The Use Of An Aac System Education Essay

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The purpose of this report is to provide quality instructional approach through research findings to children with communication difficulties. Children with communication difficulties often present difficulties with learning adaptive skills or academic skills. This research implemented a research study using three different AAC systems with students with communication problems, findings from the research will aid in providing proper assessment and recommendation of AAC systems to students with communication difficulties, both at the general and special education classroom. This research was also implemented to compare two different methods of recommending AAC systems to student's with communication difficulties. The research also compared the two methods (recommending AAC systems base on teacher's prior knowledge, and recommending AAC systems base on assessment with the use of different AAC with the students). Outcomes from the test will help to improve educational practices in the classroom settings.

Summary of Findings:

Two students of age nine and fifteen was used for this research, both student had cerebral palsy and communication problems. An intervention programme was implemented for a period of four weeks; the programme involves teaching expressive language skills, prior to the implementation of the programme, a pretest was conducted, and at the end of the programme a post test was also conducted. Students were tested with three different AAC systems, result from the implementation of the programme showed that students advanced with two of the communication system, and was unable to use one of the system. At the end of the programme, a post test was conducted, and each student were recommended with an AAC system.

Chapter One:

Background to Report

Children with multiple or severe cognitive disabilities often have difficulties acquiring abstract means of communication, such as speech or sign language, a severe disability, when in addition with an intellectual impairment can hinder the normal development of speech and language skills of children with cerebral palsy, and more often, children with the disability will show significant limitation with receptive and expressive communication skills, which may impede on the process of learning outcomes.

It is always preferable to perceive students with communication difficulties as individuals who have something to say, but have extreme difficulties in making their thoughts heard or understood by others. Intervention programme should seek ways of assessing the child's disability to marching with alternative or augmentative communication system plan that will be implemented to assist the child.

The use of an Alternative and Augmentative Communication (AAC) system is one of the best method or practice to help non- verbal children achieve their communication needs. An AAC system can take the place of, supplement or enhance speech by enabling people with severe communication difficulties communicate better.

This research study will investigate the use of multiple AAC systems (Communication board, communication book and wrist band) with non- verbal student with cerebral palsy, and intellectual disabilities

History of the school

This research was conducted at the STEP center (School for Therapy, Education and Parenting), the school is located on Old Hope Road, Kingston, the school was founded in 1993, by two parents who had children with severe disabilities and believed that their children have the right to education. The school provides education and therapy for children with severe or multiple disabilities, therapy services include (Physical therapy, speech therapy and art therapy).

Most students at the STEP centre have cerebral palsy in addition with intellectual disabilities, communication problems and other health complication such as, respiratory problems, epilepsy, and digestive system defects), and most students at the school are multiple or severely disabled. Students at the center also need assistance with basic living skills, such as self-help skills (feeding, toileting, and dressing), Communication skills (alternative and augmentative communication skills, speech therapy), and mobility and fine motor skills (physical therapy, lifting, and writing). The school has twenty - one students on roll and seven staff, the school is a non- governmental schools and it is been maintained by school fees, donations and grants from the Ministry of Education.

The research will tend to examine and answer the following questions:

Will the use of an AAC system improve expressive communicative ability of non-verbal students?

Will non- verbal children with an AAC system perform greater in academic skills than non- verbal students without an AAC system?

Will the use of an AAC improve the ability of children with non- typical verbal ability to initiate request and respond to questions.

Purpose of the research:

The purpose of this research is to investigate the effectiveness of an AAC system with non- verbal students with communication problems or challenges. Children with severe disabilities often have difficulties with speech and language production, and as such, may use natural sign, gestures, and facial expression as ways of communicating with others, teachers and peers. As the child gets older, the need to increase the child's vocabulary becomes necessary. Natural signs, gestures and facial expression may become inadequate for the child's communication needs, and hence, an alternative and augmentative communication system may be required or needed to improve or compliment the child's limited means of communication.

This research study used AAC systems to examine the validity of the thesis as it applies to improving the child's expressive communicative ability.

