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Instruction of Students with Severe Disabilities Eighth Edition Martha E. Snell, Fredda Brown, John J. McDonnell

Chapter 12
Teaching Communication Skills

Developed by:
Susan S. Johnston, PhD, SLP

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Objectives

Discuss the importance of communication & identify the primary purposes of communicative interactions
Describe the features of communication & explain the characteristics of each
Identify strategies for assessing communication needs & provide examples of how assessment data leads to the identification of target behaviors for instruction
Discuss strategies for developing a plan to teach communicative behaviors

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

The Importance of Communication

Communication is “the transmission of thoughts or feelings from the mind of a speaker to the mind of a listener”

Borden, Harris, & Raphael, (1994, p. 174)

People communicate with each other to express needs/wants, to share information, to develop friendships and relationships, and to be socially appropriate

Light (1988)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

The Importance of Communication

People use a variety of strategies when communicating:

eye gazing toward desired objects

nodding/shaking the head to answer questions

laughing in response to jokes

pointing to interesting things in a magazine

using words/sentences

sending/receiving emails

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

All Individuals, Regardless of Age or Disability, Communicate

A typically developing 1 month old communicates an interest in his mother’s voice by smiling and laughing
A 4 year old with a severe cognitive delay throws a toy across the room and then watches for the reaction of her teacher
A 13 year old with a severe physical disability isn’t able to communicate effectively via speech but is able to use a computer with voice output to interact with his friends and family

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

National Joint Committee for the Communication Needs of Persons With Severe Disabilities

A Communication Bill of Rights

All persons, regardless of the extent or severity of their disabilities, have a basic right to affect, through communication, the conditions of their own existence
National Joint Committee for the Communication Needs of Persons with Severe Disabilities (1992)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

National Joint Committee for the Communication Needs of Persons With Severe Disabilities

In order to ensure this basic right, professionals must possess knowledge and understanding of;

the different features of communication

strategies for assessing the communication needs of students with severe disabilities

strategies for developing a plan and teaching communicative behaviors

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Features of Communication

Preintentional or Intentional Communication
Presymbolic or Symbolic Communication
Modes of Communication
Functions of Communication
Conversational Functions
Receptive Communication

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Preintentional Communication

Reflexive or unlearned behaviors that are interpreted by communication partners
Prizant & Bailey (1992)

Examples

Darcy grasps her sister’s hand when her sister places her finger in Darcy’s open palm. Her sister thinks that means that Darcy wants to play and so her sister sits beside Darcy to play peekaboo.

Hui Zhong runs out of his classroom and down the hall to the school kitchen where he tries to open the locked refrigerator. His paraeducator thinks that he is hungry and so she takes him back to the classroom and gives him a snack.

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Intentional Communication

Deliberate and intended to have an effect on a communication partner

Prizant & Bailey (1992)

Examples

Camie is sitting in her high chair when she throws her sippy cup onto the floor and then looks to her dad to see his reaction. Her dad says, “Be careful!” and puts the cup back onto the table. As soon as he does that, Camie throws the sippy cup back onto the floor and then looks at her dad and laughs.

Andrew takes his friend’s hand and places it on the top of a toy that he needs help operating.

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Preintentional or Intentional Communication

Preintentional behaviors place heavy demands on communication partners to interpret
Intentional communication does not place as much of a demand on the communication partner for interpretation. This, in turn, provides intentional communicators with more control over their environment

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Symbolic Communication

Symbolic communication involves the use of symbols to communicate. A symbol is “something that stands for or represents something else”

Vanderheiden & Yoder (1986, p. 15)

Examples

spoken words, written words, line drawings, photographs, sign language, objects, tactile symbols

The ability to use symbolic communication provides an individual with a way to communicate about things that are not present in the environment as well as a way to communicate feelings

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Presymbolic Communication

Does not involve the use of symbols (also referred to as non-symbolic)
Examples
crying, laughing, vocalizing, body language, facial expressions, reaching, pointing
Although effective in some instances, it can also be limiting because it only allows an individual to communicate about the “here and now”

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Modes of Communication

Also referred to as “forms” of communication
Verbal/Vocal
Gestural
Graphic

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Modes of Communication (cont.)

