M ULTIMODALITY L ESSON P LANS
FOR F UNCTIONALLY N ONVERBAL
C HILDREN
Colleen F. Visconti, Ph.D., CCC-SLP
Christie A. Needham, M.A., CCC-SLP
Baldwin-Wallace College, Berea, Ohio
ASHA Convention - New Orleans, Louisiana
November 21, 2009
Session Number/Code: 2157
A BSTRACT

This presentation will provide participants with example
lesson plans that utilize a multimodality approach to
communication for functionally nonverbal children.
These activities have been effectively utilized in an
intensive group intervention program, with over 50
children ages 3 to 15 years old, diagnosed with disorders
including autism spectrum disorders, seizure disorders,
cognitive disability, cerebral palsy, cortical vision
impairment, and many others. Literacy activities, games,
crafts, and songs for a variety of themes will be
discussed.
L EARNER O UTCOMES
Identify the two ways to adapt literacy
activities for functionally nonverbal
children.
Define what is meant by functionally
nonverbal.
Identify at least three multimodality
activities for use with functionally
nonverbal children.
F ORMATS


FOR I NTERVENTION
Summer Camp Program

2 hours per day, 3 days per week for 4 weeks

2 hours per day, 2 days per week for 6 weeks
Weekend Program (Academic Year)

2 hours per day, 1 day per week for 12 weeks
(Fall 2008 & Spring 2009)

2.5 hours per day for 1 day per week for 10
weeks (Fall 2009)
PARTICIPANTS

Summer Camp Programs (2007-2009)

31* children (2 groups of 5-6 children)

2-4 undergraduate student clinicians and 1 clinical
supervisor
 Weekend Program (Fall 2008; Spring 2009)

22* children (2 groups of 6 children)

3 undergraduate student clinicians and 1 clinical
supervisor
* 20 child participated in more than one program
PARTICIPANTS
 Ages 3 years 5 months to 17 years
10 months
(mean age = 7 years 7 months)
 34 males and 19 females
 Children were selected for the camp on a first-
come, first-serve basis
 Requirements were that the children were
functionally nonverbal at the beginning of the
camp
PARTICIPANTS D IAGNOSES
Primary Diagnoses
- Language Disorder
- Speech Delay
- Autism *
- Rett Syndrome *
- PDD-NOS *
- Cognitive disability
- Cerebral palsy
- Angelman’s syndrome
- Ring Chromosome 13
- Seizure Disorder
- Corticalvision impairment
- Periventricular leukomalacia (PVL)
- Brian Migration Defect
Other Diagnoses
- Blind - 2
- Visually impaired – 2
- Wheelchair – 5
- Limited ambulation - 2
* 50% of the participants
were diagnosed with ASD
P RE -C AMP E VALUATION
 Individual evaluations
 1-2 hours in length
 Student Clinicians and Clinical Supervisor
attempted to elicit a variety of communicative
behaviors
 Clinical Supervisor interviewed the
parent(s)/caregiver(s) regarding the child’s
communication skills using the Functions of
Communication
G ENERAL E VALUATION P ROCEDURES
 Non-standardized,
play-based assessment of
communicative functions based on the
following:

Communicative Attempts

Communication Success

Communication Partner(s)

Communicative Mode
M ODES OF C OMMUNICATION U TILIZED

Verbal productions

Verbal production plus sign or gesture

High Tech AAC devices

Low Tech AAC (i.e., PECS, Communication Bracelets
etc.)

Signs or gestures

Nonverbal communication

Vocalizations
F UNCTIONS
OF
C OMMUNICATION

Gain Attention

Answers Where and Who Questions

Greetings

Asks Where and Who Questions

Social Answers

Answers Why and When Questions

Social Questions

Asks Why and When Questions

Closure

More

Initiates Turn-Taking (Nonverbal)

No

Follows Turn-Taking (Nonverbal)

Yes/No Differentiation

Initiates Turn-Taking (Verbal)

Answers What Questions

Follows Turn-Taking (Verbal)

Asks What Questions

Manners

Comments
D AILY A CTIVITIES
• 10-15 minutes -Arrival Time
• 15-20 minutes – Circle Time
• 60 minutes – Play and individual work time;
literacy activities
• 15-20 minutes - Games
• 15 minutes - Closing Circle
I NTERVENTION S TRATEGIES

Used variety of strategies including

Small/large group

Individual therapy

Peer modeling
Trained undergraduate clinicians to be
“highly responsive” to all types of
communication
Silence!!!!!! Waiting for communication to
happen, even in its most basic of forms.
I NTERVENTION S TRATEGIES (C ONTINUED )



Behavior Modification and Planning

“Super Nanny”

