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Improving practices based on research on Preferences, Communication, and what we know about the Brain - questions and comments

Interveners and Qualified Personnel

The Personnel Preparation Partnership Webinar Series continued with two webinars in the month of April and on in May, following the two in December and two in March. One more is scheduled for June.
https://nationaldb.org/wiki/page/9/754

These webinars are live with opportunity for a few discussion questions through chat pod or phone. They are also recorded for later access, with continued conversation on the topic through forum posting.

• Transforming Instruction for Students with Deafblindness by Marina McCormick, M.Ed. on December 1, 2016
https://nationaldb.org/library/page/2636

• Assessment and Instruction of Students Who Are Deafblind: What is the State of Our Evidence? by Susan Bruce, Ph.D. on December 14, 2016 https://nationaldb.org/library/page/2639

• Perceived Needs of Teachers of Students who are Deafblind: Implications for Training Programs by Sandy Bowen and Silvia Correa-Torres on March 8, 2017
https://nationaldb.org/library/page/2660

• Comprehensive Personnel Development in Deafblind Education: Exploration of a Model by Cathy Nelson, Ph.D. and Amy Parker, Ed.D on March 22, 2017
https://nationaldb.org/library/page/2662


Please join in new discussion of the recently presented research based practices
that guide us in use of strategies that help children who are Deaf-Blind
learn and communicate more successfully.

Identifying Learner Preferences and Utilizing Results in Designing Instructional Communication Programs by Sarah Ivy, Ph.D. and Susan Bashinski, Ed.D. on April 12, 2017 https://nationaldb.org/library/page/2668

Brain Research: How Can Current Research Guide Us in Improving Practices For Children and Youth Who Are Deafblind? by Linda Alsop on April 26, 2017 https://nationaldb.org/library/page/2671

Project Core: An Implementation Model for Building Early Symbolic Communication by Karen Erickson
on May 10, 2017 https://nationaldb.org/library/page/2672

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

7 143 views
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Comments (7)

Thank you for posting these answers to questions from your webinar chat pod, Karen. I'll watch for responses to your responses and let you know if more questions arise that we've appreciate you addressing. The time and effort you have spent explaining Project Core to our DB TA network is extremely helpful !

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

Hi! I have taken the questions that were posted in the chat pod and written responses to each. This is a long post, but if you asked a question that we did not have time to answer during the webinar, you'll find the answer here.

Lyn Ayer, Oregon DB Project, WOU: Of the 250-350 core words -- how many are nouns?

Response: Of the top 100 words on our list, only 2 are nouns. The number increases to 23% among the top ranked 350 words.

Lyn Ayer, Oregon DB Project, WOU: Also - how did you select the 36 that you selected?

Response: The 36 words were selected based in part on their rank order on a Project list of common words (621 total) that have been given priority scores based on their usefulness for communicating in social and academic contexts (see Dennis, Erickson & Hatch, 2013). In addition to the priority ranking, each word included in the Universal Core vocabulary is useful as a single word message for students who may not be combining two or more symbols together yet.

Lyn Ayer, Oregon DB Project, WOU: wondering -- because I see "up" but no "down", "here" but not "there, etc. and "turn" could mean many things -- turn page? turn around (i.e. my body)? I am sure you have got the question about how to teach good concepts to children who are deafblind without using nouns (perhaps along with the core symbols). For example -- sense of self is important and my NAME is an essential part of ME (pronounce).

Response: We had to make all kinds of decisions to include some words and not others in order to keep the total to a reasonable number as a starting point for teachers. To answer your specific question, here is on the list because it is ranked #61 on our list. There is ranked #119. You can find the original version of our list here: http://www.med.unc.edu/ahs/clds/resources/core-vocabulary

As for turn it is a perfect example of the type of multimeaning, conceptual vocabulary we intentionally selected for our original 36 words in the Universal Core vocabulary. It is a strength that the word has so many different meanings. Teachers have a chance to teach TURN many times each day as it is used to represent taking a turn, turning around, turning the page, turning the lights on/off, etc.

Mark - DE: is there a means to adjust the "High Contrast for All" pics to meet the student's visual challenges?

