PrAACtically SLPs: Hungry for Bilingual AAC

We are so excited to launch, PrAACtically SLPs, a new series featuring the voices of graduate students in SLP programs who do outstanding work in AAC. We start off with a wonderful group from the University of North Carolina at Chapel Hill. Allie Rodriguez, Caitlin Rich, and Megan Latta are second year SLP students who will be graduating in May. They recently concluded an AAC course taught by Dr. Penny Hatch, who continues to mentor them in the field of AAC and literacy. I met these energetic young professionals at the North Carolina Augmentative Communication Association Conference in February and was inspired by their passion. In this post, they tell us about their AAC experiences on a trip to Guatemala.

Hungry for Bilingual AAC?            

Today, our population is becoming more culturally diverse, which, in turn, has caused our caseloads to reflect this change. There is a growing number of Spanish speaking clients who need bilingual therapists. This post includes materials for a therapy session incorporating AAC, literacy, and Spanish. We recently had the opportunity to take a trip to Guatemala with our clinical coordinator, Lisa Domby M.S. CCC-SLP and our classmates. We were able to practice the Spanish language and provide a small amount of therapy using light tech communication boards and books we brought with us. Caitlin and Allie also gave multiple presentations on aided language stimulation to Guatemalan SLP students and teachers to share the current research and treatment methods.

Here, we have put together an example lesson plan with tips and strategies to incorporate Spanish, AAC and literacy. This activity can be used for multiple populations and age groups, although, we focused on the preschool population. The potential clients this activity would work for may be direct selectors, preschool age, bilingual children. The potential population could include autism spectrum disorders, Down syndrome, global delay, cognitive delay, etc. The particular type of AAC targeted is a bilingual light tech communication book with core and fringe vocabulary that can be used in a variety of environments. In addition, there are pictures printed directly from the book to be used for the activity that can double as communication symbols and supports. The book is organized with the core vocabulary on the top and the fringe on the bottom and uses the Fitzgerald key color code. 

Some strategies that should be used when implementing this activity include aided language stimulation, managing negative behaviors, the CAR and CROWD models for shared reading and use of an adapted book. Additional adapted books can be found on Tarheel Reader. When doing a shared book reading with a student it is helpful to engage the child in dialogic reading. This technique, based on the research of Grover J. Whitehurst, PhD, is an interactive way of sharing a picture book that helps build the language and literacy skills of children. This practice allows the child to become the storyteller, while the adult asks the child questions and engages them in discussions. One way to implement this strategy is by remembering the acronym, “Put the CROWD in the CAR” (Notari-Syverson, Maddox, Lim, & Cole, 2002).  The acronym CAR stands for Comment, Ask a question, and Respond by adding a little more. The acronym CROWD (Whitehurst et al, 1994) stands for Completion, Recall, Open-ended, Wh-questions, and Distancing.  Ideas for implementing this strategy are outlined below.

Example Session:

Other Spanish Commands that May be Helpful:

Some sample goals that could be targeted in this session include:

• Child will use communication system to make spontaneous comments at least 4 times over the course of a week.
• Using a variety of communication methods (ex. verbalization, gestures, pictures, communication device), Child will combine 3-4 words to ask simple questions, answer simple questions, make comments and requests at least 5 times across one week.
• Child will increase expressive language skills using total communication (vocalizations, signing, pictures, gestures, voice output device) to effectively communicate with others within his educational setting by labeling objects/pictures/activities, commenting, rejecting, asking for information and making requests at least 3 times in each of 5 different activities across the school day.
• Child will use the communication system to request/direct actions of others at least 3 times during shared book reading.
• During structured activities, Child will use a variety of communication methods (partner assisted scanning, communication device, voice output device) in order to appropriately interact in conversational exchanges in at least 4 different activities during the school day.

In the process of implementing this lesson plan, we learned a few important things. When using published Spanish materials (e.g. Spanish translation of The Very Hungry Caterpillar), be aware that the translation is not always accurate. If you have access to native speakers, use them as a resource. For example, in La Oruga Muy Hambrienta, many Spanish speakers use “gusano” instead of “oruga.” In addition, in The Very Hungry Caterpillar, the caterpillar eats three plums. We have learned that many Spanish speakers are not as familiar with this fruit so we replaced “ciruelas” with “uvas” (grapes). Additionally, we also learned that lamination is a must! When working with preschool aged children and children with special needs, materials tend to get worn easily and lamination preserves the materials.

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It gives us hope to see the passion and skill in the next generation of AAC practitioners. You can read more about these prAACtical professionals below and download the materials they created here. Our thanks to Dr. Penny Hatch for facilitating this connection. 

Allie is originally from Oceanport, New Jersey and received her Bachelors degree from the University of Maryland, College Park in Hearing and Speech Sciences. Her interests in the field include AAC as well as feeding therapy. She has always been interested in the area of AAC but became increasingly more interested after a practicum placement at a private school for children with special needs in Eatontown, NJ called the Hawkswood School. Upon graduation, Allie would like to move back to NJ and work in a children’s hospital or private school for children with special needs. She is looking forward to starting her career and giving a voice to children who may need some additional assistance. Megan is originally from Tahlequah, OK. She received her Bachelors degree in Biology from Northeastern State University.

After graduation, Megan moved to Gifu, Japan to teach English to Japanese children.While there, she discovered her passion for helping children learn to communicate. Upon returning to the United States, Megan moved to North Carolina and began her Masters at UNC Chapel Hill. Her professional interests include AAC, feeding therapy, and literacy. Upon graduation, Megan plans to work in Early Intervention providing speech, language, and feeding therapy to children.

Caitlin is originally from Brighton, MI. She received her Bachelors degree in Communicative Sciences and Disorders from Michigan State University. She also earned her Teacher’s Certification in Spanish Education. Coming to The University of North Carolina at Chapel Hill, Caitlin was confident in her interest in working with children with significant disabilities. She plans to incorporate her skills in AAC, literacy, and Spanish into her future practice in the school setting.

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• Notari-Syverson, A., Maddox, M., Lim, Y.S., & Cole, K. (2002). Language is the key: A program for building language and literacy. Seattle, WA: Washington Research Institute.
• Whitehurst, G. J., Zevenbergen, A. A., Crone, D. A., Schultz, M. D., Velting, O. N., & Fischel, J. E. (1999). Outcomes of an emergent literacy intervention from Head Start through second grade. Journal of Educational Psychology, 91(2), 267–272.16