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AAC Modeling Practice Guide by Dr. Samuel Sennott, [email protected] 11/6/22

Define AAC Modeling (Sennott et al., 2016) Augmentative and alternative communication (AAC) modeling-based practices all contain two key features, including communication partners (a) modeling AAC as they speak and (b) engaging in the context of a naturalistic communication interaction.

What is AAC? (ASHA, N.D.) AAC means all of the ways that someone communicates besides talking. People of all ages can use AAC if they have trouble with speech or language skills. Augmentative means to add to someone’s speech. Alternative means to be used instead of speech. Some people use AAC throughout their life. Others may use AAC only for a short time, like when they have surgery and can’t talk.

There are a lot of different types of AAC. No- tech and low-tech options include things like gestures and facial expressions, writing, drawing, spelling words by pointing to letters, and pointing to photos, pictures, or written words. High-tech options include things like using an app on an iPad or tablet to communicate and using a computer with a “voice," sometimes called a speech- generating device.

A person may use different types of AAC because there are many ways that we all communicate. An AAC system means all of the tools of this type that a person uses.

Science Theory, research, and practice-based evidence supports using AAC modeling as a practice (Allen et al., 2017; Biggs et al., 2018; Chazin et al., 2021; O’Neil et. al., 2018; Sennott et al., 2016).

• Language acquisition theory supports the practice in that AAC modeling emulates how children have massive amounts of input and interaction with speech and language. The logic is that AAC input and interaction helps stimulate language learning. Another way to think about it is related to second language acquisition and how being immersed in language environments can aid in language learning.

• Five research reviews document evidence for AAC modeling based interventions promoting early AAC learning for children and limited evidence for older individuals (Allen et al., 2017; Biggs et al., 2018; Chazin et al., 2021; O’Neil et. al., 2018; Sennott et al., 2016).

• AAC modeling is now an evidenced based practice that came out of clinical practice. The AAC intervention community has championed AAC modeling as a practice and used such terms as (1) aided language stimulation, (2) AAC input, and (3) aided AAC modeling.

How do I do “AAC Modeling”? To do AAC modeling you can start using AAC to communicate to someone who uses AAC. • For example, if a child uses an AAC speech generation software on an iPad, you could use

that system to speak out a message to the child.

Here is an example of doing AAC modeling while reading a book with a child:

There are a number of strategy instruction approaches to teaching AAC modeling as a practice. In my experience and research supports, that using strategy instruction to teach multi-step skills like AAC modeling is a very good idea. However, I also think jumping in with something like AAC modeling makes sense too. Here are some of the strategies:

Model, Encourage, and Respond (MODELER) + Read, Ask, Answer, Prompt (RAAP).

Practice Resources Here are five resources to help you get started with learning more about AAC Modeling as a practice:

How to Get Started Modeling Language on AAC Modeling AAC at Home: A Beginner's Guide for Parents Read-Ask-Answer (RAA) and Read-Ask-Answer-Prompt (RAAP) Strategies Aided Language Stimulation and a Robust Language System: Autism a Case Example Practical Strategies for Implementing Aided Language Stimulation

References American Speech-Language-Hearing Association.(n.d.). Augmentative and Alternative

Communication (AAC). Retrieved November 6, 2022, from https://www.asha.org/public/ speech/disorders/aac/

Allen, A. A., Schlosser, R. W., Brock, K. L., & Shane, H. C. (2017). The effectiveness of aided augmented input techniques for persons with developmental disabilities: A systematic review. Augmentative and Alternative Communication, 33(3), 149–159. https://doi.org/ 10.1080/07434618.2017.1338752

Biggs, E. E., Carter, E. W., & Gilson, C. B. (2018). Systematic Review of Interventions Involving Aided AAC Modeling for Children With Complex Communication Needs. American Journal on Intellectual and Developmental Disabilities, 123(5), 443–473. https://doi.org/ 10.1352/1944-7558-123.5.443

Chazin, K. T., Ledford, J. R., & Pak, N. S. (2021). A Systematic Review of Augmented Input Interventions and Exploratory Analysis of Moderators. American Journal of Speech- Language Pathology, 30(3), 1210–1224. https://doi.org/10.1044/2020_AJSLP-20-00102

O, ’Neill Tara, Light, J., & Pope, L. (2018). Effects of Interventions That Include Aided Augmentative and Alternative Communication Input on the Communication of Individuals With Complex Communication Needs: A Meta-Analysis. Journal of Speech, Language, and Hearing Research, 61(7), 1743–1765. https://doi.org/ 10.1044/2018_JSLHR-L-17-0132

Sennott, S. C., Light, J. C., & McNaughton, D. (2016). AAC Modeling Intervention Research Review. Research and Practice for Persons with Severe Disabilities, 41(2), 101–115. https://doi.org/10.1177/1540796916638822

Behavior Momentum Intervention A practice guide by Katie Johnson

What is Behavior Momentum Intervention?

• Behavior momentum strategies involve assigning a person already- mastered tasks prior to assigning more difficult tasks; evoking high- probability behaviors before evoking low-probability behaviors (Scott, 2015)

• Behavior momentum involves “increasing the rate of responding and subsequent reinforcement” of those responses (Lee & Laspe, 2003)

• The reinforcement in BMI strategies increases persistence and engagement in challenging tasks

Why is this intervention important?

• Behavior momentum intervention is an evidence-based practice • Increased rate of response and time engaged and on task in a classroom

setting, like other antecedent strategies, minimizes distractions, time off task, latency, etc.