Response: Boardmaker lets you change the background and provides multiple options for changing the color options. The high contrast symbols we are using are part of a special library of symbols from Mayer-Johnson called PCS™ High Contrast.

Mark - DE: You mentioned a student with deafblindness raking her chest for like, so she had a form of modified abstract symbols prior to implmenting this system?

Response: No. She never had access to abstract symbols. They used concrete objects (orange and apple to choose orange juice or apple juice), but she never had access to any abstract symbols.

Gwen: Is the material that is used with the 3D symbols non-caustic?
Response: PLA filament, which the FDA has approved as food safe

Linda Hagood: Do you ever work with more concrete object symbols, or do you start with this level of representation?

Response: We work with concrete symbols all the time in activity and student-specific applications, but do not find we must start with those symbols before introducing the abstract symbols that represent core. When a word lends itself to a more concrete representation like an object we have no problem using the object, but we don’t restrict ourselves only to the use of objects or other concrete representations.

Gwen: Are the symbols also provided with raised tactilely?
Response: It is possible to download the graphic symbols and create them with raised boarders like you might find with thermoform.

Lyn Ayer, Oregon DB Project, WOU: i love the black background to your symbols -- make them stand out so much better for most children (not just children with visual issues). Also love that you incorporate the Communication Matrix and the basic reasons to communicate. However -- dislike using miniatures for children who cannot see well -- since the tactile sense does not communicate the same thing as the real objects (e.g. a bathtub miniature feels like a box since the faucet is too small; a school bus miniature (esp a tiny one) is nothing like the big yellow thing.

Response: We are using the same term to mean two different things. The tiny symbols we are creating are the same as the 3D symbols but small. They do not represent a real object in the way that a dollhouse bathtub represents a real bathtub. In their full-size version they are abstract representations of abstract words (e.g., more, go, want, like). We make them small so that the students with the most complex motor impairments who have just the slightest movement of their thumb can put their thumb over the whole symbol instead of touching only a small piece of it.

Linda Hagood: What do you mean by "conceptual understanding of language?"
Response: I used the term “conceptual” to differentiate between words that have concrete and/or single referents and words that are conceptual. Words that I am calling conceptual tend to be more general and multipurpose. Snodgrass, Stoner & Angell (2013) published a great article in the Augmentative and Alternative Communication journal called, Teaching Conceptually Referenced Core Vocabulary for Initial Augmentative and Alternative Communication (http://dx.doi.org/10.3109/07434618.2013.848932). In the article, they use the word more as an example of “conceptually referenced core vocabulary.” They write, “[more] does not have a concrete referent unless it is paired with another word. The message, ‘more juice’ has a different concrete referent (i.e., refilled cup of juice) than ‘more movie’ (i.e., turning the movie back on). The word more alone has only a conceptual reference, unlike juice and movie, which have concrete referents.” (pg. 323).

Linda Hagood: How do you choose vocabulary?
Response: The 36 words were selected based in part on their rank order on a Project list of common words (621 total) that have been given priority scores based on their usefulness for communicating in social and academic contexts (see Dennis, Erickson & Hatch, 2013). In addition to the priority ranking, each word included in the Universal Core vocabulary is useful as a single word message for students who may not be combining two or more symbols together yet.

