The number of topics an individual communicates about each day is extensive. Communication helps us form and maintain relationships, express likes/dislikes or wants, ask and respond to questions, etc. These skills are just as important for individuals who use augmentative and alternative communication (AAC) systems as they are for you or me. Similar to us, individuals who use AAC require access to language on their communication systems. They require support to develop these skills. They also require the opportunity to communicate using these skills. There are six primary communication functions of AAC that we use.

Six Primary Communication Functions of AAC

Requesting

Individuals use requesting in a variety of ways. This includes: requesting a preferred individual (e.g., “mom” or “dad”) or activity, gaining someone’s attention, or communicating a basic want or need (e.g., “food, drink,” or “bathroom”). Requesting can indicate a food/drink order, someone we want to speak to, a place we want to go, or a game we want to play.

Protesting

Similar to requesting, individuals use protesting to reject or decline things that they do not want. This might include: a food/drink that we do not want, an activity, or a chore that we do not wish to do. While protesting can sometimes be considered inappropriate (e.g., skipping school or work), it is something that we use our words or actions to effectively communicate.

Describing

Describing explains the things that we see by labeling or explaining our wants and needs. For example, we may label our list of items for the grocery store or the ingredients that we need to make cookies. By using labeling and describing, we increase our ability to communicate more successfully.

Asking and Responding to Questions

Asking questions includes use of the five “wh” questions: “who, what, where, when,” and “why.” We also use “how, can, do, are you,” as well as “yes/no” in order to ask and respond. Individuals use questions in order to gain information about a topic or person. When someone asks us a question, we answer by providing enough details to appropriately respond. We ask and respond to questions to share our thoughts and ideas. This results in a communication exchange between two or more individuals.

Commenting

Individuals use commenting in order to remark on what they see, feel, hear, or otherwise experience (e.g., taste). For example commenting with “yum” after tasting something good, or saying “whoa” or “wow” when experiencing surprise. Commenting may also be used to indicate a like or dislike (e.g., a favorite color). It is used to provide basic information in a clear and concise manner.

Expressing Feelings

An individual uses communication to express their physical and/or emotional state (e.g., “happy, angry, sick, tired,” or “in pain”).  If in pain, or sick, we use communication to specify how or why we feel the way we do. If we are excited, we explain what is making us feel that way.

In summary, we use these primary communication functions to help us effectively and efficiently communicate. You may notice that several of these functions overlap, or coincide with one another. For example, you can express that you are sick, then respond to questions about “how” or “why” you feel sick. If you comment on how you like something, you can also use communication to request a repetition. The communication functions listed above are continuously used throughout our day. This is why it is important to support individuals who use AAC systems to communicate using these functions.

Vocabulary provided to individuals on their AAC systems should be intentional. This includes what is important to the individual and/or their caregivers. Preferred objects or persons are most likely to be used for individuals who are in the stage of language development and have not yet expressed a “first word.” Also, being able to communicate medical needs is an important skill to address when applicable. In general, including vocabulary on an AAC system that can meet the need of all six communication functions is crucial. Check out additional resources from Autism Classroom, Cornerstone Autism Center, and Communication Community. If you or someone you know needs additional support we AAC, our speech therapists at MOSAIC can help!

Reference

1. Beukelman, David R., and Pat Mirenda. Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs. Paul H. Brookes Pub., 2013.

What is sequencing, and why is it important? We use sequencing as a part of our daily routine. It involves ordering events based on their chronological timeline. Essentially, these are the steps that we use to complete a task (e.g., hand washing or following a recipe). For example:

Washing Hands:

1. Wet hands
2. Put soap on hands
3. Lather hands with soap and water
4. Dry hands with towel

While this may seem fairly straight forward to most, several individuals with developmental delays and/or young learners experience difficulty with sequencing. As a result, they may need explicit instruction on how to complete a routine.

Why is it Important?

The ability to sequence tasks and understand information in a chronological manner is critical to development of literacy skills. Target literacy skills include: the ability to identify the beginning, middle, and end of a story, making a prediction for “what will happen next?’ in the story, and retelling or summarizing a story in a sequential manner.

The most basic level of sequencing exists in functional routines (e.g., washing hands or getting ready for school/work). Most individuals acquire a rote means of completing a functional routine without needing to reference a picture or visual. However, the development of these skills evolves from functional routines to higher-level language functions including:

• Understanding cause and effect
• Following multiple step directions
• Narrative skill development
• Understanding and using transition words (e.g., “first, second, then, next, last, finally)
• Reading and writing
• Learning schedules and creating them
• Organizing information
• Time management skill development

Sequencing skills are targeted throughout nearly every level of the school-aged (i.e., kindergarten through 12th grade) academic curriculum. A strong foundation for the above higher-level language functions is essential for understanding and using information covered throughout the curriculum.

How is Sequencing Taught?

Therapists often implement picture cards to teach or improve sequencing abilities. This includes a picture representation of each step in order to complete a task. Once the learner can sequence a task using the pictures, the visuals are often removed. Instruction remains ongoing until the person can complete the task independently.

Sequencing or picture cards can be used not only in speech therapy, but across other therapies, at school, or at home. Not all sequencing cards come in picture form. Higher level learners who have developed reading skills may benefit from text cards. A great example of this is a recipe card. Aside from sequencing cards, graphic organizers or timelines are also used to target sequencing skills.

