Purpose:
This clinical focus article presents a review of literature supporting the importance of fostering positive peer interactions for students with complex communication needs (CCN). A resulting template is included to help guide educational teams, including speech-language pathologists (SLPs), in planning for paraeducator training specific to supporting peer interactions for children with CCN. This clinical focus article summarizes the current literature available on inclusion and peer relationships for students with CCN in general education classrooms and paraeducator roles and training. The World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth framework was consulted to help establish considerations relevant to paraeducator training. With many demands on the time of SLPs throughout the school day, paraeducators may offer an often untapped resource to help support positive peer relationships for students with CCN.
Conclusions:
This clinical focus article provides an overview of challenges that may impede positive peer relationships from developing in inclusive classroom settings, including ones related to (a) the student with CCN, (b) the peers, (c) the augmentative and alternative communication systems, or (d) the environment. The readers will be provided with a template to guide educational teams and SLPs in collaborating with paraeducators to foster positive peer interactions, including the following steps: (1) define goals for the student with CCN and determine supports required from paraeducators, (2) determine content of training for paraeducators, (3) choose an effective instructional approach, (4) establish a feasible training format, and (5) implement the paraeducator training and evaluate outcomes to ensure benefits for students with CCN and their peers.
Purpose
Individuals with cortical visual impairment (CVI) can have difficulties with visual processing due to physical damage or atypical structures of visual pathways or visual processing centers in the brain. Many individuals with CVI have concomitant disabilities, including significant communication support needs; these individuals can benefit from augmentative and alternative communication (AAC). Because much AAC involves a visual channel, implementation of AAC must consider the unique visual processing skills and challenges in CVI. However, little is known empirically about how to best design AAC for individuals with CVI. This study examined processing of visual stimuli in four young adolescents with CVI.
Method
This study used a within-subjects experimental design that sought to provide an in-depth description of the visual engagement of individuals with CVI when viewing stimuli of various levels of complexity, either with or without a social cue.
Results
Participants engaged most with the simplest stimuli (relative to the size of those stimuli) and engaged more when a social cue was provided during the task. The level of engagement with more complex stimuli was related to participants' score on the CVI Range, a clinical assessment tool that characterizes level of visual functioning.
Conclusions
Implications for AAC include considerations for the internal complexity of AAC symbols and the complexity of the arrays created for individuals with CVI. Clinicians working with children with CVI who use AAC should consider the unique features of their visual processing.
Purpose:
This tutorial aims to introduce school-based speech-language pathologists (SLPs) to developmental systems theory as a framework for considering interactions across functional domains, such as language, vision, and motor, for students with complex needs.
Method:
This tutorial summarizes the current literature on developmental systems theory in its application to working with students who have needs in multiple domains of functioning in addition to communication. A hypothetical case of a student, James, with cerebral palsy, cortical visual impairment, and complex communication needs, is presented to illustrate the primary tenets of the theory.
Results:
Specific reason-based recommendations are presented that SLPs can put to practice with their own caseload in direct response to the three tenets of developmental systems theory.
Conclusions:
A developmental systems approach will be useful in expanding SLP knowledge of where to begin and how to best serve children with language, motor, vision, and other concomitant needs. The tenets, including sampling, context dependency, and interdependency, and the application of developmental systems theory can be instrumental in providing a way forward for SLPs struggling with the assessment and intervention of students with complex needs.
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