Lyn Ayer, Oregon DB Project, WOU: ThreeD symbols from a 3-D printer feels the same -- because the material is all the same. I am waiting to see when the creators of 3-D really introduce truly different textures -- not just different designs!
Response: We recognize this issue but have done everything we can to address the issues of tactual perception given the limitations of the filament in 3D printers. Using the same material to produce symbols that are intended to represent a variety of words and concepts is problematic. While we agree that there are problems to address, the benefits of the 3D printer led us to try to design symbols that provided adequate tactile information even though they are all made from the same plastic. In designing the symbols, we attended to the characteristics of materials that make them relatively easier or more difficult to perceive. These characteristics include things like roughness, compliance, coldness, and slipperiness.
Roughness: Research suggests that the roughness of the surface is the most important feature for tactile discrimination among textures. Roughness refers to the height differences on the surface, which produce uneven pressure distribution on the skin. Experiments involving roughness have compared different weights of paper and sandpapers with different levels of coarseness. These are minor tactile differences and these minor differences support both active and passive discrimination. We have maximized the roughness differences among the tactile symbols we’re creating by giving them a shape and covering the surface of each shape with a dramatically different pattern or texture. The patterns include ridges, crosshatches, and bumps that maximize the height differences within the constraints of symbols designed to fit in the palm of a child’s hand. These shape and texture differences represent the word class for each word. In addition, we maximize the roughness (differences in height) of the symbol that is incorporated into each shape to specify the individual word.
Compliance. This is a characteristic that we could not vary among the symbols being created on the 3D printed. Compliance refers to the stiffness or squishiness of the object. A pool ball has low compliance and a beach ball or ball of play dough has high compliance. All of the 3D symbols have consistent compliance because they are all made of the same material. Because we cannot address the barriers of reliability and safety while using materials with different levels of compliance, we have to maximize the factors that are in our control in designing and producing the symbols.
Coldness. This name is a little deceiving because this characteristic isn’t about the temperature of the object, but rather about the tactually perceived temperature of an object at room temperature. The coldness of an object is determined by properties of the materials (which is constant in the 3D symbols) and the geometry of the objects created with the materials (which varies among the 3D symbols). While there are still many questions to be answered regarding the impact of this coldness on tactile perception, what is know is that the rate of heat transfer, and perception of coldness, is smaller for a rough surface and that different levels of roughness influence the perception of coldness. Once again, since we cannot change the properties of the materials we use in a 3D printer, we have attempted to maximize variation in geometry and roughness in order to impact the variables related to coldness.
Slipperiness. Little is known about the impact of perceived slipperiness on tactile perception. It is known that slipperiness is related to the friction that is produced when a person’s finger slides over the material to be perceived. We can distinguish between materials using perceptions of slipperiness, but research hasn’t pinpointed how given that slipperiness is not just about the properties of the materials but also things like the force and speed of the finger sliding. A faster, more forceful slide will produce more friction regardless of the properties of the object itself. Furthermore, a rougher surface will impact the friction and perception of slipperiness. Most of the students in Project Core who use or need the 3D symbols have motor impairments, which prevent them from sliding their fingers purposefully over the surface of the object to create friction or perceive slipperiness. Nonetheless, we have tried to design the symbols in such a way that slipperiness varies. For example, we have embossed each symbol with Braille across the top and suggest that the symbol be oriented in the student’s hand with the Braille under the pads of the student’s fingers (see picture below). In this way, if the student is able to slide his or her finger, the perception of slipperiness will be impacted first by the differences in the Braille labels from one symbol to the next and secondarily by the textures on the sides and the object on the top.


Lyn Ayer, Oregon DB Project, WOU: The old thermoform machines had the same problem.....same "feel"
Response: Yes, but as described above 3D printers allows us to add design features that are a giant step forward from the old thermoform machines.


Linda Hagood: What does the modeling/pairing look like? Do you put the student's hand on the symbol, or hand the symbol to the student?
Response: This varies based on the physical abilities of the students. For most of the students, we literally put the symbol in their hand. Two of the students now actively reach for them and pick them up themselves (one from a slant board like you saw in the picture and one from a lanyard around her neck).

Gwen: Files can be utilized on our own 3D printer?
Response: Yes! You can download them here: http://www.project-core.com/3d-symbols/


Mark - DE: You mentioned that the universal tier was not meant to replace the individualized tier. Does that mean that philosophically this system would rather see everyone (staff) having the skills to be a communication expert to create an individualized communication system based on the individual complexity of each student as a step towards moving them from where they are at to the more universal level? Does the system help staff, without communication expertise identify where to begin based on the previous question or does this system start them at the universal level?

Response: As with all multi-tiered system tiers build on one another. The goal of this system is not to create communication experts but to help all teachers develop some basic knowledge, skills, and dispositions to be successful in teaching early symbolic communication. We do not see the individualized system as a replacement for the core, but a meaningful addition to the core when experts are available to create a meaningful, individualized system and help teachers gain the skills to teach them to use it. As for the training, it teaches all teachers to start with the same 36 symbols with all students.