If you have concerns about your child’s ability to sequence and complete tasks, call MOSAIC today to schedule an evaluation with one of our speech therapists.

There is a lot of talk in the world today about Social Emotional Learning or SEL, as well as social topics. We also see and hear from clients daily about their child’s behavior and the idea of the iceberg analogy when speaking about behavior. Here is an occupational therapist’s perspective about this topic.

Occupational therapy has always considered social emotional learning or emotional regulation skills in the work provided. It typically comes from a sensory processing viewpoint. Behavior is often treated with external methods and teaching to address both wanted and unwanted behaviors in children.

Social Emotional Learning Perspectives

Occupational therapists may choose to view social emotional learning from a psychosocial development perspective and use psychology and neurocognitive development to guide treatment approaches. This begins by meeting the child where they are in their development. This is where the iceberg analogy comes into play. An OT’s job is to look at the outward function of the child. Then they look below the surface to the possible reasons or causes leading to a disruption or difficulty experienced in the function.

The OT will look into how the child is learning, the environment, and their experiences in learning. OTs consider the foundation of their development. Looking into how the child feels and perceives their world helps in developing a treatment plan. Is the child experiencing the world from a heightened or depressed sensory world? How are they experiencing internal needs/desires? Does the child have strengths or weaknesses in cognitive learning? How can we help a child understand their role and purpose in situations? Social Emotional Learning models discuss self-awareness, self-management, and relationships.

How to Support These Areas

Self-awareness involves an understanding of self and how one feels about self. Is the child able to make the leaps that us adults and parents desire? Can the child learn and accept themselves individually? Once a child learns about emotions and feelings, they then can be more expected to flexibly change and be responsible for their behavior. This is less about teaching emotion and more about learning about individual emotions and how that sits in a person. It includes being uncomfortable and comfortable and observing that this is flexible. Self-awareness is a great foundational tool for cognitive development. In order to be able to form successful pathways and support emotional regulation, we need supportive self-awareness that is child led and then met from an adult.

Once self-awareness skills start emerging, self-management learning can begin. Again, using a development framework versus a specific behavior problem-solving framework works best here. Is the child able to make the best choices in situations based on their development and their awareness abilities? Using skills to support this learning is definitely needed. It is the first approach to looking at emotional regulation, also known as behavior. When behaviors are extensive and extreme, alternate approaches are also used but in conjunction with the first approach. As this learning develops, more support to relationships is introduced. Self-management draws on and allows for further cognitive development leading to what is sometimes coined as emotional intelligence.

From the get go, humans connect and need relationships.

Most of the children we see have difficulties forming and maintaining friendships. When approached with this difficulty, we draw on foundational skills. We work towards improving a child’s interactions in a variety of social situations. This includes working on friendships but mostly working on social perspective taking. How can a child use their individual strengths and weaknesses to be successful in relationships? Typically at this stage the child shows more integrated cognitive abilities. They are ready to meet age-expected challenges with improved performance.

OT is a great option for supporting, improving, and promoting social emotional learning. We use a variety of individually based activities and learning approaches to achieve outcomes for children and families. We have the knowledge to provide support to all children with or without specific mental health challenges. A mental health tier model can also guide interventions.

In addition, OTs have training in how to promote such learning in children with all levels of function. The framework discussed and a neurodiversity approach to intervention can be successful when working with children with autism. This framework is useful for children who struggle with learning. It is also useful with kids who have experienced a neurological trauma. Counseling may be beneficial in addition to OT. It is important to acknowledge that both have a purpose and place in working with children. OT is typically a more physically active treatment. It includes additional support for meeting functional outcomes with daily life activities and routines.

If you are seeking more information, MOSAIC’s occupational therapists can help. You can also check out the Mindsight Institute and a guhttps://mosaicrehabmt.com/pediatric-occupational-therapy/ide on how Occupational Therapists can promote mental health.

Is your child struggling to practice their handwriting skills because sitting down to write letters is just too boring? Well, we have some tips to encourage handwriting practice! One of the best ways to encourage handwriting practice is with board games.

Tips for Handwriting Practice

One favorite happens to be the game “Guess Who?”.  You can play this game in a more non-traditional manner encouraging children to write their questions instead of say them. Pretend as if you’ve “lost your voice” for the entirety of the game. The child then has to work on formation, orientation, spacing, and punctuation while writing out their questions. For example, instead of saying “Does your character have red hair?” the child has to write this question and show to their partner.

Does your child love to color and draw pictures? To encourage further learning, encourage the child to illustrate and write a book. Have your child draw a picture at the top, color, and label the parts. Then have them write one to two sentences on each page, creating a story! Laminate and bind to store for memories or to read during bedtime routines.

Are you familiar with the game “Spot It”? Turn this game into a “silent game” just like “Guess Who?”. Instead of having kids yell out their answers, be the first to write down the answer and then slap the cards. This will encourage speed and efficiency of handwriting. You can even have your child re-write their responses to work on accuracy and formation of their written responses.

Does your family often play scrabble or Bananagrams? If you haven’t guessed yet, make it a handwriting game! After scoring and counting up the points for each turn, have your child write their words on their lined paper to earn additional points. Encourage accuracy of letter formation but give bonus points for letters written correctly on the first try!

Handwriting can be a difficult and mundane task to practice. If you can implement these games and strategies into your weekly family routines, it may make the fight to practice writing less dreadful. Good luck and happy writing! You can also find toys that will help with pencil grasp and writing here.