The research also investigated the effectiveness of the use of a communication book, wrist band, and communication board with non- verbal students, the result will help to reduce challenges that teachers experience with teaching a non- verbal student.

Definitions of terms:

Augmentative and Alternative communication (ACC) is an area of assistive technology that attempts to compensate (either temporarily or permanently) for the impairment and disability patterns of individuals with severe expressive communication disorders (i.e. the severely speech language and writing impairments), (American speech - language - hearing association, 1989). It is an inclusive term for any system that facilitate communication that can include strategies, techniques and or devices that support an individual's expressive communication (Glennen & Decoste, 1997).

Augmentative Communication System: This is used to describe adaptations used to help a student's ability by supplementing (not replacing) natural signs, gestures, speech, vocalization, facial expression, and other means the student may have to express message. (Ford 1989, P. 191).

Alternative Communication: This refers to techniques that substitute for spoken communication for those individuals who appear unable or unlikely to develop spoken language skills Cormick & Shane (1990 in Kuder 1997).

Communication: This is defined as the process of exchanging information and ideas between participants Owen (1992 in Kuder 1997). In order for communication to take place, there must be four elements: a sender of the message, a receiver of the message, a shared intent of communication and a shared means of communication.

Picture exchange Communication System (PECs): This is a form of augmentative and alternative communication (AAC) that uses pictures instead of words to help children with communication problems.

Persons with intellectual disability is defined as "individuals of all ages who require extensive ongoing support in more than one major life activities in order to participate in integrated community settings and to enjoy a quality of life that is available to citizens with fewer or no disabilities. Support may be required for life activities such as mobility, communication, self-care, and learning as necessary for independent living, employment and self-sufficiency. (Wrestling & Fox, 2004)

Cerebral Palsy is defined as a neurological disorder resulting from the inability of the brain to control the voluntary muscles in a normal fashion, thus interfering with normal movement and posturing abilities. (Westling & Fox, 2004),

Intellectual disability, this is defined by the American Association on Mental Retardation (AAMR), based on three characteristics. The individual must have an IQ of below average, limitation in two or more adaptive skills, and the age of onset must be before eighteen years old.

Situation Analysis:

Three students were assigned to my class, and two of the students have cerebral palsy, severe intellectual disability, and communication problems and the other student has Angel man syndrome, cognitive disability and communication problems. Each student has different communication needs. A single intervention system will not accommodate the diversity of the disabilities of the students, the school uses An AAC system know as the picture exchange communication system (PEC) as a means of helping students meet their communication needs, the school uses just one form of the PEC system for all students, which might not work best with all students. This research implemented the use of variety of the PEC system with each student and sees what works best, with each of the students. Since students with severe disability show wide range of diversity, intervention programmes should accommodate the characteristics of the child's disability to match the feature of the intervention provided to the child. Students also demonstrated wide range of receptive skills but showed limited expressive ability.

Access to Augmentative and Alternative Communication system has been demonstrated as means to acquire some of the necessary prelinguistic and cognitive skills that are essential for language development (Brady, 2000, Light Collier & Parnes, 1985, Romski & Sevcik 1996).

Profile of students used for the research study:

Student (A) is fifteen years old, he has cerebral palsy, he is nonverbal, non - ambulatory, and confined to a wheel chair, uses much of gestures, vocalization, facial expression, and objects as a means of communicating with others.

Student (B) is nine years old, he has cerebral palsy, non-ambulatory, has limited speech, and confined to a wheel chair. He has poor gross and fine motor skills, uses much of gestures, limited speech and gazing as means of communicating with others.

However, base on the student's profile, teacher is faced with the challenges of understanding when students actually understands a lesson or not, quite difficult to understand what challenges the child will like to share, or discuss with others. Base on these problems, teacher implemented a programme, using a communication board, a wrist band, and communication book with the students.

Chapter Two:

Literature Review

Adams, Romski, Bakeman, & Sevcik, (2010).Studied fifty- seven, non-verbal children with their parents, to determine the most effective method of vocabulary acquisition using three different interventions. They used two different types of AAC systems with speech generating devices and speech alone. Thirty-nine of the children were males and eighteen were females, and fifty- three were mothers and four were fathers, the parents were randomly assigned to one of the three interventions. Two of the AAC systems were focus on augmentative input or output (AC - 1, or AC - O). Result from the study showed that twenty - five children of the sixty- two children produced one or more of their target words using speech, while all except one of the children from the augmented group produced one or more words using speech generating devices. (SGD).

