Abstract
The incidence of disabilities that affect communication in children is on the rise. Disabilities that affect communication often cause other developmental challenges that hinder a child’s ability to develop literacy skills. This exploratory study examines the literacy skills of 179 children who received an interdisciplinary AAC evaluation. Study results describe OT’s role in providing literacy supports to professionals who work with children that use an AAC device.
Primary Author and Speaker: Christopher Trujillo
Additional Authors and Speakers: Carrie Westcott, Tauni Malmgren, Kelly Moritz
Contributing Authors: Brenda Del Monte, Melanie Conatser, Gina Norris
The number of children who have significant disabilities that impact communication is on the rise. It is estimated that 1 in 59 children are diagnosed with autism spectrum disorder, and many do not develop functional speech. The incidence of cerebral palsy has also increased due to improved survival rates, and the majority of these children experience language limitations. There are more than 130,000 children with multiple disabilities (MD) who receive special education services in the United States. Children with MD can experience developmental challenges that hinder their ability to develop literacy skills. This exploratory study seeks to identify how the complex needs of children with MD can impact literacy learning and what occupational therapists (OTs) can do to address these needs.
Children with complex needs may have difficulties with literacy learning when their disability impacts their occupation of communication management. The skills needed for communication include recognition of letters, sounds, and rules for language, initiating interactions, understanding words and contexts, the ability to maintain visual attention, and other performance skills. The four areas of literacy are reading, writing, speaking and listening. All of these literacy areas are important performance skills that enable children to engage in meaningful occupations. Considering that children need literacy skills for social participation, play, and school activities, deficits in these areas can lead to decreased occupational participation in the home, classroom, and community environments.
179 AAC evaluations for children and adolescents was conducted and several demographic variables and literacy skills were quantified. This post-hoc analysis of evaluation data examines the evaluation results. The results show that 13.4% of children had literacy within functional limits, 1.7% knew letters and sounds, 12.8% knew letters, sounds, and sight words, 17.3% knew sight words, and 54.7% had no functional literacy. These results also indicate a need for literacy to be addressed for children with who use an AAC device or have MD. OTs have the unique opportunity to address literacy skills in children with MD, during their interdisciplinary AAC evaluation, or when they are receiving literacy-learning supports.
When teaching literacy and language to children who utilize an AAC device, OTs do not consider diagnosis alone but take into account a child’s sensory processing, occupational performance skills, and functional deficits. OTs can teach parents and teachers to implement adaptations that successfully compensate for a child’s sensory and functional deficits when teaching literacy skills. OTs may collaborate with speech language pathologists, teachers, parents, and other team members to encourage each child’s participation and inclusion in their environment. OTs are capable of teaching caregivers how self-determined exploration of a child’s environment facilitates learning. A reflective practitioner can consider the implications of literacy during AAC evaluations in order to better support children with complex needs.
Andzik, N., R., Schaefer, J. M., Nichols R. T., & Chung Y. C. (2018) National survey describing and quantifying students with communication needs, Developmental Neurorehabilitation, 21:1, 40-47, DOI: 10.1080/17518423.2017.1339133
Centers for Disease Control and Prevention (2018). Community report on autism 2018. Retrieved April 25, 2018, from https://www.cdc.gov/ncbddd/autism/addm-community-report/documents/addm-community-report-2018-h.pdf
Clark, G. (2016). The occupations of literacy: occupational therapy’s role. Journal of Occupational Therapy, Schools & Early Intervention, 9(1):27-37. doi: 10.1080/19411243.2016.1152835
Hustad, K.C., Miles L.K. (2010). Alignment between augmentative and alternative communication needs and school-based speech-language services provided to young children with cerebral palsy. Early Childhood Services. 4(3) 129–140