The Joseph Robert Shaw Foundation

Helping Children Recover from Brain Injury

When Presuming Competence Gets Hard

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There are times when presuming competence is easy. Joey has a light in his eyes, and he’s clearly trying to tell me something. He giggles and laughs, and persists in finding the right answer. We’re connected, and I know he’s trying to find the right word.

Other times, it’s not that easy. He knows his numbers and letters. I know he knows them. I have data that reflects this. So what’s up today – why is he selecting every number but the one I’m asking him? 

Has he regressed? Is he having trouble lining up his eyes with his device? Is he bored? Is he rebelling? Did he hear my question? Did I just imagine that he knew his numbers and letters last spring? There are times it is easy for that last question to slip into our thoughts when we are working with students like Joey. For some reason, the worst thing that we can imagine as special education teachers is that we give a student credit for doing something they cannot do. And so, in the world of self-protection to our own egos, we are more likely to assume a student can’t do something than can do something.

I have a decision to make. Do I assume Joey academically knows the information, but has trouble selecting the button? Do I assume Joey has forgotten what he knew, and I need to re-teach? The decision feels heavy because the wrong decision could mean frustrating Joey – either for moving too fast or too slow. Frustration decreases engagement, and once we lose engagement we lose our opportunity to interact. 

In these moments I find myself watching Joey intently, looking for cues one way or the other. Does his brow furrow because he’s frustrated that he’s not selecting the right icon, but he’s determined to so he continues to try? Or is he wildly guessing, not looking committed to the task? Is his mouth making the initial sound for the word? Is he leaning forward, trying to find the answer? Or leaning back, avoiding my eye contact?

I won’t find the answers inside my own self-doubt or worries, but within him. And again, I come back to the common question, which assumption leads to the least amount of damage to Joey?

I decided to presume competence with the high frequency words I’ve been showing Joey, and assume he’s having trouble finding them on his device but not reading the words themselves. I pulled out a simple Developmental Reading Assessment Level 1 book that I use with typically developing kindergarteners in the beginning of the year. It has repeated sentences on each page, and for most kids relies on memorization, an understanding of how words are made up on the page, and that we can check the picture and first letter to decode a word. Typically, this should be a fairly easy book. Presuming that Joey was on a beginning of kindergarten reading level, I moved ahead. 

Holding my breath I brought out the book. He grinned. He knew what it was. I’d brought similar looking books to his brother when his brother was in kindergarten. He leaned in, looking ready. He quickly found the word “see” when I pointed to it and asked him to read the word – even though I didn’t know that was a word he already knew. He learned where to find the button “I can” and was able to make the sentence “I can see” repeatedly, though painstakingly. As I turned each page he was excited to tell me what the last word on the page was, and if he didn’t have that word on his device, he looked around his room to show me where I could find a matching item. If I asked him what a word on the page started with, he was quick to tell me.

This task exhausted him, and before long we were done. He couldn’t sustain the energy needed to carefully read each and every word on the page. But I learned that he is able to read a book with a repeated sentence, and is able to use the picture to make meaning in the book – just as we would expect all beginning kindergarteners to do. 

By the end we were both exhausted. I found myself wondering about his ability, and then reminded myself that fatigue doesn’t mean he can’t do it. It just means it’s harder to accomplish because we’ll have to take slower steps, present material differently, change how he responds. But he can. 

Initiating vs Responding in Communication

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When we talk about reciprocal communication, we think about having a conversation when one person speaks, someone replies, then the initial speaker follows up. Harvard’s Center for the Developing Child refers to this as “Serve and Return”, and Dr. Stanley Greenspan coined the term “circles of communication”. These reciprocal interactions occur outside of verbal communication and start as early as infants cooing at their mothers, or reaching their arm out to touch their mother’s nose.

Although I’ve been focused on increasing Joey’s reciprocal communication, I haven’t tracked his specific participation in these “circles”. I have taken data on the purpose behind his communication, such as was he making a demand, responding to a question, making an observation, or exploring the vocabulary on his device. Although this gave me an interesting insight into Joey’s communication patterns, it did not specifically look at whether or not he was initiating the interactions, simply responding to a question, or stating a word or phrase that was not intended to be responded to by a conversation partner. After I realized that his communication had changed to being mostly responses in August as we prepared for school, I began to realize that I needed to also monitor how Joey participates with his conversation partners if I want to create meaningful change.

