Lana: On a Better Road to Communication

Like most children her age, Lana Carle likes to play outside. She feels comfortable acting silly and jumping around with the neighborhood kids. During their running games, she can hold her own.

And Lana, 9, absolutely treasures playing memory matching games with her younger brother Bret, 4, or a favorite video dance game with Casey, 7, a girl who lives on their street. One-on-one time with Bret and Casey is a nice change from group situations where everyone has a lot to say and must strive to be heard. That’s a challenge for Lana because she is primarily non-verbal. Sometimes it’s easier to express herself through behaviors of frustration.    

Thanks to her desire to listen and learn, along with the great support she has at home and school, Lana is finding better ways to communicate. And with innovative augmentative and alternative communication (AAC) tools such as the Tobii Dynavox Core First app, Lana has the power to sharpen her language skills and shape her unique voice. The app, which she uses on a tablet device, is a catalyst for her newfound success.  

Lana’s family and friends are excited for her, perhaps none more so than Maria Carle, her mother and number-one advocate. Mrs. Carle recalled a time when communication with her daughter seemed tentative at best. Born with a rare chromosomal disorder (9p22 deletion) and diagnosed with autism at age five, Lana presented developmental delays in early childhood. This limits her ability to speak, but her visual learning abilities are strong. She has done well with sign language and, to a point, static communication boards or printouts with picture symbols. These, however, eventually proved more of a nuisance than a solid communication solution, Mrs. Carle said, as Lana often tore or lost them.

As Lana grew, so did her habit of speaking a word or two, then remaining silent. Others would try to figure out the rest of whatever Lana wanted to say while she filled in some of the blanks by signing. Lana reached a promising crossroads as a second grader at Haine Elementary School in the suburban Pittsburgh, PA community where she lives. At that time, Lana had been using a more limited AAC app on a tablet device. She relied heavily on prompting from others before choosing her words and many of her communication exchanges were touch and go. Then, during a speech therapy session, Lana tried the original Core First on Tobii Dynavox Compass software. Already, it has taken her far.  

With its vibrant symbols and color-coded arrangement of language content by parts of speech, Core First engaged Lana from the get-go. Her mother said there’s been a “night and day” difference in her interactions ever since. Lana now strings more words together at a time and more fully grasps language concepts such as the need to pair verbs with nouns to get messages across.

Core First is a “language-rich” software, said Kaitlyn Graham, M.A., CCC-SLP, Lana’s school speech-language pathologist. It gives Lana steady access to frequently used or “core” words even as the topic she wants to talk about changes. “Lana can get ‘more bang for her buck’ by learning those core words and generalizing them across activities.” She “learns and benefits from information presented in multiple modalities,” Ms. Graham said. “The software provides visual representations that facilitate comprehension. The auditory feedback provides Lana with a consistent model of the word(s), and she’ll often repeat the word(s) after hearing it on her talker.” 

The software supports Lana in achieving her IEP goal of following directions using language concepts. It is also helping her progress toward the goals of producing targeted speech sounds and every syllable in multisyllabic words, as well as increasing her mean length of utterance to three words

No matter where they are in their speech and language development, students moving toward similar goals can use Core First Books and Core First Lessons to supplement their efforts. While showing the books and lessons to Lana and some of her other students, Mrs. Graham saw a twofold benefit. The materials “help to break down a large and daunting task (teaching a child to use language) into manageable steps,” she said, and “are presented in a way that is easy for all team members to understand and implement.”

In a recent therapy session, Lana had the opportunity to try the new Tobii Dynavox Indi speech tablet featuring Snap + Core First. Through her own verbalizations, augmented by the newest version of the software, she demonstrated understanding of noun-verb relationships and full sentences when she said she had to “roll” a piece of red clay into a “ball” to make an apple. The software keeps communication flowing because core words such as HAVE, ON, IN, AND and THE are always handy. Words associated with a specific topic (the phrase “concession stand” if the topic were bowling, for example) are reachable with a few touches on the screen.

Implementation help for those supporting Snap + Core First users is available on the Pathways companion app, which can be downloaded free of charge. Sometimes referred to as a “therapy-in-a-box” solution, Pathways lets clinicians and parents access expert knowledge, step-by-step instructions, fun learning activities and other practical resources, all meant to be used while the augmented communicator is with them.

Pioneering technologies like Snap + Core First and Pathways set the foundation for a future of powerful interaction for individuals like Lana and their communication partners. Lana’s Core First experience puts her on that road. “From the beginning, she really took ownership of (Compass with Core First) as her voice,” Ms. Graham said. It also helps that Mrs. Carle insists on keeping two tablets for Lana at home: one for playing games or watching videos, the other for communication. Mrs. Carle makes printouts of the Core First content for when the communication tablet is not available so Lana’s words are always with her.     

Core First provides the “middle ground” that Lana and her peers need to enjoy their time together, Mrs. Carle said. Through the technology, Lana can share her feelings with Bret, Casey and the others. She can easily ask them to dance with her or tell them she is tired. One day while playing with friends, Lana picked up her and chose vocabulary in the software to let them know she felt left out.

Mrs. Carle believes there is a correlation between Lana’s love of memory games and how easily she absorbed the organization and depth of the Core First content. As a mom, she has not ruled out the possibility that natural speech will someday be Lana’s primary form of self-expression. As an informed parent, however, she also says she plans to heed the advice she has received at special-needs conferences and make sure Lana always has a go-to AAC solution like Core First to ensure her a clear voice for all to hear. 

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