Mirende (2003) cited a large body of research, in which the author cited evidences of research works done through the years, as it relates to supporting the effectiveness of an AAC system to improve communicative ability of non - verbal students with communication problems. The research was conducted to compare a total communication system with speech only and / or with manual signing as a means to teach children with autism or limited functional skills receptive and expressive vocabulary skills. Result from the study showed that, manual signing or total communication resulted in a faster and complete receptive and / or expressive vocabulary acquisition than does speech alone.

Ganz & Simpson (2004), studies how non- verbal children with ASD can use PEC systems to improve receptive and expressive communicative skills, and also cited research work done by others using the PEC system. Bondy & Frost (1994), cited in the research provided a group outcome of young students that were provided with training picture exchange system (PECs), at a statewide autism program, he found that seven of the twenty-six preschool students acquired the use of ten picture symbols to make request in an average of three months, and eighty - five students who entered the programme with no functional speech learned to exchange at least one picture within the first month of training. And after five years of using PECs, 52 % of 66 children acquired functional speech and no longer needed an AAC system and another 21% acquired some speech that they used in combination with PECs Schwartz et al. (1998) also cited in Ganz & Simpson (2004) reported the study of eighteen students, of whom eleven has ASD, he discovered that students who had five or more words at the beginning of the training showed growth in speech.

Cress & Marvin (2003) studied a research based evidences of the use of AAC systems with children and adults with communication problems and also used evidences from research to support their findings, Millar, Light & Schlosser (2000) cited in the article, studied six- nine children with communication problems, using AAC as an intervention system, they found 50 of the 69 participants of study showed an increase in speech production after the use of the AAC interventions, only two of the participants showed a decrease in speech use. Romski, Sevcik, Reumann & Pate (1989), also cited in the article, discovered in their studies that children who received naturalist modeling and prompting in using a communication board showed increase in their level of vocal response. Glennen & McPartland (1999), cited in the same article, noted five of nine non-speaking children in their study developed some speech ability after an AAC implementation, while ten of the total twenty- four children who were studied improved their functional speech abilities. Kahn (1981) cited also in the same article found that, children who received training that was focused on sign language in the context of total communication (TC) learned more spoken words during training periods than children who received specific vocal training alone. McIIvane, Bass, O Barien, Gerovac & Stoddard (1984), also cited also in the same article, stated that children and adult with intellectual disability who are risk for delay or long term difficulties with oral communication. Sign language has been demonstrated to be very effective at prompting their vocal speech development as well as overall communication development.

Rispoli, Franco, Meer, Lang, & Camargo (2010). Studied the use of speech generating devices as intervention for communication of individuals with developmental disabilities, stated a great deal investigating a speech generating devices (SGD) with individuals with developmental disabilities, in which he listed five article reviews, focusing on various issues related to the use of AAC devices. Schlosser and lee examined the efficacy of fifty AAC studies between (1976 - 1995), in their review, they supported the positive outcome of the use of AAC systems in general, while Lancioni et.al, also reviewed ten speeches generating devices, in which he concluded that speech out systems have been successful and practical for users with developmental disabilities.

Crary (1993), Hall, Jordan, and Robinson (1993), Cumley & Tones (1992), Blackstone (1989), Hodge and Hancock (1994) and Mirenda, Mathy & Laikko (1989) and among others, cited in Weitz & Dexter (1997), suggested AAC techniques as an effective communication therapy for children with DAS (developmental apraxia of speech), and research has also shown positive outcomes on the efficacy of AAC technique with the population. Culps (1989) also cited in the Weitz & Dexter (1997) presented a case study with an eight year old girl with DAS in which multimodal communication systems were used (natural gestures, communication board, sign language and natural speech). Result indicated increase in communication from the inclusion of the program.

