Tuesday, July 23, 2013

AAC Update: Emma's progress with the Eco2

This summer we are focusing on Emma's communication.  This is important to me since she will be starting Kindergarten in the Fall at a new school with all new teachers and therapists.  The one thing that is making me rest easier about this transition is that her fantastic one-on-one aide will stay with her! I can't imagine how anxious both me and Emma would be if the school decided to use a different aide...

Anyway, in keeping with a communication focus we added in some Speech therapy sessions with the AAC specialist at Emma's hospital.  We've had 4 sessions so far and I've had quite a few A-Ha moments.  These sessions are as important to train me on the device as they are for getting Emma to become a more proficient user of her "voice".  The SLP picked up on Emma's social focus right away and decided that we should encourage her to use the device for social situations.  We decided to show (instead of hide) the "talk" core word.  And in the activity row I programed in things that Emma might want to talk with others about.  To start we are programming in 2 different topics with 3 buttons each.  The idea is to eventually program in some "Pages" so she has a lot of choices about conversations with others.  This, however, is the first step towards that goal.

For example:  Emma lost 3 different teeth recently.  That is something most children want to talk about so I programmed in the following activity row buttons.

  • I lost my tooth.
  • I put it under my pillow.
  • The tooth fairy took my tooth and gave me some money.

The idea is to change these frequently so she can start conversations with people.  Another example was something I programmed in after our vacation.  She was able to tell her friends and team at school what she did on vacation without me writing it in her communication notebook.  The following was programmed in three different buttons in the activity row of "talk".  They were programmed after skipping a space between her tooth fairy talk and the vacation talk.

  • I went to the beach for vacation.
  • I swam in the ocean and the water was warm.
  • I went on the boardwalk and rode in a lot of rides.  I like the rides the best.
I love how adding in the "talk" section has opened her world to initiating and participating in conversation rather than focusing on her wants/needs with her core vocabulary.  It took a while for her to get this change in the way she can use her talker but I think it's starting to click.  She selects that talk button frequently and has used all 3 phrases for her topics often.  At first she only used one but now she is up to selecting all three.

I want to incorporate other fun ways for Emma to use her talker so I brought her favorite book of the moment - We're going on a bear hunt - to a Speech session for ideas on how to incorporate it into her talker so she can read along with me.  Since there are so many repeated sentences in this book we decided to program in along the top row with a space in between each phrase the phrases as follows:

  • We're going on a bear hunt.  We're going to catch a big one.
  • What a beautiful day.  We're not scared.
  • We can't go over it.
  • We can't go under it.

We added in the core area the fun words:  Swishy Swashy, Stumble Trip, etc.  and we used Julia's voice recorded saying those fun words.  Emma really likes reading the book with us and amazed me with how she intuitively knew how to use this Bear Hunt page.  I teared up because she was so into reading the book and knew exactly what to say and when to say it.  We did turn taking and where I would say the lines that weren't programmed into the device such as Oh no a River, We've got to go through it, etc.  I wish I had a video of her doing that but she gets so distracted when I take a video she won't do anything on camera.

Another recent change is Emma prefers to use her hands to access the talker rather than her eye gaze.  This is both harder and easier for her.  Easier in that it is quicker to make word selections, harder in that her hands don't work so well and she needs some help.  She has demonstrated that she is very accurate with her hand use to both me and her SLP at the hospital.  He determined this by having Emma use his hand to stabilize her arm rather than my hand.  When he gave her a bit too much "assistance" with her arm she yelled at him in her manner and then took over.  It's funny - she doesn't want anyone putting words in her mouth!  He is very seasoned in AAC (actually, he has worked exclusively on AAC for many years) so his progress notes will be particularly helpful in her upcoming IEP meeting when we set new goals for her.  When setting the goals higher than expected based on her recent performance it generally goes over better coming from a professional than me saying it as her Mom.

School is also reporting that Emma is looking to use her hands over her eyes for the talker.  They are reporting that she is selecting appropriate words when using her hands for the activity they are doing.

I took a couple of videos this morning before school.  Here is Emma using her talker inside when she tells me how she feels, talks about what we did last night and then tells me she wants to go outside.

I'm excited that she told me so many things using her hands (which is quite new for her) while clearly not in a great sitting position  - it was a spurt of the moment conversation that she started that prompted me to get my camera out to take a video and continue our conversation.  I had planned on putting her in her wheelchair with the talker on her mount to chat but she had other ideas so I went with it.

7 Comments from readers:

Laura said...

How exciting, great job Emma!!!!

JNR said...

Seeing all this progress you two have made makes me want to have a magic window into the future so I can see the next leaps of communication. Go Emma!

Anonymous said...

She is poised to take off in a big way, you can really see that here. What a team you guys make!! Love this so MUCH!

jwg said...

If she doesn't already have it, there is a beautiful pop-up book of Bear Hunt, the Helen Oxenbury / Michael Rosen version. Good stiff pages so that she might be able to manipulate at least parts of it herself.

Brielle and Me: Our Journey said...

That is SO exciting! I remember so well when my 17yo daughter with CMV started using her Dynavox communication device. She was already using sign, and doing well with it despite fine motor skill issues. But, there is something... magical... about that talking box that creates a voice for those who cannot speak. I videotaped some of the first few days with it and I am brought to tears every time I see that video clip. Brielle does not use a communication device (except at school) since she is fluent in sign, but those years were powerful with her device. It's a precious time when Emma's whole world is opening up. I don't have to tell you to embrace it. You are doing that quite well! Yay Emma!

Anonymous said...

Emma - M~1Meom and Pop are truly excited about your new journey. Keep up the good work. Your mom and dad are soooo proud of you.

The Bynums said...

Oh goodness Kristina, so wonderful to see!! We only had a few days at home with a Tobii for Tessa, but man the similarities between our two girls is just amazing to me. I feel like I get a tiny glimpse into Tessa's future...and maybe for you it's more like remembering back when ;)
I have to admit, I laughed so hard when Emma started saying "Go"...your laughter and then that LOOK she gives you. We get that look all the time, and I just love it. And all of the vocalizations she makes are so familiar. Ya'll work so hard and you both are always such an encouragement to me!