Monday, April 2, 2018

Expanding the Use of Animated Step-by-Steps® to Dementia & Aphasia Therapy.

As a disclaimer, I've really NOT worked with clients with disorders such as Dementia and/or memory loss, but a recent article in the ASHA Leader (Toss the Workbooks! Choose treatment strategies for clients with dementia that address their specific life-participation goals by Becky Khayum & Emily Rogalski) made me wonder whether Animated Step-by-Steps® might be used to support therapeutic training with this population. According to the authors, "Instead of 'testing the person to identify impairments, then using drills to improve the impairment – person centered care is client-directed: Collaboratively written goals address the client's and family members' concerns, and aim to increase the person's participation in meaningful life activities".

In the Khayum & Rogalski article I was particularly interested in Case 2: Mrs Brown, a woman with mild cognitive impairment manifested as memory loss. Mrs. Brown's personal goal was to be able to cook her favorite recipes when she returns home after recuperating from a hip fracture.

Recommended treatment included:
-using visual and graphic cuing
-breaking the recipe into simple steps
-adding pictures
-using a large font
Wow! …. Check , check , check, check …. these are all strategies that an Animated Step-by-Step recipe already offers. Although assistance may be needed in reading the text up to the star, a simple swipe or tap produces an animation with sound effects that can support comprehension. In some versions of the resource, symbols appear to nurture improved comprehension and expression(through the use of Aided Language Stimulation techniques). 

Examples of Meaningful Life Activities

Making an egg salad sandwich for lunch …

Making no-cook playdoh for when the grandkids' visit …

Using an Animated Step-by-Step format to pace through the tasks of getting ready for bed.

Initially the client might perform each small animated step as they 'read-animate' through the page, but eventually they might be required to progress through several animations before performing the sub-steps. That is, you are systematically increasing the memory task requirements.

Several months ago I assisted Invictus Enterprises (a work program for young adults on the spectrum) in creating an Animated Step-by-Step Recipe to help pace their interns through the steps required for making gourmet dog biscuits. The verdict is in! … The Animated Step-by-Step PowerPoint recipe (displayed on a Surface 2 tablet) has proven to be an extremely helpful training tool.

An Animated Step-by-Step Recipe, Brownies is available as a free resource on the Teachers Pay Teachers site (3 versions: Regular - no Symbols, Picture Communication Symbols, SymbolStix) so download the free resource and give this therapeutic approach a 'test drive' with your clients!

I would love to hear how Animated Step-by-Steps® work as a therapeutic tool with clients diagnosed with dementia and memory constraints.

…’til the next post … 

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©2018 Carol Goossens’, Ph.D.
Augmentative Communication Consultant
Speech-Language Pathologist
Special Educator

Monday, March 19, 2018

Who Came to School Today? Who's Going Home Today?

Who Came to School Today is now available as an Animated Step-by-Step digital resource (PCS, SymbolStix) and a Fan Display (PCS version) through Teachers Pay Teachers. 

The Animated Step-by-Step version can be displayed on the Interactive Whiteboard, a computer monitor or an iPad/Android tablet (free Microsoft PowerPoint app). The launch page is designed to add a literacy component to this activity. You can opt to add the initials of your students or just the first letter of their name. 

On subsequent linked pages you will be substituting photo faces of your students for the 'illustration place holders'. Don't forget to also change the xxxx to their printed name. 

To change the text just click to highlight the XXXXX then type over the highlighted text (Do not delete the text placeholder as it has been assigned a specific font and font size).  

To change the picture, right click  (Control-Click for Mac) on the illustrated face … select Change Picture from the drop down menu … navigate to the student photo face that you wish to insert. 

When using the low tech Fan Display, the Facilitator flips back and forth between the two sides of the display … hopefully building a little suspense in the process ("Whoooooo's next?")
Side 1: WHO CAME to SCHOOL TODAY? (suspense builds)
Side 2: JOEY JOEY (pointing to reflection in mirror or the large photo face)
Side 1: Joey (pointing to Joey) CAME to SCHOOL TODAY

Side 2: Can he/she/you SAY HI

In response to the question “Can you say hi? a range of differentiated options are possible:
-wiggle your fingers
-‘fist bump’
-'high five'
-hand wave hi
-say “hi” using the voice output of a single message device, e.g. BIGmack
-spoken ‘hi”
(encouraging the non target students to respond in kind)

You can opt to use a mirror (cognitively young option) or large photo faces to represent the target child.
Does the child seem to recognize their reflection in the mirror? (smiles)
Does the child appear to recognize their own life-size photo face? (smiles)
Does the child appear to recognize the life-size photo faces of their peers
(e.g., looking to the corresponding target child or shouting out their name when the photo face is first introduced)?

When conducting the Who’s Going Home Version of this song:
Does the child seem to recognize the photo of their home? (smiles upon seeing the picture of their house or front door).

There should always be a reason why a particular song has been included in your roster of Circle Time Songs.  Who Came to School Today? is a great song for helping students recognize their own name and picture, recognizing their classmates' names and pictures, working on social closeness through establishing a greeting routine and understanding the distinction between school and home.