Mirenda & Benkelman cited in Desch and Gaebler (2008). Suggested a successful outcome for children with severe disabilities who are able to use AAC device at the early stage. By the time the child gets to first grade, the child would have mastered the skill and will participate more effectively in classroom settings. And that, children who are skilled and comfortable with AAC devices will communicate more effectively and frequently with their typically developing peers and their teachers.

Kaiser, & Robert (2011), studied the findings by others to support the positive outcome with the use of AAC systems with children with communication problems. Drager, light, & Naughton (2010), cited in the article stated result of more than sixty students indicate that, young children can learn to communicate using different types of AAC systems. Romski et al. cited in the same article also supported the use of AAC system, in which he said Teaching toddlers to use speech generating devices during interaction with parents has resulted in more use of AAC communication and spoken words. Preston & Carter (2009) cited in Kaiser and Robert (2011), stated, The use of picture exchange communication system is effective for increasing child social exchange with partners using pictures, particularly with children who have autism.

Bourque (2010) studied the difference on request made by teaching PECs and request made by teaching Responsive education and prelinguistic milieu Teaching (RPMT), using a randomized control trial method for selection of students into the two groups. Responsive educational and prelinguistic milieu, (RPMT), is a therapy technique which involves parent and children in a play - based method that is designed to improve communication of verbal and non- verbal children with autism. Thirty-six preschool children were selected thirty three had autism and three had pervasive developmental disorders (PDD). It was concluded that children who were taught to use the PEC system were able to communicate with adults in generalized or untrained settings than children who participated in the RPMT treatment, while RPMT was suggested to display an increase with initiating joint response.

Calculator, (2000).Cited, in his article (2009).Stated that AAC proficiency if conceptualized as a means rather than an end, and as a system as opposed to a thing, and if administered properly, will not only enhance a child's communication skills but all skills dependent for effective communication. Calculator (1997) also argued that AAC instructions can actually enhance the cognitive ability of children with severe communication needs, rather than skills such as means -end in isolation, a student might use her AAC system (Means) to accomplish a desired end (obtaining) a pencil which is instrument to the task of writing.

(Kouri, 1988, Schepis et al. 1998) cited in Nunes & Hanline, (2007).Noted that the use of environmental arrangement when combined with naturalistic strategies with children with autism will yield increase in verbalization and non- verbal communication behaviours, such as gestures. Hancock & Keiser, 2002, Kaiser et al. 2000, Koegel et al, 2002, Woods et al, 2004 in the same article has also reported successful results in using naturalistic teaching with AAC systems within apparent implemented format to improve communication with children with ASD in home environment.

White, Carney, & Reichelle (2010). In their article review discussed the effectiveness of the use of an AAC system with children with severe physical disabilities, in which they use direct selection and group item selections as way of communication for children with severe disabilities. In their report, they stated the effectiveness of both methods to improve communication and direct scanning will yield faster outcome than group item selection technique. (Reichelle et al. 1991) cited in the article, said direct scanning requires fewer pulses to select a desired symbol than is required for group - item scanning.

Romski, Sevcik, Adamson, Smith, Barker, & Bakeman (2010), in their study compared the language performances of young children with developmental delays who were randomly assigned to one of three parents coached language interventions. Sixty - eight toddlers with fewer than ten spoken words were engaged in the study, and randomly assigned to augmentative communication inputs (AC - I), augmentative communication output (AC - O), or spoken communication (SC) intervention. Result from the study showed that sixty - two children completed the intervention, all children from the AC -O, and AC - I intervention group used augmented and spoken words for the vocabulary items, whereas children from in the SC intervention produced a very small number of spoken words. Vocabulary size was substantially lager for AC- O, and AC-I than SC groups.

McClannahan & Krantz (1995), cited in Harrower & Dunlop (2001), used a picture book schedule to describe a daily general education classroom activities for three students with severe communication and one with autism. Result from the study showed that alone with reduction in prompts used by the teacher aides, the students followed their activity scheduled 90 to 100 percent of the time. The strategy received a high rating of social validity.

