This month, guest author Renee Bourke shares her perspective of how CVES can be used as a language teaching tool with the Early Intervention Population.
I think one of the most underutilized interventions in early intervention is Augmentative and Alternative Communication (AAC). And, I get it. The pressure is to make these littles talk; that is the family goal- Abby will use words to tell us her wants and needs. Parents want you there to make their child actually say words. I find this pressure leads clinicians to ‘forget’ the two most important things that are fundamental to what we do 1. You can’t talk about what you don’t understand or understanding comes before expression and 2. Communication is our ultimate goal; not speech. Don’t get me wrong, I see each one of my kids with the hopes that they leave me talking or at least saying a few words; but, and more importantly, my goal is that they leave me empowered with the ability to understand language and communicate.
This leads me back to my original statement: AAC is too often underutilized in early intervention. With the exception of using a few signs; it is rare that low tech picture communication systems are used in early intervention. However, the research tells us that using AAC will support our goal … and it is not just for kids who are not talking. I have used the Core Vocabulary Exchange System (CVES) to support comprehension and to increase the utterance length of early intervention aged kids.
So here is why I think you should use AAC with your early intervention clients and how I have used CVES with my youngest clients:
Provides a visual to support understanding:
Research in learning tells us that visuals help us to learn and remember information. For a child who is struggling to process auditory information, pictures provide a support to aide in understanding by requiring the person giving the direction to use fewer words, increasing the child’s chances of processing the information and being successful. A pictures also provides information about a word a child may not understand or missed. CVES makes it easy to use visuals with my clients because it has the core words need to provide meaning to utterances.
Keeps language simple:
Using pictures can help remind us to keep our language simple and clean. It is easy to forget that a child who is using little or no language may also be understanding little or no language. By keeping our language simple; for example instead of ‘ Hey Sally do you want a chocolate chip cookie?’ we use pictures to just say ‘want cookie’ we provide a situation where the child is more likely to understand and process what was said. Simultaneously, we are modeling language closer to the child’s developmental level; giving them the model of how to use that language appropriately (in this example the model would be requesting a cookie in the future using want cookie); and providing a model for how to create that sentence by the child watching you pull the icons of the board and sequence them on the communication card.
Slows rate of speech:
I’m a fast talker. It’s my nature. Even though I know I need to slow down when I’m working with a client, it’s tough. Using pictures as I talk slows my rate down. When using CVES I go to the board and remove each icon I am targeting and place it on the communication strip as I say it. This slower rate of speech supports increased language understanding because it reduces the number of units that need to be processed per time unit. A slower rate of speech has also been shown to support language production.
Provides a visual for making utterances longer:
I have used CVES to help the littles on my caseload who just can’t seem to get past single word utterances. Putting the icons of the targeted utterances on the communication strip and pointing to each one as you say it, provides a concrete model to the child that each word is a different and independent piece of information. When it is the child’s turn, the icons are a visual prompt for the target utterance.
AAC has many benefits in early intervention and these are just some examples of the benefits that using CVES has brought to my sessions with this population. The takeaway here is that as a discipline we need to remember to incorporate what we know works and we know AAC supports language both receptively and expressively even in our youngest clients.