Verbal/Vocal
crying, cooing, babbling, spoken words
Gestural
facial expressions (e.g., smiles, frowns)
physical position (e.g., backing away from an activity that is non-preferred or unfamiliar)
conventional gestures (e.g., head nods to indicate “yes,” pointing to desired objects), and the use sign languages/sign systems

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Modes of Communication (cont.)

Graphic mode
real objects
color photographs
black-and-white photographs
miniature objects
black-and-white line drawings
Blissymbols (a series of meaning-based shapes that can be combined into black-and-white line drawings to create messages)
written word / traditional orthography

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Graphic Mode Considerations

Basic agreement on a general hierarchy (see prior slide) that exists with regard to the degree to which a graphic symbol is similar to its referent (translucency) and/or the guessability of a symbol to an untrained viewer (transparency)
Mirenda and Locke (1989)
Some inconsistencies in this hierarchical relationship have been noted in subsequent studies, which may be a result of differences in participants across studies (e.g., age of participants, disability, language comprehension, visual–perceptual skills, cultural factors) as well as the characteristics of the symbols across studies
see Johnston & Cosbey (2012) for a review

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Graphic Mode Considerations

When using graphic symbols with individuals with severe disabilities, more transparent/translucent symbol systems can be used as a bridge to support learning more abstract symbol systems
Rowland & Schweigert (2000)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Augmentative and Alternative Communication (AAC)

Aids or techniques that supplement or replace an individual’s vocal or verbal communication skills
Mustonen, Locke, Reichle, Solbrach, & Lindgren (1991)
AAC includes unaided communication modes as well as aided communication modes

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Unaided Communication Modes

Do not involve the use of additional equipment or materials
facial expressions
body language
gestures
sign languages
sign systems

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Aided Modes

AAC Systems	Examples
No Tech	-communication books that include multiple pages of symbols -communication boards that are portable or are mounted on a wall, desk, or wheelchair tray -communication wallets with symbols inserted into the photograph holders of the wallet
Light-Tech (Low-Tech)	-single switch speech generating devices in which one message is emitted when the switch is accessed -simple scanning systems in which symbols are systematically presented (e.g, via a cursor or backlighting) and the individual selects the symbol by accessing a switch upon the presentation of the desired symbol
High-Tech	-systems designed solely for the purpose of communication that utilize recorded speech -systems designed solely for the purpose of communication that utilize computer generated speech -systems that were not designed solely for the purpose of communication (e.g., laptop/tablet computers) that can be used for communication with the addition of software that allows for speech output and display of symbols

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Concerns Regarding AAC Use

Will AAC negatively impact verbal language use?
Millar, Light, and Schlosser (2006) conducted a review of literature examining the impact of gestural and graphic modes on spoken language and concluded that concerns that teaching graphic/gestural communication will negatively impact spoken language were not founded

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Concerns Regarding AAC Use

Should I teach gestural and/or a graphic mode of communication?
Most of us use all three modes of communication throughout the day
Given that we all use multiple modes to communicate, it may make sense to ensure that the same range of communicative options is available for an individual with disabilities

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Concerns Regarding AAC Use

Should I teach gestural and/or a graphic mode of communication (cont.)?
Choose the most effective and efficient mode(s) for the individual and the demands of the environment.
Example: gestural mode may be more effective or efficient in environments that make it difficult to carry or use a graphic mode (e.g., while swimming in a pool)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Concerns Regarding AAC Use

Example: graphic mode may be more effective or efficient in situations where an individual’s communication partners don’t know sign language
Example: graphic mode can compensate for visual or motor problems of a user (size or color of graphic symbols can be modified for individuals with visual impairments, graphic mode requires a more limited range of movements relative to gestural modes)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Communicative Functions

Regardless of mode of communication, we use communication for a variety of purposes
Example
Carl: Hey. (Function: REQUEST ATTENTION)
Friend: Hi, Carl. What’s up?
Carl: Baseball on TV. (Function: COMMENTING)
Friend: Yeah, did you watch the game last night?
Carl: Good game! (Function: COMMENTING)
Carl: Game tonight? (Function: REQUEST OBJECT/ACTIVITY)
Friend: Yeah, do you want to come to my house to watch it with me?