Chapter Three

Methods:

This chapter looks at the implementation of the programme; it provides a detailed analysis of the methods and procedures that were used in the implementation of the research. It highlights the frame work of the research; and also provided a systematic steps or method that would be followed in order to accomplish the expected result; it further provided a detailed explanation of lesson plans and the different instruments that was used during course of the research.

Research Design:

This research is a case study / Action research; an Action Research is a disciplined process of inquiry conducted by and for those taking the action. The primary reason for engaging in action research is to assist the "Actor" in improving and refining his or her action (Sagor, 2000).

A case study research method is defined "as an empirical inquiry that investigates a contemporary phenomenon within its real life context, when the boundaries between phenomenon and context are not clearly evident, and in which multiple sources of evidence are used. (Yin, 1984).

Research questions:

Will the use of an AAC system improve expressive communicative ability of non-verbal students?

Will non- verbal children with an AAC system perform greater in academic skills than non- verbal students without an AAC system?

Will the use of an AAC improve the ability of children with non- typical verbal ability to initiate request and respond to questions.

This research sample was chosen because of the size of the sample group for which the research is being conducted, it allows the researcher to use more than one test samples with the students. And It is very flexible, such that, it can be administered with children and adults within the same sample group and will still yield the same outcome or result, and more also it is less time consuming. The research study will employ the use of primary data for collecting information; instruments will include the use of questionnaires, check list, rating scales, communication boards, and wrist bands, lesson plan and IEPs. An open- end questionnaire was used with an average of eight to ten questions. The researcher used the following steps in the implement of the research. Step one - the researcher collected information on each child's communication skills, by distributing questionnaires to parents and teachers of each of the student. This information helps the researcher with the basic knowledge of the child's communication needs, forms and repertoire. Step two - The researcher will then conduct a pre- test, to assess the student's receptive and expressive skills. The researcher first tested receptive skills, in which she used an informal test or a teacher made test. Secondly, she then went ahead to assess the students expressive skills, using a teacher made check list. Base on the outcome of the test, the researcher was able to determine the child, s expressive and receptive language skills. Third step - The researcher then wrote an Individual Educational Plan to teach expressive language skills to each of the students. The IEP programme was to implement an AAC programme, using a communication board, wrist band and communication book, the researcher will teach four consecutive lessons, each lesson will last for thirty minutes, and will teach the students skills on how to request, ask for items or request for help or needs, using a communication board, communication book and wrist band. A lesson plan and a unit plan will also be implemented during the course of implementing the lesson. Fourth step - The researcher conducted a post test using a rating scale to evaluate the performance of each student, after the implemented of the programme; an analysis of the implementation of the programme is done.

Sample group:

Two students both males, with severe cerebral palsy, intellectual disabilities and communication problems. One is eight years old and the other is fifteen years old, selection was done based on previous knowledge of the sample group.

Procedures:

Step one - The researcher distributed questionnaires to parents and class teacher of the students and were asked to fill informations that was asked on the questionnaire. The information obtained from the questionnaire provides the researcher with background information of the child's communication needs, forms, and style, these provides the researcher with the child's language repertoire. Having gotten this basic knowledge of the child communication style, forms and existing repertoire, the researcher then went on to conduct a pre - test. The pretest tested the child's receptive and expressive skills.

Step two - The researcher administer the pre-test, testing the receptive and expressive skills of the students, using a teacher made check list; The researcher first administered the test on receptive skills to examine the students receptive language skills, and he further went on to administer the second test, which is to examine expressive language skills. A checklist was used for the testing the receptive language skills. The checklist consists of ten questions, and each student is expected to be able to perform all skills that are listed in the instrument. While the expressive language test instrument consists of fifteen questions, students are also expected to perform all tasks on the instrument.

Step three - The researcher implements an Individual Educational Plan (IEP) with each student, base on the result of the pretest for receptive and expressive skills, each of the student showed poor ability or performance with the expressive language skills test. Then an IEP was implemented with each student to teach expressive language skills, the IEP involves the implementation of an AAC system with each of the students, using a communication board, communication book and wrist band, the researcher will then teach four consecutive lessons; each lesson will last for thirty minutes, and each lesson will teach the students expressive language vocabulary skills, using a communication board, communication book and wrist band. The programme will also teach the students skills of how to request for items, and needs, using the picture exchange communication technique.

