One Easy Way to Increase Vocabulary on AAC Devices

How do we add vocabulary when a child is physically limited to a few keys on a screen?

In the world of AAC, conflicts and compromises abound. We sacrifice battery life for weight, screen size for portability, budget for specialized access modes. We sacrifice the size of the vocabulary set for the number of buttons a child can access.

When children begin to use an AAC device, motor or cognitive challenges may limit them to just a few words on a screen. How in the world are we going to help them transition smoothly into a larger vocabulary accessed with more—and smaller—keys?

The secret is to use motor automaticity to our advantage.

Let’s step back and take a look a motor automaticity. Motor automaticity is the ability to carry out motor patterns without thinking about the movement. We all do this, all the time.

For example, walking is a skill many of us can do successfully without thinking about. Many of us can even complete other tasks at the same time as walking, such as talking to a friend, carrying objects, or looking for a misplaced coffee cup.

But someone recovering from a brain injury or stroke who has lost that motor automaticity must concentrate hard on the movements needed to walk. All their cognitive energy must focus on moving their legs correctly; carrying on a friendly conversation or looking out for that missing coffee mug is too demanding during the task of walking.

Another example of motor automaticity at work is touch typing. A typist can concentrate on forming words on the page without having to think about which finger to move to spell out the words. Remember this example; we’ll come back to it again.

When kids rely on AAC to communicate, motor automaticity allows them to access symbols on a screen without having to think about movement. This greatly enhances their rate of expression and makes conversation much more accurate and fluid. Kids can focus on the meaning of what they are trying to say rather than the motor mechanics of finding and targeting a symbol on the screen.

Without motor automaticity, locating a target and touching or eye-dwelling on it can be very demanding work. Communication is slow, exhausting, and creates a frustrating number of mis-hits.

We support motor automaticity by keeping buttons in the same location as much as possible. Just as we keep letter keys in a consistent arrangement on a QWERTY keyboard, symbols located in consistent arrangements are easier for kids to retrieve. They can find the symbols and letters they want easily, without having to scan through many keys.

To maximize motor automaticity...

Introduce screens with the end result in mind.

How many buttons on a page will a child be able to access in the future? No one has a crystal ball, so you’re just going to have to make an educated guess based on your child. With semantic compaction vocabulary sets, it’s hard to access a full vocabulary in less than 45 or 60 keys. Category-based pages might allow you to communicate with 30 to 42 keys on a screen, but fewer than that is going to mean a whole lot of tedious page flipping. The more buttons per screen, the fewer hits are needed, whether you are accessing words through categories or semantic compaction.

“But,” you say, “my child can only handle 8 buttons on a screen right now...”

You could offer eight buttons that fill the screen. However, what happens in the future when your child is ready to add more vocabulary? You would have to shrink the buttons and shake up their order to make room for more words or categories. Remember motor automaticity? Your child would have to learn their locations all over again. How discouraging is that?!

How naturally do these 8 buttons...

...become this? (Sono Lexis 9 x 6)
Not very!

Instead, take the screen that is your end goal and hide all buttons except the eight starter words/categories your child is using. He still has access to the same eight selections as the large keys filling the screen. Yes, these buttons will be smaller, but they are surrounded by plenty of null space that won’t activate if he hits it. You might be surprised how fast he can learn to target the smaller button size.

With this end goal in mind (Unity 45, full hit)...

...we start with these few word combinations.

When it is time to add vocabulary, you UN-hide hidden words or categories. They won’t change anything your child has committed to motor memory; they simply begin to fill in void space.

Child begins with these words and category...

...and ends with this 9 x 6 Sono Lexis display over time.

Remember learning to touch type in your keyboarding class? You started with the home row of keys:  asdf jkl;. It wasn’t much; you were limited to words like “fad,” “ask” and “lass.” But after a few days (weeks?), the teacher introduced “e” and “i,” and that opened up a huge new world of words! Now you had command of “alike” and “fleas” and “skidaddle!” The good news is that you didn’t have to relearn where the home row keys were located; they stayed consistent while new keys were added. Eventually, you mastered all 26 letters of the alphabet, along with some punctuation and formatting keys. That’s at least 40 keys...more for the kids who mastered the number row and got an A in typing.

This same concept is what I am asking you to try.

·        Start with the board set you think your child might be able to manage in a few years.

·        Select a few important buttons—the same ones you would have made up into a smaller set with large buttons.

·        Hide all the buttons around these select few.

·        Give your child time to learn to target these smallish buttons in the middle of large null spaces; it may take awhile, but trust that it will happen.

·        Then, when it is time to reveal a few more buttons, your child will be able to move forward with great confidence.

