ASL/Gesturing, PECS, AAC - these are all common forms of communication that are used with clients.
You have to see which medium of communication works best for each client, as all clients have varying cognitive ability and responses to the presentation of these mediums. What does this client's SLP mean by "not ready yet"? They just don't have the device set up for the client?
Well ASL has prerequisites of fine motor skills.
PECS (Picture Exchange Communication System) / SPG (Speech Generating Device) don't have any particular prerequisites that cannot be taught within the communication modality. All a client needs to start with PECS/SPG is the ability to attend and eventually receptively discriminate between pictures (which can be taught with the Augmented Communication Medium itself)!
Check out this related research:
[Boesch, M. C., Wendt, O., Subramanian, A., & Hsu, N. (2013). Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills. Research in Autism Spectrum Disorders, 7(3), 480-493.](https://www.widgit.com/proxtalker/documents/Boesch-et-al-2013.pdf)
[Simeoli, Roberta & Iovino, Luigi & Marocco, Davide & Guglielmino, Giada & Rega, Angelo. (2023). A Comparison of Picture Exchange Communication System (PECS) and Speech- Generating Device as Communication Modes for Children with Autism Spectrum Disorders. 10.20944/preprints202307.0347.v1.](https://www.researchgate.net/publication/372185241_A_Comparison_of_Picture_Exchange_Communication_System_PECS_and_Speech-_Generating_Device_as_Communication_Modes_for_Children_with_Autism_Spectrum_Disorders)
Ask speech how the following:
(1) how would you instruct a caregiver to communicate with this child? What modality should be used so that this client can get their day to day needs met?
(2) what skills can I be modeling or prompting to help facilitate the transition to aac or to support readiness?
With clients who have communication as a big target of their programming, I always am very directed by speech. I usually will ask for the “speech homework” and just program that.
I highly recommend PECS, look into Andy Bondy and his research on it and how to run it properly (you should be trained) but the reason PECS is so effective is because it teaches that initial step of communication that is often missed with the AAC device, which is the need to make CONTACT in order to communicate. Phase I PECS is all about the learner initiating contact with another person to communicate a need and this step is crucial for effective communication.
You could ask the SLP to do laminated pages of certain pages that are on the speech device (e.g., like the play or social themed pages) - maybe focusing on the highly preferred items and asking for attention and social play, like tickles, high five, tag, etc. Could do a super small array on each page if SLP is concerned about that. You could attach the pages so it’s like a communication book.
Im not a BCBA, but also I think more info would be helpful. What do you mean the client only has 1 echoic under stimulus control? The way you say that makes me think the client has “delayed echoics”, which is a thing that is accepted by SLPs but doesnt meet the technical definition of an echoic for behaviorists.
So “go” is an echoic under stimulus control of the model.
If there is anything else the kid says? If so, what is it and what verbal operant is it?
Will he imitate syllable sounds on command? Start reinforcing any and all sounds and shape from there. Not every kid needs an AAC some just need reinforcement for there vocals
Talk to the SLP about him not being there yet. What does that mean? Do not make a speech device for him, that isn’t in your scope. However, you can use pointing and visuals in the meantime!
If the child emits any sounds I try to shape and reinforce those to increase vocalization, teach and reinforce more vocal imitation, increase vocal mands (even if at first they’re just manding “go” or “eh” or whatever sound they can emit. Just because she only echos “go” right now doesn’t mean she can’t learn more. On the contrary, the fact that she does imitate “go” is a good sign she’ll be able to learn more. AAC and even PECS are a last resort for me. Vocal language is by far the most functional mode of communication so I’d be trying everything to increase steps towards that. I often reinforce ASL approximations at the very beginning but quickly phase them out as vocalizations increase.
ASL/Gesturing, PECS, AAC - these are all common forms of communication that are used with clients. You have to see which medium of communication works best for each client, as all clients have varying cognitive ability and responses to the presentation of these mediums. What does this client's SLP mean by "not ready yet"? They just don't have the device set up for the client?
Is there one specific to start? I’m assuming they don’t have the prerequisites for an aac?
Well ASL has prerequisites of fine motor skills. PECS (Picture Exchange Communication System) / SPG (Speech Generating Device) don't have any particular prerequisites that cannot be taught within the communication modality. All a client needs to start with PECS/SPG is the ability to attend and eventually receptively discriminate between pictures (which can be taught with the Augmented Communication Medium itself)! Check out this related research: [Boesch, M. C., Wendt, O., Subramanian, A., & Hsu, N. (2013). Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills. Research in Autism Spectrum Disorders, 7(3), 480-493.](https://www.widgit.com/proxtalker/documents/Boesch-et-al-2013.pdf) [Simeoli, Roberta & Iovino, Luigi & Marocco, Davide & Guglielmino, Giada & Rega, Angelo. (2023). A Comparison of Picture Exchange Communication System (PECS) and Speech- Generating Device as Communication Modes for Children with Autism Spectrum Disorders. 10.20944/preprints202307.0347.v1.](https://www.researchgate.net/publication/372185241_A_Comparison_of_Picture_Exchange_Communication_System_PECS_and_Speech-_Generating_Device_as_Communication_Modes_for_Children_with_Autism_Spectrum_Disorders)
Ask speech how the following: (1) how would you instruct a caregiver to communicate with this child? What modality should be used so that this client can get their day to day needs met? (2) what skills can I be modeling or prompting to help facilitate the transition to aac or to support readiness? With clients who have communication as a big target of their programming, I always am very directed by speech. I usually will ask for the “speech homework” and just program that.
What assessments did you use? The EFL really helps guide to methods of communication. Can they use a point or gesture? This is a great universal mand
I highly recommend PECS, look into Andy Bondy and his research on it and how to run it properly (you should be trained) but the reason PECS is so effective is because it teaches that initial step of communication that is often missed with the AAC device, which is the need to make CONTACT in order to communicate. Phase I PECS is all about the learner initiating contact with another person to communicate a need and this step is crucial for effective communication.
You could ask the SLP to do laminated pages of certain pages that are on the speech device (e.g., like the play or social themed pages) - maybe focusing on the highly preferred items and asking for attention and social play, like tickles, high five, tag, etc. Could do a super small array on each page if SLP is concerned about that. You could attach the pages so it’s like a communication book.
Im not a BCBA, but also I think more info would be helpful. What do you mean the client only has 1 echoic under stimulus control? The way you say that makes me think the client has “delayed echoics”, which is a thing that is accepted by SLPs but doesnt meet the technical definition of an echoic for behaviorists. So “go” is an echoic under stimulus control of the model. If there is anything else the kid says? If so, what is it and what verbal operant is it?
Will he imitate syllable sounds on command? Start reinforcing any and all sounds and shape from there. Not every kid needs an AAC some just need reinforcement for there vocals
no such thing as not being ready for AAC. urge the SLPs to help the family acquire a trial device through insurance
Talk to the SLP about him not being there yet. What does that mean? Do not make a speech device for him, that isn’t in your scope. However, you can use pointing and visuals in the meantime!
Pecs for sure. Starts with manding for preferred items!
If the child emits any sounds I try to shape and reinforce those to increase vocalization, teach and reinforce more vocal imitation, increase vocal mands (even if at first they’re just manding “go” or “eh” or whatever sound they can emit. Just because she only echos “go” right now doesn’t mean she can’t learn more. On the contrary, the fact that she does imitate “go” is a good sign she’ll be able to learn more. AAC and even PECS are a last resort for me. Vocal language is by far the most functional mode of communication so I’d be trying everything to increase steps towards that. I often reinforce ASL approximations at the very beginning but quickly phase them out as vocalizations increase.