much preparation this lesson takes.  It is worthwhile because your students will be motivated by the chance to make a s'more and then eat it, and this lesson can target SO many of your IEP goals.  Plus, you can save this and use it every single summer that you are working, regardless of the population you work with.  Every lesson plan you make should ideally be flexible enough for you to differentiate it for any potential caseload population.

-Don't rush this activity.  Create your schedule so that you have back-to-back speech sessions in the same classroom.  I usually spend a full hour in the classroom for this lesson.  The first half hour is for the interactive vocabulary book and the second half hour is for the making/eating of the s'mores.

-CHECK FOR FOOD ALLERGIES!  Triple check the IEP, check with the teacher, and check with the nurse, before bringing any kind of food item into the classrooms.  Also, be sure to check with the teacher in advance to see if they have any new kids in their room that day so you can find out about their potential allergies as well!

Hope you all find this lesson plan helpful!! I'd love to hear your feedback on how it goes with your students!