Joey’s initiations into communication are important because they show us his sense of agency. All children, but particularly children like Joey who have constraints around their independent motor movement, need to understand that they can interact with their environment – they do not simply need to wait for something to happen to them. This sense of agency is where children begin to develop their ideation – when they form their own ideas, opinions, and thoughts. Through identifying what they want and how to get it, they independently create multi-step plans, which supports the development of their executive functioning skills. This sense of agency is critical to development.

Although Joey does a wonderful job responding to my communication initiations, I want to see him initiating more. I want Joey to share his opinions, make plans, and purposefully tell silly jokes without being prompted. In short, I want Joey to be in charge of his communication. 

In my first day of tracking, Joey’s patterns varied in both ten minute time samplings. For our first activity, Joey responded to nine of my requests, and initiated ten times. Six of his words came from exploring his device, when he was not intending to interact with me. During the second ten minute segment, Joey responded to me 11 times, but never initiated conversation. By this time he was getting tired, and seemed ready to explore words rather than discuss our activity. Seeing that Joey went ten straight minutes without initiating an interaction with me tells me that I need to increase my wait time, or build more activities where Joey feels inspired to initiate and make observations. 

Listening Closely to Presume Competence

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I plopped down beside Joey one afternoon, and asked him how his day had been. He quickly began chatting away, “More, stop, vehicle,” he said. 

“Really?” I asked, “Tell me more.”

“Caterpillar. Eagle. Awesome. Whale.”

“Cool,” I replied. “So what book do you want to read?” 

“Don’t, itchy, hole, hump, brush, antenna” he said.

“Let’s stay on topic” I replied cheerily, as I do sometimes when he doesn’t answer my direct question. “We can read the book about the bugs, or the book about the stick. You can tell me which one you want using those words.”

Joey looked at me with frustration and maybe a little disgust. He stared hard at one of the boxes on the floor that contained our book. Finally, he added “Paintbrush”.

Oh. Of course. We have been reading Not a Stick. He was trying to get as close as he could to telling me what he wanted to read. Don’t is on the same page as not, and the picture icons that represent the words are not obviously different. He eventually found brush when he couldn’t remember what paintbrush was. The other words were all ones he either hit accidentally, hit because he couldn’t remember what word the picture represented, or couldn’t remember exactly where the vocabulary for the book was on the device. These mis-hits create a string of random words, which can easily get lost in what looks like “playing around” behavior.

It can be hard to know if Joey is simply selecting words on the device, or if he is really trying to tell me something. Sometimes, he really is just choosing random words. And other times, he’s actively seeking for his vocabulary and trying to make his ideas known, as much as he can.

Sometimes, I never do figure out what he’s talking about. And maybe at those times he really is just saying random words. But more often than not, someone will later tell me, “Oh, we saw a caterpillar on our walk today,” or, “There was a picture of a whale on the TV behind you”, and I realize that what I assumed was random was actually attempts at communication.

Sometimes, presuming competence can feel awkward. Yet, if we don’t, we discourage a person’s communication attempts. If no one listens to you, will you keep trying to talk? Will you believe that you have something important to say? 

As I pulled the book, Not a Stick out of its box, Joey grinned. “Awesome” he said. I thanked Joey for sticking with me enough to get his message across. “Sometimes I might not understand you the first time. Thanks for helping me get there.” “Read” he replied.

 OK, enough small talk. We’ll read.

Learning Prepositions

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I was gathering my things to leave Joey’s house, when I heard Joey say “under” from the eye gaze device. He’d been playing with a toy bee on his tray and he’d lost it. As I chatted with his mom, he said “bee, grasshopper, fly” and pointed in the direction of the floor. But I was busy with my conversation, and didn’t really notice what was going on. And so, he reached deeper into his repertoire. UNDER. He told me where I could find the item. Independently. Without prompting.

Like so many times with Joey, one small word is so meaningful. 

Usually, when Joey drops items, he points to them. I use the strategy of “playful obstruction”, (also known as playing dumb), and I pretend to be confused about what he wants. This means he has to use his device to tell me specifically what he wants – the toy car, dragon, or bug – whatever he’s been playing with. Sometimes, we work on using the whole sentence “I want….” or “Please give me….” Other times, I pretend I can’t find the item he’s asked for.