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Communicative Functions

The ability to use communication for a variety of purposes allows us to exert control over the environment and express a wide range of thoughts and feelings

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Conversational Functions

Turn-Taking
the back-and-forth nature of an interaction
Initiating, Maintaining, and Terminating topics
important because it facilitates the fluency, and thereby influences the success, of the interaction
Repairing Breakdowns
the ability to recognize and repair breakdowns in communication
strategies for repairing breakdowns in communication include; repeating the original message, revising the original message, and adding information to the original message (Brady & Halle (2002)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Comprehension

Understanding the message that is coming from others
Examples: following directions, understanding a story, understanding non-literal language
Issues related to comprehension
verbal and gestural modes of communication are transient (e.g., messages communicated in these modes are fleeting and the message “disappears” shortly after it is communicated). As a result, these modes require memory/recall
graphic mode is permanent, which may result in fewer cognitive demands for an individual

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

Formal Assessment Procedures
standardized and norm-referenced
well suited to making decisions regarding eligibility for special education services
sometimes underrepresent the actual skills/abilities of an individual (Downing, 2010) and do not provide IEP teams with specific information regarding an individual’s use of communicative skills in everyday environments

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

tend to examine broad areas of skills and, therefore, their utility in terms of assisting IEP teams to identify targets for intervention and progress monitoring is limited
given the limitations of formal assessment procedures, IEP teams often use them in conjunction with informal assessment procedures

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

Informal Assessment Procedures
not standardized but allow teams to obtain information about an individual’s communication skill/abilities
particularly helpful in enabling teams to identify behaviors and document behaviors across environments

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

Indirect Assessment Strategies
provide information via subjective reports from people who are familiar with the individual
include interviews, checklists, rating scales, and questionnaires
can be very helpful in obtaining data about skills/abilities across a range of environments (e.g., home, school, community)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

are useful when the person conducting the assessment is less familiar with the student and the environment
information collected is subjective (and is therefore dependent upon the memory and/or perceptions of the person completing the assessment)
often helpful to use indirect strategies in conjunction with direct observation strategies

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identifying and Assessing Communication Skills & Abilities

Direct Observation Strategies
involve watching the individual and recording specified behaviors
can include observations of the individual’s communicative skill/abilities when presented with planned opportunities
can include observations of the individual in the context of his/her natural environment
Communication Dictionary
Communication/Language Sample
Participation Inventory

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Linking Assessment to Intervention

Understanding of communicative features and the use of assessment strategies may be the most informative when used in combination
Example:
IF….an indvidual’s verbal language skills are not adequately meeting her communication needs. Further, modeling and verbally prompting verbal language is not effective
THEN…….teach another mode (e.g, graphic, gestural) of communication to supplement existing verbal language skills (e.g., Johnston, McDonnell, Nelson, & Magnavito, 2003)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Linking Assessment to Intervention

Example:
IF……an individual has difficulty understanding verbal directions
THEN…pair verbal language with graphic symbols in order to increase comprehension (e.g., MacDuff, Krantz, & McClannahan, 1993; Pierce & Schreibman, 1994)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Developing an Instructional Plan

Identify opportunities for instruction
Prompt the behavior
Deliver consequences
Fade prompts
Monitor progress

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Identify Opportunities for Instruction

Consider
the environment where instruction will occur
the communicative partners
who will initiate the instructional opportunities
the number of opportunities per session/frequency of intervention sessions

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Prompt the Communicative Behavior

Response Prompts: prompts directed at the individual’s behavior
Models
communication partner shows the individual what to do by demonstrating the communicative behavior
Verbal Prompts
teacher verbally comments, asks questions, or provides instructions.
set the occasion for a response, direct the student to respond, or explicitly state the required behavior

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Prompt the Communicative Behavior

Gestural Prompts
the teacher uses a motion to encourage engagement in the desired communicative behavior
Physical Prompts
teacher provides physical contact in order to encourage an individual to engage in a behavior

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Prompt the Communicative Behavior

