Thursday, November 26, 2009

From Recipes to Rockets: Building a Fun Foundation for AAC use

One of my biggest thrills is getting to be there when students get their "voice". It is extra special when it happens over the holidays, making them ones to remember. I have been working with a speech pathologist and a family for over a year trialing devices and doing activities to develop skills with a middle school boy in order to have a speech device. We decided on the Dynavox V, and designed activities for him to use coordinating communication boards we designed.
This student had a history of short attention span, getting bored quickly with everything. I had tried working with specialists through elementary years to design a binder, picture exchange systems, use recordable symbol boards like with a Go Talk, but he would refuse an nothing could be developed.
So... last year, in a new school in a new district, we embarked on the Dynavox trials. Our first activity was building a peanut butter and jelly sandwich. Since food is the way to a middle school boy's heart, we graduated to a build a pizza activity as well. As we did these, we had a partner for the student be a helper and we set out all the ingredients. We had a folder in a snacks category that was "Build a Sandwich" or "Build a Pizza". We had all the ingredients pictured and listed with voice output and also had directive buttons labeled and pictured with a sequence of tasks to complete the activity. We went through all the items and directions with the students and checked him out on them by having him show us and "tell" us each button.
Then he used the buttons to tell the partner what to get and what to help him do to finish the recipe and then the the finished product.
We video-taped each of these and with permission from the family, showed them to the fellow-SLP's in staff meetings.
Last spring our culminating activity for the year was pretty ambitious. We bought a simple beginner level rocket kit and took digital photos of all the parts and sequences to building it. We built pages in his school/classes/science area and followed the same process of teaching him the parts identification, labeling and sequences to the finished product. We then took him out with his class to the football field to launch the rocket. We even had the countdown and lift-off ready for him to use on the device.
We saw a boy that never would use a device to communicate, begin to get the connection that this could be fun and be used to do things and work together. It went beyond the usual run-of-the-mill buttons we tend to use at school - "I'm thirsty", "I'm done", "when is recess?", "I need to use the bathroom" - with the picture of the toilet on the button - how exciting!
We began the actual funding piece with awesome support from the Dynavox team in Pittsburgh, and our area consultant. We applied to Medicaid, got the SLP report, all essential pieces in the packet and off it went.
About July, we heard back that Medicaid had denied the claim and we were back at square-one having to re-submit the claim. Summer turned to fall and still no device. There had been 9 months of school dedicated to training and trialing, we had all our ducks in a row, but still no device.
Was all our labor in vain? I received emails from the rep and the company that they were trying to find out why Medicaid denied it and we just had to sit tight until we knew what was wrong so we could correct it.
Part 2 is coming up with the end results...

All the best,

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