Lyn Ayer, Oregon DB Project, WOU: How much training and supervision will a teacher or team need to follow through appropriately with what you are presenting? My question is because we already struggle to get time commitment from teams -- who are already "required" to do so many things......

Response: In our first school, they received a total of 14 hours of group professional development delivered over the course of a full year. Teachers are able to get started with modeling the use of the Universal Core and attributing meaning after the introductory session of an hour or so. They get better by doing it while learning more about the system through the additional modules.
We have divided the modules into 30-45 minute segments to help address this issue. The self-directed modules are often helpful when the time crunch is big because teachers complete them whenever they fit in.

Linda Hagood: How do you build in opportunities for the student to use new vocabulary during academic instruction? Again, how is this modeled in a group instructional format--handing the student the symbol, placing the child's hand on the symbol? How do you distinguish between modeling and prompting to use the symbol expressively? Sorry so many questions but they're coming up as I watch and listen.
Response: Check out the modules on the Project Core web site (http://project-core.com). We provide specific information about integrating instruction in non-instructional and instructional routines.
Mark - DE: After your project is completed who will provide the professional development to the masses to get them skilled to use this system?
Response: The whole project is designed to result in an implementation model that does not require us. Starting in September we’ll be studying 4 new sites that will use the facilitated professional development modules delivered by coaches they have identified in their own schools. The coaches are not communication experts. Instead, they are used to facilitating training for adults. We’ll have data a year from now that will let us know what the results look like when we aren’t providing any of the training.

Lyn Ayer, Oregon DB Project, WOU: Karen -- I appreciate that you have been looking at children with intellectual disabilities -- or who not be as intellectually disabled as people think. Hope that we can connect to the deafblind field some more -- because I still see some difficulties with the tactile group of symbols. Am encouraged that you use hand under hand and the communication matrix -- but the field of deafblindness has many more techniques that we may not be able to follow through on.

Response: I tried upfront to make it clear that we are trying to make sure our system works in a universal way with all kids with significant cognitive disabilities, which means we must find ways to make it work with kids who are deafblind. We are not trying to implement all of the evidenced-based approaches in AAC or the field of deafblindness because our goal is not to help teachers become experts in either. Instead, we are trying to create a system that will efficiently help them develop knowledge, skills, and dispositions to make symbolic communication intervention a part of their every day instruction. They’ll still need SLPs and DB experts to help them implement all of the evidence-based approaches with the level of fidelity required to help students achieve maximum levels of success. We’re trying to raise the floor rather than trying to be all things to all students.


Linda Hagood: do you have disaggregated data for visually impaired and deafblind?

Response: Check out the handout that is posted on the NCDB site and you’ll see the data I shared fairly quickly. We do plan to continue to disaggregate and understand DB and VI and those who use the 3D symbols, high contrast graphic symbols, and other systems.


Mark - DE: "Neal", partner assisted scanning – could you give greater detail in his example?
Response: You’ll find a good example here: http://praacticalaac.org/tag/partner-assisted-scanning/ and here: https://bridgeschool.org/transition/multimodal/partner_assist_scan.php
Lyn Ayer, Oregon DB Project, WOU: I also love that you start with "All students communicate" -- but sometimes for some of our children these communications stay at the level of behaviors, body language, facial expressions -- I am thinking of some children who have extremely poor vision and hearing, and cannot really use touch effectively either.... because of CP issues --- and it is sometimes hard to measure the tactile since tactile sense is not "measured" as vision and hearing can be measured.
Response: We are using symbols with the children you describe. They are not all learning to use the symbols, but they are making progress toward more intentional and conventional communication as a result of their teachers using symbols and the instructional principles that are part of mSAL.


Mark - DE: How do you differentiate the growth from this system versus the fact that the environment is now interacting with expectations of communication?
Response: Our goal is for kids to have more effective communication. Whether that happens as a result of specific principles of mSAL or the general change in teacher disposition and expectations, we will never know. I’m not sure it matters if teachers find the system easy to use, start using it right away, and see changes in student communication skills we will be happy.


