MichaelAnn doesn't communicate with words.
Watch her eye gaze for what she wants to do or responses to questions.
Kicking her leg and/or legs usually means more or yes.  Could also mean she is very happy.

Use a "sing-song" tone of voice when talking with her.

You need to be very attentive and intuitive at reading MichaelAnn's body language and watching her eyes to see what she wants or needs and helping her with those needs.

  • MichaelAnn will communicate some things through blowing raspberries.
  1. When MichaelAnn gets up from a nap or in the morning she will blow raspberries to let you know she is up.
    • Let MichaelAnn know you hear her if it isn't time to get up tuck her back in.
  2. MichaelAnn will blow raspberries when she is content.  This is usually when she is playing with her beads and no one is in her space.
  3. MichaelAnn's raspberry blowing gets louder and more intense, she doesn't want you in her space or do what you are asking.
    • If it isn't important, let her know you hear her and you will let her be for awhile.
    • If it is something you need to do, explain to her that we need to get this done and then she can play again.

iPad & Communication Cards
  • MichaelAnn received an iPad 12/2011 and has been doing amazing using it to communicate.  It is being used more than the communication cards or switches.
  • MichaelAnn uses the iPad and communication cards for some activities to:
    1. Know what activity is coming up or what she will be doing.
    2. Make a choice of what to do.
    3. To answer yes & no questions.
  • New pictures can be added to the iPad and cards can be made at any time.  Let Sherry know if there is a picture or card you would like to include.

Using the iPad or Communication Cards
  • Before an activity, show MichaelAnn the picture (either on the iPad or communication card) of the activity and tell her the activity she will be doing.
  • Show her the picture at eye level.
    • I.E. "MichaelAnn you will be brushing your teeth soon" (while showing her the picture for tooth brushing).
  • Let her look at the picture until she turns away.
  • This gives her time to process the activity before doing it.
  • Show her the picture again when it is time to do activity.
  • To make a choice, show MichaelAnn tow different pictures and ask her "Do you want to ____ or ____?" while holding the cards up and separated or the iPad with the 2 choices on it.
  • She will use eye gaze to make a choice for the communication cards or will touch her choice on the iPad.
    • If she doesn't touch the iPad and just looks at a picture, go with that but first encourage her to try and touch the picture.
  • Show her the picture she chose and say "ok, you chose ____, so let's go ____."
  • If she doesn't make a choice, change one of the pictures and see if she makes a choice.
  • If still no choice, chose an activity for her and show her the picture and say "We are going to ____."

Everyday activities that are routine and done at same time each day (e.g. hair brushing, tooth brushing) may not need communication cards/pictures because it has become such a habit that it seems MichaelAnn knows what is coming next.  If she screams at the beginning of an activity she probably didn't know what was going to happen and a communication card/picture may be needed.

Asking MichaelAnn Yes & No questions using eye gaze.
  • MichaelAnn looks at you when you ask her a yes/no question this means YES.
  • MichaelAnn ignores you or even turns away, this means NO.

Asking Yes & No questions using the iPad for school assignments.
  • MichaelAnn is asked a multiple choice question with 3 possible answers.
  • The question is usually up on the smart board so MichaelAnn can look at and read the question & answer.
  • Select the first answer from left to right and ask MichaelAnn if it is correct, hold up the iPad with the Yes/No icons on it.
  • MichaelAnn will chose answer.
  • Let her know if it is correct or not, if not select next answer.
  • MichaelAnn takes more time for questions that are more difficult for her.

Make communication simple.
  • One step instructions.
  • Short sentences - with one thought at a time.
  • Don't over talk (e.g. repeating instructions without allowing process time in-between).
  • She is beginning to respond to repetitive simple statements (e.g. time to eat, time for bed).

Explain everything - even if MichaelAnn doesn't seem to be listening or understanding.
  • If MichaelAnn screams or fusses when doing something with her...Did you explain what you are doing and give her time to process it?

Give her choices between two (2) items throughout the day (e.g. what to wear, eat, do, read).
  • Use communication cards, iPad or actual items.
  • Wait for her response.
  • Give her time to process what you say.
  • It might take a few minutes.
  • Watch her eye gaze for the communication cards or actual items.
  • MichaelAnn will touch the picture on the iPad.  This may take a little more time.

Does seem to understand some things that are said.
  • We think she understands a lot of what is being said because of different/appropriate reactions she has when we are talking to her or with others.

Let MichaelAnn know you hear her when she "vocalizes".
  • When you respond to her sounds, she learns that what she "says" means something and is important to you.

MichaelAnn expresses some emotions through screaming - like vocalizations (e.g. happiness, frustration).
  • Usually can identify the emotion by facial expressions and/or tone of voice.
  • Acknowledge the feeling (e.g. "MichaelAnn, I see you're unhappy because dinner is not ready.  It will be ready in a little bit.").

Sometimes MichaelAnn will scream and have tears.  Crying is extremely unusual and there is something happening (e.g. medical, pain).  We don't usually know what it is but many times but we may give her Tylenol/Ibuprofen for possible pain.

To help calm MichaelAnn down
  • Offer your hands (palms up) for MichaelAnn to touch/rub.  This action seems to calm & reassure her.  She will also rub the back of your hands.
  • Massaging MichaelAnn's hands can also help calm her down when she's upset and/or screaming.

Other Ways MichaelAnn Communicates
  • When MichaelAnn is in the living room she will put her hands out to you if she wants to be somewhere else.
    • She could want to go to her room, to bed or to sit in the chair or on the floor.
    • Assist her to where she wants to go.  You can usually tell this by standing her up and the direction she moves her body.
  • When MichaelAnn sits in front of or looks at a chair or couch, (she may put her hands on it) she wants to sit there.
    • Stand her up, you are holding her from behind and facing the chair.
    • Assist her by telling her to put her hands on the chair.  She will put both hands on the left side of the chair.
    • She should lift her right knee and put it by the left arm of the chair.  You may need to assist her and move her knee by the arm.
    • Rotate her hips so her butt is in the back of the chair.
  • When MichaelAnn is in the living room on the floor and she begins crawling toward the doorway, she wants to go to her room or to bed.
    • Get her ready for bed if it is bedtime.
    • Assist her to her room.
  • When MichaelAnn watches you come in and out of the kitchen she is probably hungry.
    • Let her know it will be ready in a little while if it is mealtime.
    • Give her something to drink and/or a little snack if it is not mealtime.

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