Engaging Students with Special Communication Needs

Department of Communication Disorders Western Kentucky University August 20, 2007 Lauren Bland, Ph. D, CCC-SLP Richard Dressler, Ph. D, CCC-SLP Joseph Etienne, Ph. D, CCC-A Frank Kersting, Ph. D, CCC-SLP Debbie Parsley, M.S., CCC-SLP

Section 504 of the Rehabilitation Act of 1973

stipulates that no otherwise qualified person due to disability may be denied the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance (29 U.S.C. § 794(a)).

Americans with Disabilities Act of 1990

Title II of the ADA prohibits public entities (e.g., state government, public schools, public colleges) from denying qualified persons with disabilities the right to participate in or benefit from the services, programs, or activities that they provide, and from subjecting such individuals to discrimination if the exclusion or discrimination is due to the person having a disability (42 U.S.C. § 12132).

What is a Communication Disorder?

Impairment in the ability to receive or process information, represent concepts or symbol systems, or transmit and use symbol systems; can involve hearing, language, or speech processes.

Nicolosi, L., Harryman, E. Kresheck, J. (2004).

Terminology of communication disorders, 5 th edition

WKU

• Demographics – In the Spring 2007 semester, 391 students at WKU self-identified as needing having a special need

Demographics, continued

• Of the 391, over 200 had a disability of either learning disability or psychological disability.

• Other areas include - hearing: 17 - physical: 50

Student Engagement at WKU

QEP Goal

Students will engage with communities other than their own in purposeful learning activities that explicitly address their capacity and responsibility to contribute to community and society.

Attendant Student Outcomes

Students will demonstrate • their capacity to apply knowledge and training to address relevant concerns in community or society • respect for diversity of people, ideas, and cultures • awareness of their opportunities as responsible citizens working and living in a global society

Students with Asperger’s Syndrome and their success in Higher Education

Didactic Issues

• Your classroom and style?

– Lecture while students take notes?

– Emphasis on note-taking?

– Lectures posted?

– Reliance on discussion format?

– Group work and reports – Lectures? Are they multimodality? Auditory Visual Tactile/Kinesthetic Use of WKU’s Blackboard?

What is the composition of your students?

– Non-majors – Majors – Interesting topic – Learning styles – Students with Disabilities?

The Diagnosis Asperger’s Syndrome, • In general, DSM-IV and ICD10 base their diagnostic criteria for Asperger's Syndrome on the following:

Impairment of social interaction Impairment of social communication Impairment of social imagination, flexible thinking and imaginative play Absence of a significant delay in cognitive development Absence of general delay in language development but probably have a delay in higher order thinking and language skills.

• Recent research establishes the prevalence of Asperger's Syndrome as approximately 1 in 300, affecting boys to girls with a ratio of 10:1

Visual Teaching: a Requisite

• Therefore use of visual methods of teaching, as well as

visual support strategies

, should always be incorporated to help the student with Asperger's Syndrome better understand his environment.

Group interactions

Students with Asperger's Syndrome tend to exhibit a

lack of effectiveness

in social interactions rather than a lack of social interactions. They tend to have difficulty knowing how to 'make connections' socially. Social situations are easily misread by students with Asperger's Syndrome and as a result, their interactions and responses are often interpreted by others as being odd.

“Inner Language” Think it=don’t say it!

•

Characteristics:

Children with Asperger's Syndrome can "blurt out" their thoughts as statements of factual information, resulting in an appearance of insensitivity and lack of tact. However these children typically do not understand that some thoughts and ideas can and should be represented internally, and thus should not be spoken aloud. Therefore, whatever they think, they tend to say aloud.

Sameness

•

Rigid, egocentric perceptions:

Students with Asperger's Syndrome tend to have very rigid egocentric perceptions of the world, and thus can become quite upset when changes occur that "go against" their preconceived "rules" or perceptions. Therefore, when a new situation occurs, they have to learn a "new rule" (perception) which can be very upsetting to them.

WKU’s Role

• Community College – Associate’s Degree – Transfer to the main campus WKU’s Supports 1. Student Success Center

The Kelly Autism Program

Circle of Support

• Housing, single occupancy • Mandatory study hall Goal:” support students as they strive to achieve success in a higher education environment”

Engaging Students with Acquired Brain Injuries What is an acquired brain injury?