Step Four: - The researcher then conduct a post test (using a rating skills) after the implementation of the intervention programme, the rating scale consist of fifteen questions and each question has three options and a scoring scale, skills at the non- mastery level is measured between the number (0-3), near mastery is measured between (4-6), and mastery is measured between (7-10). Then an analysis is made from the evaluation of lessons taught, using pretest and post test results.

Description of the Programme:

An intervention programme which consists of lesson plans and unit plan was designed to teach the students with improving their expressive language skills. This programme has four contact lessons and each of the lessons was taught for thirty minutes. For each lesson the researcher taught the students skills of how to request for items or needs, using the communication board. The objectives of the programme are:

Students will request for items, using the communication board, communication book, or wrist band with eight out of ten tries.

Students will show increase in their grades or scores from worksheet activities or classroom participation.

Students will initiate request to communicate with peers or teachers, and will also respond to questions during classroom activities.

Lesson one, the researcher taught the skill of requesting for a juice, using the communication board. Methods used, include discrete trial method, picture exchange system, and prompts. Activities carried by the students involved using a picture card to request for an item from the fridge.

Lesson Two, The researcher repeated the same lesson, used a communication board, picture cards, and a glass of juice, method also used involved discrete trial method, picture exchange system and prompts. Activity performed by the student involved, student using a picture card from a communication board to request for a juice from a communication partner.

Lesson three; the researcher repeated the same lesson, but used different activities, the researcher used picture cards and a communication board to teach the lesson, method involves, discrete trial method, picture exchange system, and prompts. Activity involves students identifying the picture card of a juice from different picture cards displayed in front of them.

Lesson four, the researcher will repeated the lesson, using a communication book, and wrist band, to teach the students to make request, method involves, discrete trial method, picture exchange system, and prompts.

Summary / Conclusion:

Base on the result of the pretest conducted, both students were unable to perform none of the skills, then the researcher implemented an intervention plan. The plan was to teach the students expressive vocabulary communication skills. Lessons were taught with communication book, board and wrist band. A post test was then conducted; result from the post test shows that students mastered most of the skills that was taught. Evaluation from the lesson shows that, students interacted more with the communication book and wrist band, while students need more time to master skills with using the communication board.

Chapter Four:

Introduction:

This chapter evaluates, analyzes and shows graphic representations of results from the implementation of the intervention programme that was implemented in chapter three; it also contains pre and post test results that was conducted with the students, it also shows evaluations of the performances of each student with the use of communication board, communication book and wrist band.

Pre -Test:

A checklist, which contained fifteen different skills or activities were used before as pre- test with each student, the check list was administered with both of the students; out from the test shows that, both students were unable to perform any of the skills listed from the checklist.

A rating scale was used bi - weekly to assess the performance of each of the student, the rating scale has fifteen skills with three criteria, each criteria is scored between a set of given numbers.

Criteria for rating scale: Scores:

Non - Mastery (0 -3)

Near Mastery (4-6)

Mastery (7-10)

Presentation of Data:

Results from the implementation of communication board as part of the programme with both students, shows that Student A, was able to learn or use three words. Fifteen vocabularies were pasted on the communication board; student was able to master three of the picture cards.

Student B, was able to master two words from the implementation of a communication board as part of the programme.

Student A, was able to mastered eight words from the implementation of the use of a communication book in the programme.

Student B, was able to master four words from the implementation of a communication book in the programme.

Student A, was able to master four words from the implementation of a wrist band in the programme.

Student B, was able to master seven words from the implementation of a wrist band in the programme.

Post -Test Result Using Rating Scale

The post test was conducted after the implementation of the intervention programme, when it was used with Student A, student was able to master nine of the skills, and was at near mastery with two of the skills. Student B, was able to master ten of the skills and was at near mastery for one of the skills, and did not master four of the skills.