Individualized based on needs and abilities
Consistency

Clinicians

Routine

Parents
Repetition of activities
PARENT I NVOLVEMENT

Daily Logs sent home

Take home activities

Literacy Activities

Adapted children’s books

Trained parents on how to use the take
home activities

Parents established social network for
support
S TUDENT C LINICIANS

Undergraduate Students

Had completed at least 1-2 semesters of Clinical
Practice

Specific training prior to this clinical experience

Responsiveness to communication

AAC training by SLPs at the Cleveland Clinic Children’s
Hospital – Shaker Campus – Shaker Heights, Ohio

AAC programming for intervention activities
R ESULTS : G ENERAL
 This program has lead to significant improvements in
the communication abilities of functionally nonverbal
children.
 Specifically, significant increases in the following:

Number of communicative attempts

Use of more sophisticated modes of communication

Attempting communication with both familiar and
unfamiliar partners

Greater communicative success of the participants
I NTERVENTION T HEMES

4 themes used per 12 week intervention
program

To-date over 20 themes have been used

Each theme contains:

Literacy activity

Crafts

Games

Songs
S TARRY S AFARI

Summary: Follow a boy through his dream
of a safari

Activities

Chosen based on animals and different events
in the book
S TARRY S AFARI

Large Group Activities

Jeep craft

Animal Rattles

Building a tent

Flashlight Safari

Making playdoh

Animal parachute
S TARRY S AFARI

Small Group and Individual Activities

Hide and seek animals

Animal matching

Pin the tail on the lion

Alligator seesaw

Decorating picture frames
F UN D OG S UN D OG
 Summary:
Follow a boy and his dog
through a day of fun
 Activities
 Verb activities chosen because of action
words throughout book
 Other activities chosen based on different
events in the book (i.e., going on a walk)
F UN D OG S UN D OG

Large Group Activities

Dog puppet

Verb charades

Shell wind chime

Twister verb game
F UN D OG S UN D OG

Small Group and Individual Activities

Earth book

Bubble fireworks

Simon Says

Beach matching

Sunglasses craft

Dog bath time

Beach dress up
W HAT W ILL FAT C AT S IT O N ?

Summary: Follows Fat Cat as he sits on
various animals and objects

Activities

Chosen based on events in the story
W HAT W ILL FAT C AT S IT O N ?
Large Group Activities
Fat cat masks
Animal paper bag puppets
“Sit on” activity
Don’t let fat cat sit on you
I spy
Fat Cat face
P UMPKIN C IRCLE
 Summary:
A non-fiction book focusing
on planting, growing, and harvesting
pumpkins
 Activities

Chosen based on pumpkin/fall theme of
book

Focus on descriptive words
P UMPKIN C IRCLE

Large Group Activities

Pumpkin guts

Carving pumpkin

Nature walk
P UMPKIN C IRCLE

Small Group and Individual Activities

Fall matching game

Decorating gourds

Bird feeders

Planting seeds

Painting small pumpkins

Foam pumpkin faces

Making playdoh
I WANNA I GUANA
 Summary:
A series of letters between mother
and son about him wanting an iguana
 Activities

Majority chosen based on letter format of the
book

Others chosen based on reptile theme of book
I WANNA I GUANA

Large Group Activities

Mailboxes

Writing letters to each other

Sponge painting iguanas
I WANNA I GUANA

Small Group and Individual Activities

Reading parent letters

Writing letters to parents

Playing mail man

Journaling

Go Fish

Matching reptiles
A CKNOWLEDGEMENTS :

AAC devices loaned by:
 Prentke Romich Company
 Assistive Technologies
 Saltillo
 Words+
 DynaVox Techologies

AAC Training was provided by
SLPs at the Cleveland Clinic
Children’s Hospital – Shaker
Branch
 Glenna Greenwald
 Jackie Wolslager
 Lisa Leonard
A CKNOWLEDGEMENTS :
 Thank you to the Student Clinicians

Alyssa Austin

Chelsea Lengal

Erin Boeshart

Emily Lowe

Gina Campellone

Emily Pifer

Meridith Caraway

Chisomo Selemani

Katie Crow

Crysten Skebo

Holly Emmons

Amanda Smith

Taylor Evans

Meridith Teagarden

Morgan Foit

Cassandra Turic

Kalli Kontoveros

Julianne Wolf

Amy Lagzdins
R EFERENCES
Ashman, L. (2005). Starry safari. New York: Scholastic.
Heiligman, D. (2005). Fun dog, sun dog. New York:
Scholastic.
Levenson, G. (2004). Pumpkin circle: The story of a garden.
New York: Tricycle Press.
Orloff, K. K. (2004). I wanna iguana. New York: Scholastic.
Thomas, J. (2007). What will fat cat sit on. New York:
Scholastic.
C ONTACT U S


AT
Colleen F. Visconti, Ph.D., CCC-SLP

[email protected]

440-826-5909
Christie A. Needham, M.A., CCC-SLP

[email protected]

440-826-2149
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