Communication Takes Two How I Can Help Enhance Consumers’ Communication Carrie Leonhart, M.S., CCC-SLP Lynette DiLuzio, M.S., CCC-SLP Augmentative Communication Services Coordinators August 6, 2012 PFCS SC Meeting

Pennsylvania’s University Center for Excellence in Developmental Disabilities Education, Research and Service

Introductions and Welcome Survey Your role and Current Knowledge Housekeeping Presentation posted at www.CommunicatePA.wikispaces.com (“Behavior & Communication” Page) Print your own handout, or e-mail Dana Questions Time at end Phone or e-mail

Learning Objectives Understand different types of communication services and supports Describe uses of a communication dictionary (“Understanding Communication” section of ISP) Identify general strategies for supporting a consumer’s communication Identify at least 2 resources (IDS, community) for supporting communication in PA

Why Communication? Federal Communication considerations need to be included in all individual support plans (ISPs) Communication Bill of Rights, National Joint Committee State Office of Developmental Programs (ODP) issued a Communication Bulletin (00-08-18) January 2009 Outlines policies for addressing communication needs Local Communication is often a targeted area for Quality Management Plans

Why Communication? Independent Monitoring for Quality (IM4Q) data shows that 20-30% of people served in Pennsylvania don’t have effective communication using speech Formal communication system in place for only 1/3 of this population segment These individuals need people (like you!) to advocate for and support their communication

Communication Bill of Rights (Handout)

Why Communication? Effective communication allows the person to: Interact with and control environment Express needs and wants, Make choices, Share preferences, Socialize Express self-determination, advocacy, and self-empowerment Access and participate in: home, education, community, and employment activities

Why Communication? Effective communication allows the person to: Provide an effective way to express self Reduce frustration, fear and anxiety Behavior IS communication Including challenging, inappropriate, or self-injurious actions Providing a different mode of self-expression can reduce these undesired behaviors

Why Communication? “Careful attention to communication reveals that behaviors that on the surface appear to be random, maladaptive, or challenging, are purposeful…” Olney, M. F. (2001). Communication strategies of adults with severe disabilities: Supporting self-determination. Rehabilitation Counseling Bulletin, 44, 87-95.

Not being able to speak is not the same as not having anything to say clearly

CommunicatePA.wikispaces.com Communication & Inclusion http://communicatepa.wikispaces.com/Communication+%26+Inclusion Communication Bill of Rights Presentation Action Steps

IDS & Communication Intellectual disAbility Services (MRS) History of augmentative communication services with city of Philadelphia IDS Successes Challenges Next Steps Triage model?

AAC Notice ALL the ways the person communicates When 1 mode breaks down, try another way Explore assistive technology for communication (called Augmentative and Alternative Communication; AAC) Strategies and supports (low-tech to high-tech devices) to minimize or compensate for communication difficulties Provide opportunities to practice communication and build on skills

CommunicatePA.wikispaces.com AAC 101 http://communicatepa.wikispaces.com/AAC+101 What is AAC? (and where to get it) No Tech • Low Tech Mid Tech • High Tech iTech http://communicatepa.wikispaces.com/iTechnology

Your Turn Challenge - use AAC “ways” to find out about me

Materials Resources FREE! Low-Tech AAC or “Aug Comm” Materials www.speakingofspeech.com/AugCom_Materials.html Topic and routine-specific communication boards Social stories Materials saved in PDF format (even if made in Boardmaker) Emergency Preparedness Boards disabilities.temple.edu/aacvocabulary September = National Preparedness Month

AAC Overview Keep it simple Not all devices have to be a computer Low-tech can be very effective “Don’t use a hammer when you need a screwdriver” —Sarah Blackstone (PSHA, 2009) Goal is to be engaged in the communication (conversation) process Build on person’s existing communication skills Use creative problem-solving! DON’T give up

So What Can I do? Start the process Team (IFSP, IEP, ISP) should discuss functional communication every year (is the current system working?) Team consensus identifies need for “formal” assessment Helpful info may come from progress notes, evaluations, SIS, PA Plus, SIB-R, FBAs

So What Can I do? Document communication Services: Evaluation &/or Therapy; State how often and who provides Supports: Document existing successful strategies (especially devices – even if low-tech) Goals: Incorporate AT/AAC with existing goals For example, “Jim will participate in the community by ordering from a restaurant using his communication device/strategy 80% of the time with moderate assistance.”