- traumatic brain injury open/penetrating or closed - stroke hemorrhage or ischemic - hypoxic-hypotensive brain injury - tumors - infectious diseases (e.g. meningitis) - progressive disease processes (e.g. MS, parkinson’s, dementia)

Types of injury -Focal damage (e.g. stroke) - disrupts discrete function(s) like speech, language, voice, hearing, fluency, or swallowing - Diffuse damage (e.g.closed head injury) - disrupts global functions like attention, information processing, cognition, memory

Disruption of discrete functions Speech poor articulation (e.g. ) Language disrupted ability to express thoughts difficulty comprehending speech unable to formulate written responses difficulty comprehending writing Voice hoarse, strained, mute

Disruption of global functions Attention - relatively intact during routine tasks but greater difficulty with novel or complex tasks Memory - Working memory appears to be particularly vulnerable following acquired brain injury it’s a set of processes that allows us to hold onto information until it can be utilized or encoded, or to keep stored information readily accessible - resources for working memory are split between those processes that are being accessed (visual, hearing) and short term storage - the coordination of this resource allocation is the prime function of working memory while storing information requires other demands of the system

Engaging students with brain injuries Discrete impairments speech refer to WKU’s C D Clinic - allow student to present in alternative modality - have student communicate using language speaking device refer to WKU’s C D Clinic - give students instructions in both verbal and written forms - encourage the student to use alternate words of expression voice refer to WKU’s C D Clinic

Global impairments attention - refer to the Acquired Brain Injury Program - use as many visual and audio aids as possible - ask the student to repeat the instructions memory - refer to the Acquired Brain Injury Program * - have student use memory aid e.g. diary, PDA - review previous information before giving new - have the student use alternate methods for testing

Facts about Hearing Loss

• Nature and Degree of Hearing Loss • Treatment of Hearing Loss • Hearing vs. Understanding • Effects of Hearing Loss • Compensatory Strategies

Nature of Hearing Loss

• Conductive Hearing Loss: Outer/Middle Ear Disorders • Sensorineural Hearing Loss: Inner Ear Disorders • Mixed Hearing Loss: Combination

Degree Of Hearing Loss

• Descriptors of Degree: Mild, Moderate, Moderately Severe, Severe, and Profound • Impairment Relative to Everyday Sounds: Intensities of Common Environmental Sounds

• 0 dB • 10 dB • 20 dB • 50-60 dB • 70 dB • 80-90 dB • 100 dB • 115 dB

Intensity Examples

• Just Audible Sound • Soft Rustle of Leaves • Whisper @ 4 ft.

• Conversation/Speech • Busy Traffic • Niagara Falls • Rivet Gun @ 35 ft.

• Hammering on steel plate @ 2 ft.

Hearing Versus Understanding

• Issues Contributing to Clarity • Vowels vs. Consonants • Background Noise Levels • Availability of Visual Cues • Use of Hearing “Aids”

Effects of Hearing Loss

• Lack of Volume • Lack of Clarity • Ability to Attend and “Focus” • Changes in Behavior: Too Agreeable, Isolation, “Everyone’s Looking at ME”, Misunderstanding the Conversation, Defensive

Compensatory Strategies

• Use of Amplification/Assistive Devices • Use Interpreter, if appropriate • Maximize Availability of Visual Cues • Don’t Hesitate to “Ask” (Rephrasing) • Be Aware of Distracting Stimuli in the Environment • Use a “Buddy System”

AAC

Alternative and Augmentative Communication

What is AAC?

• Augmentative/Alternative Communication System supplementation or replacement of natural speech and/or writing using aided and/or unaided symbols.

Unaided Communication

– requires no additional pieces of equipment. Uses only the individuals own body as the mode of communication (e.g., manual signing, gestures, miming, pointing, finger spelling, and eye gazing.

Sign Language

Aided Communication

–uses of some external device or equipment ( e.g., from very simple handmade materials to highly complex electronic devices that produce synthesized speech.) Needs a transmission device.

AAC Devices

What students may be using AAC?

• Cerebral Palsy • Autism • Traumatic Brain Injury • Multiple Sclerosis (MS) • Amyotrophic Lateral Sclerosis (ALS) • Persons who stutter • Deaf/ Hard of Hearing • Any disorder that effects speech intelligibility

AAC Intervention

• AAC interventions offer valuable options for persons with severe disabilities when the individual’s strengths and needs are carefully assesses and appropriate goals are established.

AAC Intervention

• AAC helps individuals with severe expressive communication disorders interact with people in their environment.

• Develops independence, increases productivity, and allows for active voice in decision making

How to engage AAC users

• Open communication • Encourage use of device • Consider the ways students can be successful • Accept mode of communication in class • Seek out help where needed

WKU’s Student with Disabilities Services • Dr David Coffey 745-5004 • Mr. Matt Davis • A Letter of Accommodation, based on Section 504, documentation of a disability • Accommodations – Extended test time – Books on CD – Priority registration – Note takers – “

Captionists”-

for hearing impaired