Marlene Cummings, AAC Consultant

19/10/2024

It is almost time! Are you going to Closing the Gap? Come join me to dive into 2 of my favorite topics-Vocabulary Instruction and Capacity Building. See you soon!

06/10/2024

Going to Closing the Gap? I hope you will join me as I share about 2 of my favorite topics - Vocabulary Instruction and Capacity Building. Can't wait to see old friends and meet new ones.

12/02/2024

There's still time to join me for this free workshop presented by AbleU. We will be exploring aspects of capacity building and the impact it can have. I encourage you to join as team to collaborate as you consider your current state and determine next steps. Hope to see you there.

Here is the link:

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22/02/2023

Here is post # 4 from Rachael Langley. It is vital for us to develop a mindset that supports the development of authentic communication for those supported by AAC.

Revisiting the Prompt Hierarchy for AAC (Part 4 of 4)

Recap & Resources

While I’ve just shared three days of posts on the topic of prompting in AAC, please know that this is just a snapshot of the topics and research related to this. I understand that many teachers, parents, and SLPs work with people in the behavior field. Behaviorists have a deep rooted understanding and believe in the use of prompts to shape behavior.

I’m sharing with you the impact on communication. AAC is a visual representation of language. Language and thinking are not behaviors to be measured. SLPs are firmly planted in the world of cognitive linguistics, where language development guides our work. While our roots may be different from behaviorists, many times we support the same learners. This series of posts doesn’t begin to describe this relationship.

I propose a few “next steps” for you to consider:
- If you use prompting in your therapy, in your classrooms, or as part of your instruction, take a step back and think about how much you are prompting and why.
- Have a conversation with your team about how we describe and define prompts. What is a “minimal” prompt? When - if ever - is it okay to use physical prompts to direct a student’s body?
I- f you see other team members using physical prompting, ask why. If the answer is related to compliance and getting a task done, it’s time for a bigger conversation.

Know that the field of AAC is relatively young. We are now using AAC with a wider variety of learners than we once did. As we figure out the most supportive strategies, we may make mistakes. The important thing is that we keep learning and, as Maya Angelou said, when we know better, then we can do better.

Thanks to my friends and colleagues who generously agreed to preview and edit the content in this series.

Edit to add direct links:
The Problems with Hand-Over-Hand v2.0 by Jane Farrall
https://www.janefarrall.com/the-problems-with-hand-over-hand-v2-0/

Rethinking the AAC Prompting Hierarchy in Severe Apraxia by Kate Ahern
http://teachinglearnerswithmultipleneeds.blogspot.com/2016/03/rethinking-aac-prompting-hierarchy-in.html

Verbal Prompting, Hand-over-Hand Instruction, and Passive Observation in Teaching Children with Developmental Disabilities by Biederman, et al
https://journals.sagepub.com/doi/abs/10.1177/001440299806400406

Physical Prompting is Excessive
https://teachingunicorn.wordpress.com/2020/12/05/physical-prompting-is-excessive/

How I Do It: Prompts and Cues by The AAC Coach
https://m.facebook.com/theaaccoach/posts/194495858704259/

21/02/2023

Part 3 of 4 - you don’t want to miss the next post of this very important message. We have to re-think how we support authentic communication for our students with complex communication needs.

Revisiting the Prompt Hierarchy for AAC (Part 3 of 4)

“But we’ve always used hand-over-hand in this classroom.”
“Kyle wants help! He sticks out his hand for us to guide him.”
“I care about my students - I’m not harming them by helping them point to things. I want them to get the answer right!”

Why has special education stuck with using hand-over-hand prompting? Sometimes strategies like this are taught to teachers and SLPs in college programs. But most often, I find the use of strategies like this are inherited. “My mentor said this is how to do it.” Or “My partner teacher says this is the only way to get them to do the work.”

When you know better, you do better.

So listen: We should not be making kids say things. We just shouldn’t. Full-physical prompting is rarely needed. At times, when a learner has a visual impairment, they may benefit from feeling what the movement is like, where their communication system is, & how to interact with it. Others need support learning to sequence their movement. Kate Ahern does a great job of explaining the role of support for students with motor apraxia in her blog and in her FB community. One powerful point from Kate’s discussions on this topic is this: If you ever need to offer tactile/physical support to a student, first ask their permission. Teach them consent. Through your interactions, they will learn that they have the right to bodily autonomy.

Rather than defending the exception to the rule, think about how often you see physical prompting used in relation to communication skills. My message is my own; your message is your own. We don’t teach that kind of autonomy by “assisting” someone in authoring a message.

