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Sunday, April 7, 2013

Advice from the ASHA Community - Repetitive Requesting...

There are so many useful conversations on the ASHA Community SIG 12 discussion board (the group's AAC Special Interest Group) 

Here are excerpts from one that got a lot of response recently, subject line: "Advice"
Does anyone have any advice on how to reduce a student's use of her AAC device to request one item only? I am trialing the Dynavox with a student who goes straight for 'I want Cookies' every time she sees the device. (she is independent with this and has the potential to use the device to request other items) I recently deactivated the button but she continues to attempt to navigate to the location. I have not given her any cookies for the last (at least) 20 trials. I don't know what else I can do to break this habit! Thanks in advance. :)
- Canton, MA

Don't break the habit! Try using it to expand the communication, instead!  I don't know much about her skill level with the Dynavox as you are trialing it with her or the number of buttons she can utilize on one screen - but I know at this point, you have found what motivates her - so now you can use it for more natural communication exchanges to expand her repertoire and sentence length!  You could actually pair it with number so she has to hit 2 or 3 buttons - to get 1, 2 or even 3 pieces of a cookie!  (I want...3 pieces...cookie) You could use it in a play routine with a doll/monster/puppet - feed  the doll/monster/puppet a cookie or find the lost cookie or play 'who took my cookie?' with a series of questions to ask to gather clues about which doll or person took her cookie.  Instead of Where's Waldo - play 'Where's the cookie' and take turns hiding the cookie and asking and responding to Yes/No questions. You could combine it with 'Lets sing... a cookie.... song' or perhaps 'Lets watch... a cookie... video.' You could add a series of buttons for a recipe that will lead to the making and eating of a homemade cookie try adding some funny comments for her to say during the baking to develop sense of humor!  Later, after she gets the idea that she will always be able to talk about cookies, and you have spent time discovering other motivating things she'd like to talk about, you could use a paper visual schedule with other topics to show her:  first we have to do this, then this, and then we can talk about cookies again!  You may have to pair this with a visual reward system so when she completes two other topics/activities then she sees its time to talk cookies again! Eventually, she will find another motivator to talk about and the cookies will lose their luster!  I would be careful removing access to something that she has found empowering and motivating because it could cause her to feel loss of control or even hope and I have found that something you want to avoid!  I hope these ideas help! Good luck!  
- Southbury CT  

Dynavox has a online training through their Pathways series called "Beyond Requesting". You may want to view this series. The cost is minimal $25 and you can also get 3.5 CEU's.
- Nashville TN  

From your post, it seems your student can use the device to make varied requests but maybe always starts out with "I want cookies" because of a learned motor pattern. I've had success with "reteaching" the motor pattern -- leave the device programmed as-is, without blocking or hiding the "cookies" button. Reteach the motor pattern by supporting her intent in a reciprocal activity (i.e. a game or activity the student likes to play or engage in with another person that has a back and forth/reciprocal component --- singing lyrics to a song, playing a board game, etc.). Start off wuth her typical pattern (asking for cookies, then saying her intent/other message) and acknowledge there are no cookies available while you act as per the message she relayed after the rote message was activated. Once you can understand the message she is going to respond with in that back and forth game, you can show her she can initiate that communication without composing "I want cookies" first. You may need to support her by guiding her hand to her supposed "true intent" so she does not activate the "I want cookies" --- if you can break the motor pattern and she experiences successful communications more quickly if bypassing that rote message she may carry that over. Does this make sense?
Of course, if she really just likes cookies she may just always have cookies on her mind. No amount of reteaching or motor plan intervening is going to stop her from asking everyone for cookies. So, she should always have access to ask even if the answer is "no".

- Philadelphia PA

I know it's not very fun to deal with this all the time, but I would strongly recommend that you do not deactivate a button that she uses. If this same student was using verbal communication, we would not and could not delete this message from her vocabulary but instead would continue to try to teach her when it is appropriate to ask for cookies. We need to treat her communication development the same as we would if she was a verbal communicator. To me, deactivating her favorite button would be the equivalent of putting your hand over her mouth to stop her from inappropriately requesting cookies during circle time. It takes a lot of patience, but I would recommend continuing to explain that it is not time for snack and modeling appropriate messages to use during those other activities. I hope this helps!
- Albuquerque NM  

 So good to hear from helpful colleagues!

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