Stimulus Prompts: altering the environment in order to increase the likelihood that an individual will engage in the desired behavior. Examples:
Increase the size or color of a graphic symbol
Gradually Exposure
Create a communication board and then cover all but the most critical symbols for the initial stages of intervention (i.e., place pieces of paper with non-permanent adhesive over non-essential symbols)
After the individual learns to use the initial set of symbols, expose more and more symbols over time

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Prompt Fading

Must reduce prompts over time
Ensure that prompts are faded across
force (how much help is provided)
time (the delay between the instruction and the prompt)
space (the physical distance between the individual with disabilities and the teacher).
Earles, Carlson, and Bock (1998)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Consequences

What occurs after an individual engages in a behavior
Consequences for correct responses
Goal is for the consequence to increase future engagement in the target behavior
Should correspond to the communicative function of the target behavior (e.g., consequence for emitting the rejection response should be the removal of the undesired item/activity [negative reinforcement])

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Consequences

Consequences for incorrect response
Do not provide the same consequence as would be provided for a correct response
Provide feedback indicating that the response is incorrect. Feedback might be verbal (e.g.,“Try again.”) or the teacher might ignore the incorrect response, pause briefly, create a new opportunity for communication, and provide an additional prompt to increase the likelihood of a correct response

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Response Efficiency

Sometimes, an individual has the desired communicative behavior in his/her repertoire but may refrain from using that behavior in the context of natural interactions
One concept that may be helpful in this regard is response efficiency
When a person has the opportunity to choose between two or more possible responses (e.g., biting a teacher or signing “break” to request a break), the response that the person perceives as most efficient will be chosen
Mace & Roberts (1993)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Response Efficiency

In order to increase the likelihood that an individual perceives the target skill as the most efficient option, the teacher can control some variables related to efficiency. These include ensuring that
the effort required to engage in the target behavior is relatively low
the quality, immediacy, and rate of reinforcement for engaging in the target behavior are relatively high

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Monitoring Progress

Allows an IEP team to determine whether an intervention is producing the desired effects
Steps in monitoring progress
specify the behavior that will be monitored in a way that will allow anyone to accurately measure the behavior
choose a measurement system (e.g., frequency count, percentage, how much time lapses between an opportunity and a response)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Monitoring Progress

create a data collection form that will allow the teacher to collect data on the individual’s performance as well as the prompts that were provided
display the data (e.g., in a graph) in a way that allows for analysis

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Outcome Summary:
The Importance of Communication

Communication provides a way to express needs/wants, to share information, to develop friendships and relationships, and to be socially appropriate
Light (1988)
People use a variety of strategies when communicating including eye gaze, nodding/shaking the head, laughing, pointing, and speaking
All individuals, regardless of age or disability, communicate
In order to support the communication needs of individuals with severe disabilities, professionals must possess knowledge and skills regarding communication

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Outcome Summary: Features of Communication

Communication is multifaceted and is comprised of many features
In order to meet the communication needs of individuals with severe disabilities, teachers must understand
the extent to which communicative behaviors are intentional and symbolic
communication modes, communicative functions, conversational functions, and comprehension
Understanding the different features of communication provides teachers with a framework for describing the strengths and areas of need that might be experienced by individuals with severe disabilities

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Outcome Summary: Identifying & Assessing Communication Skills and Abilities

An important step in helping an individual with severe disabilities develop functional communication skills is to identify or assess his or her current communication skills and abilities
Communication assessments for individuals with severe disabilities can be formal or informal. Furthermore, the process used for gathering assessment data can rely on either indirect or direct observation strategies
Once collected, assessment data can be used to identify targets for intervention and to develop intervention plans

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Outcome Summary: Developing an Instructional Plan

Once an appropriate target has been identified, the next step is to develop an instructional plan to teach the skill
Teaching the skill involves
identifying opportunities for instruction (i.e., the environment where instruction will occur, the communicative partners, who will initiate the instructional opportunities, and the number of opportunities per session/frequency of intervention sessions)

Instruction of Students with Severe Disabilities, 8e Martha E. Snell, Fredda Brown, John J. McDonnell

Learning Outcome Summary: Developing an Instructional Plan

making decisions regarding prompting the behavior (i.e., response prompts, stimulus prompts), delivering consequences, and fading prompts
monitoring progress to determine whether an intervention is producing the desired effects and/or if changes need to be made to an intervention