Vocabulary Selection Frameworks and Implementation in AAC

Three Frameworks for Vocabulary Selection and Decision Making

• When conducting an assessment process, clinicians must make decisions and recommendations regarding the vocabulary available to a client.
• Vocabulary selection is governed by three primary frameworks:     * Functional Framework     * Developmental Framework     * Cognitive Framework
• Framework application is client-specific, meaning the clinician might prioritize these frameworks differently depending on the individual.
• Vocabulary selection can also be situational specific, meaning the choice of words might change based on the specific situation the client is facing.

Functional and Environmental Frameworks

• Functional/Environmental Approach: This approach emphasizes essential vocabulary or messages that an individual needs within specific situations to meet specific needs.
• Situation-Dependent Examples:     * Pain Management: Selecting specific words for a client to communicate their pain level or location.     * School Needs: Providing functional choices so a child can communicate when they need a break or need to go to the bathroom during the school day.
• Environmental Approach: This is a subset of the functional framework where vocabulary is chosen based on a specific location or environment.     * Home vs. Grandma's House: A child might need different vocabulary choices at home compared to their grandmother's house.     * School: Specific vocabulary tailored for the academic environment.     * Speech Therapy: Creating a "speech therapy page" on a device because there are specific toys and activities unique to that environment.
• Routine Analysis: Clinicians can analyze daily routines within specific environments to identify frequent communication needs, which then guides decision-making.
• Lexicon: Defined as a vocabulary or a set of words.

Developmental Framework and Language Learning

• This framework considers the child's or adult's current developmental stage in terms of language.
• Adult Populations:     * Post-Event Recovery: If an adult had a robust verbal language system before an event (like a stroke or accident), the clinician must judge if they can access previous knowledge.     * Spontaneous Recovery: If quick recovery is expected, the device should have many words available to match the rapid skills they regain daily.     * Established Disorders: For an adult who has lived with a disorder their whole life (e.g., a $26$-year-old with autism), language skills are often established. In these cases, there may not be a huge learning curve or rapid development, and clinical judgment should reflect this stable plateau.
• Pediatric Populations:     * For a child who never established language, the approach is entirely different from an adult with acquired loss.     * Forward-Thinking: Vocabulary should not be limited to what the child can communicate "now." It must support growing linguistic abilities and anticipate what is coming next in their development.
• SLP Expertise: Clinicians are language development experts (trained in birth-to-five and school-age language disorders) and must use that expertise to plan for the client's next developmental steps.

Cognitive Framework and Conceptual Development

• This framework recognizes the impact of language on cognitive and conceptual development.
• Cognitive Activity Expression: Individuals need vocabulary to express complex processes such as comparing, describing, evaluating, measuring, and categorizing.
• Essential Non-Object Words: It is a mistake to exclude abstract words like "same," "different," "longer," "wrong," "less," or words referring to thought processes and conclusions.
• Early Cognitive Concepts (Motivation-Based):     * Recurrence: The concept of wanting something "more" or "again." The word "more" is one of the earliest taught because it is powerful and generalizable across many activities.     * Existence: Understanding that something is present or when it is "gone." Typical games like hiding items under blankets help develop these concepts. Clinicians should include phrases like "Where did it go?", "There it is!", and "Uh-oh."     * The "Uh-oh" Example: If a child enjoys throwing items off a high chair, "uh-oh" becomes a functional, motivating first word for commenting on the activity.     * Containment: Children (especially ages $2$ to $3$) are motivated by putting things in and dumping them out. Functional words include "in," "out," "lid," "on," "off," and "down."     * Action/Go: "Go" is an early concept that can be used during highly motivating activities like spinning in a desk chair, riding in a wagon, or using a skateboard.

Activity Planning and Relational Vocabulary

• Observing Motivation: When planning activities, clinicians must determine what truly motivates the child.     * Hammer and Nail Scenario: If a child is hammering nails into a hole, the core motivation might not be the "hammer" or the "nail" (fringe nouns). If the child is interested in the action of putting things into the hole, the targeted vocabulary should be "in" and "out" rather than the objects themselves.
• Basic Concepts:     * Strengths in Autism: Many children on the spectrum love and are motivated by colors, letters, numbers, and shapes. These strengths should be tapped into during assessment.     * Social Words: "You," "me," "my turn," "your turn."     * Texture/Quantity/Time: Words like "soft," "hard," "crunchy," "more," "first," "next," "before," and "after."
• Relationship Vocabulary: Teaching words that describe how two or more things relate, such as "same/different" or "next."
• Educational Context: These concepts are pervasive in Pre-K through $1st$ grade.
• Thanksgiving Example: Instead of teaching topic-specific fringe words like "pilgrim" or "turkey," which have limited use outside of one week, clinicians should target:     * "First" (The first Thanksgiving)     * "After" (After turkey, we eat dessert)     * "Together" (Everyone comes together for dinner)
• By providing core, personal, and relational vocabulary, the potential for novel utterances becomes limitless, even at the two-word stage.

Types of Vocabulary: Core vs. Fringe

• Personal Vocabulary:     * Uniquely relevant to the individual.     * Includes the child’s name and specific photographs of family (e.g., a photo of their actual "Mommy" rather than a generic icon).     * Specific favorite toys and foods should use actual photographs to ensure they look like the items the child uses at home.
• Core Vocabulary:     * Definition: High-frequency words used by a variety of people across all environments and topics.     * Frequency: Comprises approximately $80\%$ of the words we use every day.     * Characteristics: Small set of flexible words (pronouns, verbs, WH-questions, articles, conjunctions) that can be generalized to generate diverse messages.     * Consistency: Should be displayed in a consistent, research-based location on the device.     * Limitation: A system with only core words cannot capture specific content words and may be non-functional by itself (e.g., saying "I want" without being able to specify the object).
• Fringe Vocabulary:     * Definition: Very specific words with narrow meanings that describe particular things.     * Frequency: Comprises approximately $20\%$ of daily word use; used with decreased frequency.     * Characteristics: Mostly nouns (or specific adjectives like colors/shapes). Easier to teach via simple images compared to core words (e.g., a picture of a "hammer" is easier to represent than the concept of "in").     * Limitation: Less flexible and cannot be generalized across activities.

Device Layout and App Features

• TD Snap App (Core First): A common AAC application.
• Grid Structure: Example shown was a $5 \times 6$ grid.
• Color-Coding System:     * Yellow: Pronouns.     * Green: Verbs.     * Orange: Function words (articles/conjunctions).     * Blue: WH-questions.
• Generalizability of Core Words: In the app, words like "want" or "like" can be used for eating, watching TV, playing games, or taking naps, but require fringe words to complete the message.
• Fringe Examples in Games: In a specific game like "Simon Says" or "Hide and Seek," words like "your turn" or "my turn" are necessary but may not be useful outside of that specific game context.

Questions & Discussion

• Question: Any questions on core versus fringe words?
• (No specific questions or responses from the audience were recorded in this segment of the transcript.)