Want more information on hiding keys to support motor learning? Check out this comprehensive training material from Prentke Romich Company or sign up for one of their Language Acquisition through Motor Planning trainings. Although these are geared towards Unity's semantic compaction, the principles can be applied to most other language access software programs as well.

Easy--and Free--Playing Card Holder

Kids with fine motor issues (including very young typically-developing children) can find it difficult to play the card games they love. It’s just hard to hold those cards sometimes!

And if you have no hand use and someone else has to show you your cards without peeking, that can be a real tough order!

But it doesn’t have to be that way.

Today we’re going to make a quick and easy playing card holder using free materials you already have on hand.

Success for kids with limited motor skills

This isn’t my original idea, and I sure wish I knew where I first heard it so I could give credit. It was years ago, and during that time I’ve made a passel of these card holders for my own children and students to use. It’s an idea worth sharing, and so here you go...

Whether it’s in your mail or in the computer aisle at the store, you are bombarded by computer CD disks offering free this or that, right? Don’t throw them away...save two!

free advertising CDs...you’ll need two of these

You’ll also need some Super Glue and a paper towel or waxed paper to work on. Super Glue is not nice to get on your pretty countertops. Trust me. Ooops.

I recently discovered LocTite’s Control Extra Time Super Glue and I love it! It work so much better than those little metal squeeze tubes. It’s easy to control where the glue will go. Plus the nozzle doesn’t clog. The glue itself works just like other Super Glues, but the packaging is amazing.

I’m loving LocTite’s Control Extra Time Super Glue!
Notice the friendly paper towel protecting my countertop?

Draw a ring of Super Glue on the edge of the inner hole on one disk. I like to glue the label sides together so the holder is less visually distracting.

Draw a circle of glue around the inner hole

Now lay the second disk on top of the first, offsetting them by about 1/8”. The offset is important!

See how the holes are offset a bit?

The ruler is marked in 1/8ths, so you can see how much the disks are offset.
What a world of difference an eigth of an inch makes!

By offsetting the disks, it’s easy to slip your playing cards between.

You can wedge the disks apart a bit if you need help slipping the cards between

Fan out your cards and start your game! You can set down your hand and pick it up without the cards getting mixed up...very handy for little fingers and those that need a little assistance.

Your cards are ready for whatever card game your kids are eager to play!

There...simple, free and just in time for summer card games on the lawn! Enjoy! 

Launching "Adapting Creatively"

Today is the day! After years of contemplating an adventure into blogging, I'm lacing up my boots and jumping in with both feet.

So why Adapting Creatively? Our family is all about adapting. When our daughter A was diagnosed with Rett syndrome in late 1997, just months shy of her second birthday, our world turned upside down. Or did it really? Had our deepest goals really changed? Were we, including our daughter, truly any different than we had been before her diagnosis? As soon as we raised our heads above the dizzying emotions, we realized that deep down, we were still the same people with the same dreams. We may have become battle-worn and the path to our goals may have been routed differently, but the deepest core of who we were--each one of us--was really the same. We had to adapt to the unexpected, and that would take some creativity. We would need to adjust our attitudes, our expectations, our time. We would have to apply our "technical skills" to meeting unexpected new needs. That was going to take some creativity...but we could do this.

So, what kind of creative adapting will you find here? Lots! The ideas focus mainly on the issues we deal with daily:  severe motor impairment (fine and gross, both), non-verbal communication, daily living and simplifying caretaking, accessing the environment, recreation, schooling, attitude and outlook. With my background as a special education teacher, curriculum adaptation is a passion for me. Because I also spent a number of years teaching in general education, I'm also passionately involved in ways to involve children with disabilities in regular classrooms. In meaningful ways, I might add. Years of participation in our regional AAC professional group has taught me how to apply what I know of child development to the development of non-verbal communication. I sew and craft; it always pleases me to be able to modify something off-the-shelf that can work to make life easier or substitute for some expensive piece of "adaptive" equipment. Easy, free or cheap...that's my style! My husband is quite handy and has jumped in with a number of projects himself that I think are terribly clever. He talks at times of a father's need to "fix things," and since he can't fix the Rett syndrome, he focuses on fixing the challenges it throws our way. Wait till I show you some of the creative things he's designed!

All of this is for you, the parents and teachers of other children with disabilities. Please let me know what you find helpful or what I need to clarify. If you have a question about a project you think I might want to tackle, please do suggest. Above all, if you have ideas to share, I hope you will let me know. Together we can make this a resource for families with the need to adapt and the desire to do it creatively.

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To help you know what to expect here at Adapting Creatively (as well as to keep me on track!), I've added a Schedule of Posts page. Be sure to check it out!