“But where is it?” I’ll scratch my head, and pretend to look on top of the cabinet. “Where is that car you want?” I prompt Joey to his preposition page, and he selects a word that indicates it’s on the floor. No matter what he says, I’ll look there. Last winter this meant crawling behind his wheelchair and then telling him it wasn’t behind him, and asking him to try again. Eventually we always find it. (I do all of this while reading his frustration level. We play these games when I know he can hang in there with me on using this vocabulary. I don’t do it to the point of crying or frustration – hence the “playful” part of “playful obstruction”.)

Despite this practice, Joey rarely uses prepositions unless I prompt him to. He’ll label where things are in a book or his room, but it’s almost always after I gesture to the preposition bridge icon on his device. So to hear him independently tell me “bee under” made my heart soar.

Prepositions are tricky, because they are not as meaningful to young children as tangible nouns or physical verbs are. And yet, I once read an article on an AAC facebook group about how someone is far more likely to be able to communicate what they need if they can use prepositions. Even if a child does not have the noun he/she wants on the device, the child can use prepositions to direct the adult in the room to find the item. Prepositions are important when we communicate with each other. 

Joey’s “bee under” as I was leaving was a sign to me that he understands prepositions, and understands how to use them to communicate about where things are in space. As I’ve crawled around on his floor, playing dumb until he tells me where to find his lost toy, this moment is what I’ve been waiting for. 

Supporting All Types of Communication: Chatting vs Responding

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As we prepared Joey for school, I noticed a dip in his AAC output data. There were many reasons for this, and a main one was that Joey is becoming stronger at navigating his device. Although he still may select the wrong icon, he is able to navigate himself back to the right page faster. He selects fewer wrong pictures, which leads to a decrease in total output, but an increase in meaningful output.

Yet as I look over our back and forth communication over the last month, I suspect there is another reason the output decreased. Early on in August, we introduced a social story to Joey about being quiet in school – and how sometimes he will need to be quiet, and sometimes he will be able to talk. Read alouds were a time when he would need to be quiet, and share his thoughts and ideas when a teacher asked him to. 

His decrease in verbal output occurred around the same time that we introduced this book, and I realized that Joey pretty quickly applied the lessons of that social story into our daily work. The purpose behind his communication with me transitioned from frequently talking, sharing what he noticed, his thoughts, or his off-topic responses, to being completely on-topic, and only responding to my direct questions. The majority of the purposes behind his communication now come from responding to a question, making a demand, or selecting the wrong icon. Before, most of his purposes were from making observations and sharing them with us.

There are positive and negatives to this change. It shows pretty significant growth that Joey was able to respond quickly to a social story, and that he shows the executive functioning control to stay on topic, and answer questions when asked. These are important skills, especially for a school setting. 

The negative drawback is in my court as a teacher. Am I giving him enough spontaneous time to just talk? If he is leaning towards only responding to my questions, am I varying my questions enough so that they are open-ended and are encouraging higher level thinking? Am I giving Joey time to share his thoughts and feelings about his day, and am I communicating that I want to hear his thoughts? It would be detrimental to his communication development if I sent the message that he should only talk when prompted. 

On Friday, after we finished up a book, I asked Joey which book he wanted to read next. “Talk” he said. So we did. And in the ten minute data window, Joey made 62 hits on his AAC device – all of which were independent, and done without my prompting. His average output in a ten minute session is usually around 23 hits. We chatted about making words plural, and made silly words by adding lots of plurals to a word. He asked me how many pterodactyl would be if we had “pterodactyleseseseses” and I tried to explain how grammar works. We talked about giants, monsters, and lobsters, trucks and helicopters. Sometimes it was unclear to me what our topic was, but I tried to presume competence and kept responding to his shared thoughts and ideas. As our talking time went along, his verbal output increased as well. Although I couldn’t determine everything he was saying, he had a lot to share both verbally and on his device, and kept checking in with me through his eye gaze to let me know this was all part of the story.

It was a wonderful reminder for me that Joey needs a balance of direct, top-down instruction, as well as just open time to talk, explore, and to go off on tangents. 

Saturday Serenade

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