The biggest risk - one that is the hardest for many people to talk about - is that we are teaching learners that it’s okay for other people to touch their bodies. It’s okay for someone to move them. That because they communicate differently, they are passive members in interactions. That they don’t have the power to disagree.

Research indicates that people with disabilities are at a much higher risk of sexual abuse. [Abused and Betrayed, NPR] It is our responsibility to equip the people we support with every tool to protect themselves, advocate for themselves, and demand consent.

Kate Ahern's post (2016): https://teachinglearnerswithmultipleneeds.blogspot.com/2016/03/rethinking-aac-prompting-hierarchy-in.html?fbclid=IwAR0_mhRUx3_9jBWvcCTSCNvQoOXcNiH0xotNn7-otcfJaW6ESVFbXw-YISM

[Content Warning: The following link reports on sexual assault among people with intellectual disabilities and may be triggering or upsetting]
NPR's series titled "Abused And Betrayed" (2018): https://www.npr.org/series/575502633/abused-and-betrayed

20/02/2023

Here is part 2 of this important and timely topic by Rachael Langley.

Revisiting the Prompt Hierarchy for AAC (Part 2 of 4)

Today I want to share with you an updated version of the prompt hierarchy for AAC. In this version, I’ve tried to make abundantly clear what was implied in the original version in 2015.

The 2015 version was a recreation of a resource from the Rocky Bay Positive AACtion resource out of Australia. This resource was chosen by myself and a group of SLPs with whom I collaborated. We felt like it described the heavy-handed prompting we saw in many classrooms; often by well-intentioned staff who were given very little training on how to support students using AAC.

The only change we made was to the color gradation. The Rocky Bay resource had the least restrictive prompts colored RED and the most restrictive prompts colored GREEN. This, we feared, would lead staff to thinking they should use a most-to-least prompting method.

Since that time, several of my teacher and SLP colleagues have introduced other visuals that better describe respectful practices for teaching AAC. I’ll share some of those with you at the end of today’s post.

For now, focus on the importance of using the first four strategies during AAC instruction and intervention. Foundationally, we need to explicitly say, “We cannot prompt skills that we have not yet taught.” Just because we have a linguistic target in mind - does not mean that our learners can predict that target. First and foremost, let’s advocate for meaningful and engaging instruction BEFORE we expect learners to demonstrate new skills.

I’m going to repeat that to emphasize how simple yet foundational this is. We cannot prompt skills that we have not yet taught. As educators, we need to have a discussion about what type of explicit instruction we are providing AAC learners. Yes, modeling/demonstration. Yes, verbal referencing. But also -- teaching. Specific vocabulary, functional strategies for use, pragmatic skills, the connection to literacy. All of it. Even the healthy prompting strategies will be challenging if we are trying to magically elicit skills that do not yet exist.

So today, please read over this updated graphic. Consider which of these strategies are used the most in your program/classroom/clinic. And think about where you can start guiding teams to agree that physical prompting and forced imitation are not good practice. Tomorrow, I’ll share more about the risks associated with heavy prompting. In the meantime, consider also using these resources on supporting AAC learners in a healthy and respectful way.

Jane Farrall (2023): https://www.janefarrall.com/the-problems-with-hand-over-hand-v2-0/

The AAC Coach (2020): https://m.facebook.com/theaaccoach/posts/194495858704259/

Kate Ahern (2016):
https://teachinglearnerswithmultipleneeds.blogspot.com/2016/03/rethinking-aac-prompting-hierarchy-in.html?fbclid=IwAR0_mhRUx3_9jBWvcCTSCNvQoOXcNiH0xotNn7-otcfJaW6ESVFbXw-YISM

20/02/2023

It is important that we continue to grow in our knowledge and understanding. This post speaks to our unfolding understanding and communication and how students learn and use language authentically.

22/09/2022

This is a post I’m writing to my younger AAC mom self. Its a post that admits I don’t do the things I used to do or like I used to write about and promote. I used to spend hours matching picture books to core vocabulary so I could model on Nathaniel’s communication device in a shared reading s...

01/09/2022

Join me for this FREE workshop with AbleNet’s professional development series Able U. I’ll be presenting on a topic close to my heart - building capacity!

September 22nd, 2022

Build Capacity in AAC Implementation Across Environments by Shifting Mindsets

For more information and to register for this workshop, visit ablenetinc.com/ableu-live-professional-development