Donna Riccobono: SLP's would benefit from the same intense training as teachers. The best scenario would be to train the SLP on the same team as the teacher implementing this program centered around a student/class. Teachers really need SLP's to support them with communication strategies and it seems SLP's also may not have the training that will benefit our severe/multiple kiddos. We need our SLP's to be able to support our teachers more efficiently.
Response: In our research sites, SLPs are participating, but we want to build a system that will work even when there isn’t an SLP around. In Tier II we’re planning to build more supports that specifically target SLPs, but our primary audience is teachers. They are the ones who are with the students all day, every day and have the most opportunity to teach.


Linda Hagood: Did you do any direct observation and tallying of behaviors, or was the entire study built on reported levels on Communication Matrix?
Response: We recorded the behaviors also. We are interested in seeing students communicate at higher levels using a broader range of conventional behaviors. We’ll be reporting those as we publish our research, but it was too much to try to get into today’s presentation.


Mark - DE: Have you compared the staff receiving 14 hours of training of those 10 DB students to staff with more intensive training? I’d be curious to know what kind of training the staff of those 10 db students had prior to the 14 hours of training.
Response: All of the teachers in our study have the same access to training whether or not they have DB students in their classroom. As for other training, it varies based on years of experience and the specific school. We know for a fact that individual students have had plans developed with teams that included DB experts, but those experts were not involved in the lives of any of our students during the year of the study. One of the DB students had a full-time intervener who I think was EXCELLENT! She figured out how to continue with the program that was put in place with the guidance of a DB expert, and added the use of the three 3D symbols when the teacher used those words as part of her every day use of the Universal Core in her teaching. These 3D symbols gave this student more access to the general curriculum than she had when the concrete symbols and real objects were used alone.

Karen Erickson

Posted 9 Mo. Ago by Karen Erickson

Questions for Dr. Karen Erickson from the Project Core (www.project-core.com) presentation chat pod – unanswered during session due to time constraints:
Q9: What do you mean by "conceptual understanding of language?"
Q10: How do you choose vocabulary?
Q11: What does the modeling/pairing look like? Do you put the student's hand on the symbol, or hand the symbol to the student?
Q12: Files can be utilized on our own 3D printer?
Q13: You mentioned that the universal tier was not meant to replace the individualized tier. Does that mean that philosophically this system would rather see everyone (staff) having the skills to be a communication expert to create an individualized communication system based on the individual complexity of each student as a step towards moving them from where they are at to the more universal level? Does the system help staff, without communication expertise identify where to begin based on the previous question or does this system start them at the universal level?
Q14: How much training and supervision will a teacher or team need to follow through appropriately with what you are presenting?
Q15: How do you build in opportunities for the student to use new vocabulary during academic instruction? Again, how is this modeled in a group instructional format--handing the student the symbol, placing the child's hand on the symbol? How do you distinguish between modeling and prompting to use the symbol expressively? My question is because we already struggle to get time commitment from teams -- who are already "required" to do so many things......
Q16: After your project is completed who will provide the professional development to the masses to get them skilled to use this system?
Q17: Do you have disaggregated data for visually impaired and deafblind?
Q18: "Neal", partner assisted scanning – could you give greater detail in his example?
Q19: How do you differentiate the growth from this system versus the fact that the environment is now interacting with expectations of communication?
Q20: Did you do any direct observation and tallying of behaviors, or was the entire study built on reported levels on Communication Matrix?
Q21: Have you compared the staff receiving 14 hours of training of those 10 DB students to staff with more intensive training? I’d be curious to know what kind of training the staff of those 10 db students had prior to the 14 hours of training.
Q22: What do you think of using an eye-gaze device with the symbols?