Interpretation of Data:

The pretest result shows that both students did not perform any of the skills from the pretest, with the implementation of the communication board, student A, was able to master three skills with the use of the communication board, while student B, was able to master two of the skills with the use of the communication board. Student A, increased the number of vocabulary learned with the use of a communication book, student was able to learn eight words with a communication book - student A, seems to benefit more from the use of a communication book than a communication board as the number of words learned by the student increased, and student B, was able to learn four words with the use of the communication board, student seems to slightly increase number of words that was learned when it was compare to his performances with the use of a communication board. Student B, did not really seem to benefit much from the implementation of the communication book or board. Both students were also tested with the use of a wrist band; Student A, was able to learn three vocabularies with the use of wrist band, there was a decline in the number of words that the student was able to learn, student A, seems not to benefit much from the use of a wrist band, and as such was unable to learn more words. Student B, showed great increase with the number of words learned, student was able to learn or master seven words. When compared with a communication book or board, student seems to benefit more with is system.

At the end of the intervention programme, a post test was conducted, each student showed great improvement after the implementation of the programme, student A, when tested after the implementation of the programme, was able to perform nine of the skills at the mastery level and two at the non - mastery level from the fifteen skills that was used with him. Student B was able to perform ten of the skills at mastery level, and one at near mastery level from the fifteen skills that was used with him. A review of the pre and post test scores showed an overall improvement with both students.

The desired outcome of this research was to provide answers to the following questions:

Will the use of an AAC system improve expressive communicative ability of non-verbal students?

Will non- verbal children with an AAC system perform greater in academic skills than non- verbal students without an AAC system?

Will the use of an AAC improve the ability of children with non- typical verbal ability to initiate request and respond to questions.

The first research question was answered from the outcome of the pre- test when, it was compared with the post test result. Outcome shows that at the beginning of the programme, students did not show or demonstrate any form of express language skills, and as such the programme was put in place, at the middle of the programme the students expressive communication skills begins to improve, and later showed greater improvement at the end of the programme. Students showed greater ability with skills such as requesting for items, asking for particular toy or game, the intervention programme which incorporated the use of AAC systems and the PEC technique developed the child's ability to express themselves, and I would say, that the programme was able to improve the student's expressive communicative ability.

With the question, will non - verbal students with AAC system perform greater in academic skills than non- verbal students without an AAC system? During the course of this research, students with AAC systems were compared with their counter parts without an AAC system, results from the test shows that, grades of students during the period of the implementation of the programme improved positively than when they just came into the programme, and also when compared with their counter parts without an AAC system, students with an AAC system achieved higher grades than their peers without AAC systems.

With the question, will the use of an AAC improve the ability of children with non-typical verbal ability to initiate request and respond to questions. One of major objectives of this programme is to teach students the skills of requesting for items, needs or activities, analysis of the pretest when compared to the post test showed that, student's ability to request and respond to questions during classroom activities improved significantly, there is a drastic shift in students' performances, from non mastery to mastery. For student A, he showed great ability with tying and untying of shoe lace, there was an upward progress from non mastery to near mastery, for requesting for a juice, student also progressed from non- mastery to mastery and for requesting help with pushing of wheel chair, student progress from non- mastery to mastery. And for student B, for answering question correctly when asked, student progressed from non mastery to mastery, and for requesting help with classroom activities, student progressed from non mastery to mastery, and for seeking help with wheel chair, student progressed from non- mastery to near mastery.

Chapter Five

Discussion:

Findings from the study shows that, ACC systems will improve expressive vocabulary of students with communication difficulties, and the recommendation of AAC systems should not just be base on the teachers prior knowledge, but should be done on the basis of the child's means of communication, and also the physiological body structures of the child. For example, if a teacher is assign to six students with different communication needs, it's suggested that different communication aid should be recommended to each of the students base on their communication difficulties or needs. Student's non- verbal ability should not be mistake to mean all students with communication difficulties should be provided with the same communication systems. Findings from the research suggested two important factors that should be considered before implementing an AAC system with students with communication difficulties: 1) The physiological body structure of the child, and 2), the child's mode or means of communicating. These two factors are important for a successful implementation of an AAC system.

