The Annual Reports Submitted by the E.S. Ashburn Staff

LOUDOUN COUNTY SCHOOLS ANNUAL REPORT

PERFORMANCE ANALYSIS:

Mark's speech/language program this year has changed several times in many ways. As I've learned more about Mark and as he has demonstrated his specific abilities and weaknesses, the materials and objectives for him have been modified to meet his needs.

This becomes evidents as one looks at our focus throughout the year. When he came to us in September, Mark's primary mode of communication was the Canon Communicator. He sued facilitated communication for his mostly single-word "utterances." Our speech time was spent reading and encouraging Mark to increase the length of his facilitated responses to questions. At that time, Mark did not have a non-violent way of indicating "no." He would scream and push the item or person away, and/or run around the room. He also did not initiate any communication with adults or peers. Mrs. Hartmann noted that she could anticipate virtually all of his needs and wants and that she could also tell how he was feeling by the tone of his screeching.

By December, there had been many instances of Mark's violent behaviors during speech time (as well as other settings). He hit, kicked, pinched and bit me during "work" times. At one point, primary reinforcers were used just to keep Mark on task. It did work. Mark worked for food and the entire staff quickly learned to move away when he became agitated. The pimary reinforcers were used through January along with the expectation that he would only do 3 or 4 items before getting his "reward." WE were also careful to use "work" items that we were certain he could do with no trouble (e.g., copy words on the Canon, etc.) It was important to use to reduce his frustration and that in turn did reduce the number of severe tantrums that occurred.

It slowly became evident that Mark's facilitated communication was not improving. I began to question Mark's use of facilitiated communication and test its validity. By February, it became clear through data collection of items that I did not know the answer to that Mark's communication was heavily influenced (albeit subconsciously) by the facilitators. Even just pointing to one or three multiple choice answers proved inaccurate using facilitated communication with Mark. At that point, we began talking with the Hartmanns about reviewing and modifying Mark's objectives since many of them centered on facilitated communication.

On February 17, 1994, Giny McCulough, a special education resource teacher, was added to Mark's program for three hours of instruction per week. Her role was (and continues to be) to work with the staff and with Mark to teach him some specific math and reading skills and to adapt the 2nd grade curriculum for Mark. Her original assessment indicated that independently (without facilitiated communication) Mark was functioning at a Pre-Kindergarten level in reading and math. (See Ms. McCullough's report for more information on his gains in academic learning in a 1:1 environment.)

By 3/18/94, the IEP Committe developed more appropriate objectives for Mark. The communication objectives included social, interactional, and pragmatic (using some communication system). Because of his 1:1 time in speech/language, Mark has made gains in his ability to communicate. The first symbols used were those for "yes" and "no." The words were paired with the symbols and for rewards, Mark was asked, "Do you want this?" If he pointed to "yes" he received the reward, and if he pointed to "no" the item was put out of site. As I became more aware of Mark's likes and dislikes, I often offered him something that I knew he didn't want. This gave him the opportunity to use the "no" symbol meaningfully, and I had him pair it with shaking his head. Although nodding appears easy and natural for Mark, shaking his head continues to be difficult for him. He does, however, have a fairly consistent "no" response (pointing to the symbol) to the questions of wanting a particular object. Mark nods for yes and no, so the symbols remain important for accurate communication.

Symbols were then made for varioius objects that are rewarding for Mark. (Several stuffed animals, the computer, rest, snack, book, etc.) The symbols were on a board, paired with the word, and the question was asked (after 5 work items were completed). "Mark, what do you want?" Mark then appropriately pointed to the picture symbol of the item and then I would hold up an item and say, "Is this what you want?" Consequently for "break" time, Mark had to use two communication responses (one for pointing to an item and one for "yes" or "no").

Most recently, near the end of April, a communication board was introduced to Mark. The symbols (1 inch square, paired with words) are smaller than he was used to. They included people, verbs, social words, adjectives and objects. I began to model entire sentences in conversation using the board. Mark's teacher assistant and resource teacher have done the same. Mark has gone from single word "utterances" (e.g., "rest"), to two word "utterances" (e.g. "want snack"), to even three and four- word "utterances" (e.g., "Mark want eat snack.")

Mark now gets the attention of his listener by gently touching her arm and initiates requests for actions and objects. (He only does this with familiar adults and has not demonstrated the ability to initiate communication with peers.) Some examples of spontaneous communication include: "Mark finished snack," "Mark want go," "Mark want look book," "Mark want drink." He has also used the board to communicate his emotions (e.g., "Mark sad" and "mad") at times when his physical state matched these remarks. It is important to note that throughout the learning of new material for Mark, he continues to hit, kick, pinch, and bite. He also avoids work by running away or laying under the table. Mark demonstrated all of these behaviors in the previous school system and I feel that it is important for anyone who works with Mark in the future to be aware of his often unpredictable, aggressive behaviors.

Mark is able to identify (by pointing) many of the other symbols on his board that he has not yet used. He has learned more symbols, but needs constant repetition and practice with them in a meaningful setting. The communication board and symbols have not been generalized to any setting outside of Mark's school environment. He is familiar with the board and has used it spontaneously on many occasions with his assistant, resource teacher, classroom teacher, and me.

I truly enjoy working with Mark and feel that his progress in communication is significant. He now has a viable, universal way to express his wants and needs. I hope that he can learn more ways to use his communication board to enhance his quality of life.

Carolyn F. Clement, CCC-SLP