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

Comments from chat pod during Dr. Karen Erickson from the Project Core (www.project-core.com) presentation:
Comment #1: I love the black background to your symbols -- make them stand out so much better for most children (not just children with visual issues). Also love that you incorporate the Communication Matrix and the basic reasons to communicate. However -- dislike using miniatures for children who cannot see well -- since the tactile sense does not communicate the same thing as the real objects (e.g. a bathtub miniature feels like a box since the faucet is too small; a school bus miniature (esp a tiny one) is nothing like the big yellow thing.
Comment #2: I am so glad you do not require communication. In the field of deafblindness we teach people to pause, wait etc -- and it is almost inevitable that the child will respond -- and that the response time gets smaller as the number of trials increases and becomes more familiar.
Comment #3: Three D symbols from a 3-D printer feels the same -- because the material is all the same. I am waiting to see when the creators of 3-D really introduce truly different textures -- not just different designs! The old thermoform machines had the same problem.....same "feel".
Comment #4: Karen -- I appreciate that you have been looking at children with intellectual disabilities -- or who not as intellectually disabled as people think. Hope that we can connect to the deafblind field some more -- because I still see some difficulties with the tactile group of symbols. Am encouraged that you use hand under hand and the communication matrix -- but the field of deafblindness has many more techniques that we may not be able to follow through on.
Comment #5: I also love that you start with "All students communicate" -- but sometimes for some of our children these communications stay at the level of behaviors, body language, facial expressions -- I am thinking of some children who have extremely poor vision and hearing, and cannot really use touch effectively either.... because of CP issues --- and it is sometimes hard to measure the tactile since tactile sense is not "measured" as vision and hearing can be measured.
Comment #6: SLP's would benefit from the same intense training as teachers. The best scenario would be to train the SLP on the same team as the teacher implementing this program centered around a student/class. Teachers really need SLP's to support them with communication strategies and it seems SLP's also may not have the training that will benefit our severe/multiple kiddos. We need our SLP's to be able to support our teachers more efficiently.

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

Questions for Dr. Karen Erickson from the Project Core (www.project-core.com) presentation chat pod – answered during the recorded session (https://nationaldb.org/library/page/2672):
Question 1: What were her communication experiences before the implementation of this system (young lady example)?
Question 2: Previous tactile symbols didn't work but the 3d symbols did, what was the difference?
Question 3: Of the 250-350 core words -- how many are nouns? Also - how did you select the 36 that you selected? wondering -- because I see "up" but no "down", "here" but not "there, etc. and "turn" could mean many things -- turn page? turn around (i.e. my body)? I am sure you have got the question about how to teach good concepts to children who are deafblind without using nouns (perhaps along with the core symbols). For example -- sense of self is important and my NAME is an essential part of ME (pronoun).
Question 4: Is there a means to adjust the "High Contrast for All" pics to meet the student's visual challenges?
Question 5: You mentioned a student with deafblindness raking her chest for like, so she had a form of modified abstract symbols prior to implementing this system?
Question 6: Is the material that is used with the 3D symbols non-caustic?
Question 7: Do you ever work with more concrete object symbols, or do you start with this level of representation?
Question 8: Are the symbols also provided with raised tactilely?

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

Please add responses to the questions raised during Linda Alsop’s Brain Research presentation:
1. Based on the research, what recommendations would you give and what changes would you make to improve practices for children who are deafblind?
2. For instance, if information is not getting into the brain, for the neural networks to be built, how can access be better understood and then guide all individualized programming?
3. How can we better understand tactile cognition and learning and encourage the practice of tactile communication for interaction and language development?
4. What practices alleviate the impact of stress for children and youth who are deafblind and promote healthy brain functioning?
5. How can healthy social and emotional development be facilitated for children and youth who are deafblind – in other words, how can we support the forming of close, secure relationships?

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

Please add comments or raise questions regarding Dr. Sarah Ivy and Dr. Susan Bashinski’s Using Learner Preferences when Designing Instructional Communication Programs presentation:
• The powerpoint includes additional info regarding communication programming, which Sarah and Susan were not able to cover, due to time constraints. Susan encourages you to look over the slides, through to the end, and then contact her directly if you have questions about any of that content, or would like more information.
• I would also encourage you to listen to the recording, even beyond the end of the formal presentation (and the conclusion of the captioning). Sarah and Susan had a very good discussion with Adam Graves from Texas about Lilli Nielsen's work, which is closely related to what Sarah and Susan presented.

Linda McDowell

Posted 9 Mo. Ago by Linda McDowell

NCDB : The Research Institute : Western Oregon University : 345 N. Monmouth Ave. : Monmouth, OR 97361
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