Analysis from the results showed different abilities of the students with the implementation of three different AAC systems. Results from intervention programme with the use of a communication board with both students, showed poor performances from the students, the students poor ability would have been the result of lack of proper assessment from the teacher, in which the child's physiological body structure was not put onto considered during the implementation of the programme. The child's inability to use the system would have resulted from demotivating encountered by the students.

The lack to foresee the need to adapt AAC system to meet the child's physical need was another reason why the implementation of the programme failed with the use of the communication board. Adaptation should be one of the factors to be considered when implementing AAC system - that is, to say, observing the child's body part, and making accurate judgment as to which body part will the child use most effectively. Looking at the diagramme or graph illustrated in chapter four, it shows the different performance of the students with the communication systems. Students showed greater ability with the use of communication board and wrist band.

Results from the study also suggest that, students who show greater ability with two or more communication system should be allowed or permitted to use them. Literatures from different authors, also supports the fact that AAC systems will improve expressive communication need of children with communication difficulties. One question that came across during the course of implementing the programme was to identify, the extent which an AAC system will support or increase a child's communicative needs. The diagramme also explains this, by showing the different abilities and strengths of each of the students with the different communication systems.

Recommendation:

Teachers should be given adequate training in the use of AAC systems, or should be recommended for workshops where they can be trained on the use of AAC systems, A curriculum on speech language therapy will be of great benefit to undergraduate students who are studying to teach children with communication problems. Teachers should also work closely with the parents of their students when implementing AAC programme with the students. So that, the same system is used at the school with the child is also used at home.

Implication of findings for classroom practices:

Findings from the research will increase student's interactions with others, their teachers and peers. The use of picture symbols will provide accommodation for students in the general education curriculum or classroom settings. Subject areas such as Math, language Art, science, and reading, will no longer be a difficult task to teach children with communication difficulties. Findings from the research will also assist teachers with ways of adapting instruction strategies and the curriculum to benefit the students with communication difficulties, this in return, will yield greater outcome in student's grades and performances.

Findings from the research will also provide teachers with the necessary accommodations that can be put in place, to assist non - verbal students with classroom activities, individual seat work, and group seat work, in so doing, these will help to improve student - teachers interaction, and student - peer interaction, in so doing, student will be able to request help with classroom activity from peers. Interaction with peers and classmates will provide the classmates with the opportunity to learn more about the student.

Further research should include findings of students with other disabilities and communication difficulties, so that, research findings can will involve a wide range of data base from separate sources.

Conclusion:

This research was implemented with the expectation to improve expressive communicative ability of non- verbal students with moderate to severe disabilities; the research did not only improve expressive language skills, but also assisted with comparing two different assessment methods for selecting AAC systems.

The purpose of the research was to improve expressive communication ability of the students with communication problems. Prior to the implementation of the programme, student's expressive skills were tested, outcome from the test showed that, students did not show or demonstrated any form of expressive language skills. Base on this finding, the researcher implemented an AAC system with the students, using three different AAC systems (a communication board, communication book and wrist band), although the school has an existing AAC programme with the students, which is, they use the communication board with all the students in respective of their disabilities or age. Low performances of the students with the use of the communication board, pre- empted the researcher to carry out the research study. The students interacted differently with each of the systems, student A, showed high ability with the use of the communication book while student B showed low performance with the communication book. student B showed high performance with the wrist band while student A, showed low performances with the wrist band. Students also learned the highest number of vocabulary during the course of the programme. During the course of the programme students were also observed to score high marks in classroom activity and individual seat work. Student's participation during classroom activities was also seen to have increase from the post test. Requesting for different items and needs also gain significant increase from the digramme or graph. Students ability to answer questions, and initiate a conversation, also showed an upward increase from the diagramme.

The research also compared two different methods of recommending AAC systems to the students, prior to the implementation of the programme, students were using the schools method of recommending AAC system. The researcher compared two of the methods, the latter (which requires using variety of AAC systems with each of the student) provided a better come than the former (recommendation is made base on teacher's prior knowledge of the system). Recommendation from the research result suggested that student A, should be provided with a communication book, while student B, should be provided with a wrist band in their classrooms.

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