Services & Supports AAC services (Speech-Language Therapy) Provided (or directed) by licensed SLP CommunicatePA.wikispaces.com Providers Page May include: Initial assessment Making communication boards, Programming devices Training Person &/or Staff, Family to support communication and use recommended AAC Are funded by base MA, school-based Access, waivers, private insurance, vocational rehab

Services & Supports Experiment and explore potential devices! Free Device Loan Programs in PA PIAT AT Lending Library http://www.disabilities.temple.edu/atlend For all Pennsylvanians with disabilities, of all ages PennsylvaniA Training and Technical Assistance Network (PAttan) http://www.pattan.net/supportingstudents/shorttermloan.aspx Device loans open to “registered” educational and EI personnel, for Pennsylvanians 0-21 All PA Intermediate Units (SpED) also have AT specialists 23

Levels of Support Evaluation Formal assessment of skills Review strengths & areas of need from specialist perspective Trial strategies &/or devices with team follow-up Professional opinion for recommendations Ongoing SLP services through community provider Team follow-up Community Supports Problem-solving Review current skills (Profile) & past successes from team perspective “Notice what you notice” Trial & Error Team consensus for recommendations Team follow-up

FAQs Who can receive an evaluation? Adults (21+) served by city of Philadelphia IDS Who can make the referral? SCs complete the referral, after team discussion Commitment to follow-up

FAQs What about compliance with 90-day waiver requirement vs the wait list? Document attempts to provide services Who can perform the evaluation? If you document the need for a formal evaluation, it must be done by a qualified provider (licensed SLP) Can we choose a different provider? Yes, but will need billing through MA & approved by county If want to team problem-solve, contact community resources (Champions, Networks, PIAT)

CommunicatePA.wikispaces.com How Can I Help? communicatepa.wikispaces.com/How+I+Can+Help Brainstorming Worksheet Communication Dictionaries Opportunities for Communicating

Communication Profile A communication profile should be a part of the ISP All people who support the person (family members, DSP) should have a copy The team should develop the profile Profile should tell all the ways the person communicates, and how other people communicate with the person The communication profile should be reviewed and/or updated every year.

Communication Dictionary May be called: Profile Inventory Should be included in ISP under “Understanding ___’s Communicaton”

Communication Inventory Document the unique ways the person “says” things Helps new or fill-in staff A record across settings Keep working copy (separate from formal plan) that can easily be updated Include ?s or guesses to help problem-solve

Everyone CAN communicate Everyone DOES communicate!

FOR INFORMATION contact: PIAT - Pennsylvania’s Initiative on Assistive Technology 411S Student Center 1755 N 13th Street Philadelphia, PA 19122 Tel: 800-204-7428 (voice) 866-268-0579 (TTY) Fax: 215-204-9371 Email: ATinfo@temple.edu Web: www://disabilities.temple.edu/piat Mention area of need (“communication, vision, hearing”) and where you heard about us!

Pennsylvania Assistive Technology Foundation www.patf.us

Resources Tips for Communicating… www.dol.gov/odep/pubs/fact/comucate.htm Video Example Provide extra time for decision-making Offer assistance (don’t assume) Be patient, flexible and supportive Treat the individual with dignity, respect and courtesy

Resources CommunicatePA.wikispaces.com Website, E-mail listserv Provides information about AAC in PA Office of Developmental Programs Communication Bulletin Communication Champions (Philadelphia) iTechnology Information App presentation List of PIAT’s loaded apps Links to Resources Calendar Local, Statewide, and Web-based Training Events Resources Information Product-Devices Providers Lists SLPs working in AAC

Training Resources The FOCUSED program: A communication guide (for Alzheimer’s disease) www.musc.edu/scgec/downloads/FOCUSED%20AD%20communication_Ripich.pdf F = Face-to-face O = Orient C = Continuity U = Unstick S = Structure E = Exchange D = Direct

Next 2013 Look for information on the Institute website

Learning Objectives Understand different types of communication services and supports Describe uses of a communication dictionary (“Understanding Communication” section of ISP) Identify general strategies for supporting a consumer’s communication Identify at least 2 resources (IDS, community) for supporting communication in PA

Your Turn After today, I will do/think about (topic) differently. I will tell (person) information I learned in today’s presentation I need (resources) to help me follow-through on today’s action plan.

Wrap-Up Questions? Comments? Follow-up on referrals Thank You!