• Building momentum and receiving positive reinforcements increases motivation

• BMI has the power to strengthen adaptive behavior and decrease problem behavior in folks with Autism Spectrum Disorder (DeLeon et al., 2015)

• BMI enhances reading and fluency skills in children (Burns et al., 2009) • BMI is effective in teaching non-echolalic responses for both personal

safety questions and rituals of social politeness in children with ASD (Scott, 2015)

BMI and reducing problem behavior

• In understanding that the rate of behavior tends to match the rate of reinforcement, people using BMI strategies can strengthen relevant reinforcements for desired behaviors and responses while decreasing or eliminating reinforcements in response to problem behaviors (DeLeon et al., 2015)

• Positive reinforcers worked to decrease destructive behavior and increase compliance in 3 people who’d experienced escape- maintained destructive behavior (Piazza et al., 2013)

BMI and reading (Vostal & Lee, 2011)

• A group of teenage students with emotional and behavioral disorders were given a continuous reading assignment that was modified to meet behavior momentum intervention standards. Students were assigned paragraphs written for different reading/grade levels.

• Latency was overall shorter for participants during BMI in nearly all intervention sessions, and

• Fluency increased for participants during the more difficult reading assignment after completing the lower-level reading.

BMI and teaching non-echolalic responses to children with ASD (Scott, 2015)

• 3 children with ASD and echolalia were identified to participate in BMI (echolalia involves the repetition of vocalizations than can be caused by delayed speech development and can impair communication and socialization)

• Participants exhibited significantly improved non-echolalic responses to greetings, expressions of thanks, and goodbyes during the intervention and during the post-intervention sessions after fading.

• Significant improvement in non-echolalic responses was seen during and after BMI for the questions “What is your name?” “How old are you?” and “Where do you live?”

Ways to do Behavior Momentum Intervention

• As an educator, embed simple questions or tasks with more challenging questions and reinforce correct answers each time

• *Reinforcers must be personally relevant and meaningful to each specific student in order to increase success via preference assessments*

• For example: • Teaching math: “What is 2 + 2? Well done!” (or give a high five, give tickles, etc.)

“What is 3 + 5? Wonderful work! What is 21 + 24? Excellent!” • Transitioning to new activity: “Touch your head! Good job! Touch your nose.

Wow, excellent listening! Clap your hands? Brilliant! Line up! What nice lining up I’m seeing.”

• Teaching reading: Read the following words: bat, cow, mop, month (and reinforce for every desired response)

Ways to do Behavior Momentum Intervention

• As a caregiver, BMI can be used to help with transitions and to increase motivation or willingness to carry out a task a child might typically want to escape

• For example: • Brushing teeth: “Jump up and down! Very good! Wiggle your fingers! Beautiful.

Stick out your tongue! Perfect! Show me your teeth like a ferocious lion. Ah what wonderful teeth you have. Now brush brush brush!”

• Putting on shoes: “Spin around! Oh yes that’s wonderful. Stretch your hands to the sky! Perfect work! Wiggle your toes! Excellent, buddy! Put your shoes on! All done, that was fantastic!”

Resources for learning more

How and when to use Behavior Momentum

https://www.unl.edu/asdnetwork/virtual- strategies/behavior-momentum

Tips for using Behavior Momentum https://masteraba.com/behavioral- momentum-for-children-with-autism/

Using Behavior Momentum in the classroom (+ video)

https://autismclassroomresources.com/be havioral-momentum/

Reinforcement preference assessment https://howtoaba.com/preference- assessments/

How and when to use reinforcements https://www.unl.edu/asdnetwork/virtual- strategies/reinforcement

References

Scott, B. (2015). Using behavior momentum to teach non-echolalic responses to children with autism spectrum disorders. The California State University. https://repository.library.fresnostate.edu/bitstream/handle/10211.3/161918/SCOTT_Brittany.pdf?sequence=1

Cowan, R. J., Abel, L., Candel, L. (2017). A meta-analysis of single-subject research on behavioral momentum to enhance success in s tudents with autism. https://link.springer.com/content/pdf/10.1007/s10803-017-3076-6.pdf

Burns, M. K., Ardoin, S. P., Parker, D. C., Hodgson, J., Klingbeil, D. A., Scholin, S. E. (2009). Interspersal technique and behavioral momentum for reading word lists. School Psychology Review. https://

www.tandfonline.com/doi/pdf/10.1080/02796015.2009.12087825?casa_token=g9FYAQfdzj8AAAAA:dXLLSS3z8svd4zzs LiQ7l9FtrhLGhNxrOrvYKn3Hq7MsUI7261Sq00d0tGiAyxRRaQnkIB_JQ6b2

DeLion, I., Podlesnik, C., Miller, J. (2015). Implications of behavioral momentum theory for intervention in autism spectrum disorder. Autism Service Delivery. https://link.springer.com/chapter/10.1007/978-1-4939-2656-5_13#citeas

Piazza, C. C., Fisher, W. W., Hanley, G. P., Remick, M. L., Contrucci, S. A., Aitken, T. L. (2013). The use of positive and negative reinforcement in the treatment of escape-maintained destructive behavior. Journal of Applied Behavior Analysis. https://onlinelibrary.wiley.com/doi/abs/10.1901/jaba.1997.30-279

Vostal, B. R., Lee, D. L. (2007). Behavior momentum during a continuous reading task: an exploratory study. Journal of Behavioral Education. https://link.springer.com/article/10.1007/s10864-011-9129-6#citeas