LADL: Theory & Program Suggestions

Language Activities of Daily Living: My House, My Town, and My School by Laureate (R)
Barbara Couse Adams, M.S.

	The Language Activities of Daily Living Series consists of 3 talking instructional programs designed to help children and adults with severe communication impairments understand and express the language encountered during daily routines. Each program has four different activities designed to increase understanding of object names and their functions or descriptions. Each activity can be carried out within six scenes. In MY HOUSE: LADL, the scenes represent typical rooms in a house: a bedroom, bathroom, dining room, kitchen, living room, and utility room. In MY TOWN: LADL, a doctor's office, dentist's office, restaurant, park, city neighborhood, and suburban neighborhood are included. In MY SCHOOL: LADL, a classroom, playground, library, cafeteria, art/music room, and school hallway are shown. Improve Functional Vocabulary The term "functional communication skills" refers to the ability to understand and express the language necessary to perform everyday activities (Calculator 1988; Halle 1982). The content and design of The Language Activities of Daily Living Series is based on the language requirements of independent living skills. Specifically, it contains the language of activities of daily living (ADL) within the home, community, and school. MY HOUSE: LADL covers the language associated with a bedroom, bathroom, dining room, kitchen, living room, and utility room. In MY TOWN: LADL, a doctor's office, dentist's office, restaurant, park, city neighborhood, and suburban neighborhood are included. In MY SCHOOL: LADL, a classroom, playground, library, cafeteria, art/music room, and school hallway are shown. The activities of The Language Activities of Daily Living Series cover many skills which have been identified as necessary for meaningful, acceptable independent living. The value of pragmatic language training is evidenced by studies showing an increase in functional independence and a decrease in "learned helplessness tendencies" in those individuals receiving such training (Carr & Durand 1985; Halle 1982; Keogh & Reichle 1985). The language skills addressed in The Language Activities of Daily Living Series typically emerge in normally developing children at very young ages. One language emergence inventory reports that children are able to recognize objects according to their label by nine months of age and can demonstrate an understanding of an object's function by 27 to 30 months (Bzoch & League 1972). These two skills are targeted in The Language Activities of Daily Living Series by requiring the user to identify the object and identify the function of common ADL, household, community, and school objects. Given this, it is safe to assume that this type of training is appropriate for anyone with the language skills of a 30 month old. Actually, once it is evident that an individual has a core vocabulary, or has demonstrated awareness that oral-linguistic symbols (words) have corresponding real-life meanings, vocabulary training can take place within a variety of formats. Given the relative importance of the language of activities of daily living, it is quite natural to teach these words and their function or description to low-functioning, severely impaired individuals. Train words in realistic contexts There are six scenes in each Language Activities of Daily Living program. The scenes in MY HOUSE: LADL and MY TOWN: LADL are not age-specific and could easily represent the home and community settings of either a child or an adult. MY SCHOOL: LADL is appropriate for any age student. Each scene is depicted in full-screen, clear, concise, computer color graphics. They are proportionally accurate and stocked with common objects typically found in each setting. There are between 16-23 identifiable objects per scene with over 100 objects in each program. After selecting a particular scene in which to work, the teacher or clinician can select exactly which items to target. For example, a lesson in the bathroom might focus on only four objects (toothbrush, toothpaste, toilet & sink), or all 22 bathroom items. The MY HOUSE: LADL vocabulary was carefully selected based on a variety of independent living skills inventories (Brown et al., 1976; Rogers-Warren & Warren, 1980; SAIL, 1979; Wehman, Renzaglia & Bates, 1985). The pictures and words represent very basic skills such as toileting, as well as more advanced skills such as ironing. All items depicted in the program are essential, however, to achieving functional independence at home. Similarly, the vocabulary selected in MY TOWN: LADL and MY SCHOOL: LADL are important to achieving functional independence in the community and at school. There are four activity options in each Language Activities of Daily Living program. In Discover Names, the user simply selects an item and the computer "speaks" its name with a carrier phrase. In Identify Names, the computer verbally prompts the user to find items according to their names. In Discover Functions or Descriptions, the user selects an item and the computer "speaks" its function or description. Finally, with Identify Functions or Descriptions, the computer verbally prompts the user to find items according to their function or description. The activities are mentioned above in their order of difficulty or sequence of typical language emergence. In other words, one would be expected to be able to comprehend an item's name before being expected to identify it according to its function or description (Bzoch & League 1972; Crnic & Pym 1979). Within each activity, lessons can vary in difficulty by selecting the number of vocabulary items presented, or by including or leaving out visual cuing. The Discovery activities are designed to be open-ended, less structured exercises. The Identification activities follow a question and answer format and are appropriate for assessing and treating functional language skills. Instructional Flexibility and Control The Language Activities of Daily Living programs offer many operational options which allow the teacher or clinician to customize each lesson for each user. These features make each program useful in many special education settings as they adjust the program's difficulty level and access requirements (Eisner 1986). It is this flexibility in operation that makes each program effective for a variety of disabled populations, with a range of severity, in a variety of settings. Specifically, after selecting the appropriate activity, a particular scene, and the desired vocabulary, the teacher or clinician is presented with the Parameters Menu. The Parameters allow the program to be changed according to the particular needs and abilities of the current user. Interface options allow the user to access the computer with either the keyboard, mouse, TouchWindow, or a single switch. The Response Time parameter allows the teacher to set a predetermined length of time that the computer will wait for a response. If the Single Switch (scanning) option was selected as the interface, the Scan Speed can be slowed down or sped up according to the scanning abilities of the user. By turning Cuing on or off, you determine whether or not the targeted item will flash before the user is asked to identify it. Implementation Suggestions Functional language training, just like any training, should be done in a logical and systematic manner (Halle 1982; Kent, 1984; Spellman, DeBriere, Jarboe, Campbell, Harris 1978; Wehman et al. 1985). The suggestions made here should help increase the effectiveness of the programs. Before training with The Language Activities of Daily Living Series begins, an assessment should be conducted to determine an individual's current functional skill level and a statement of needs should be generated which prioritizes skills to be trained (Snell 1981). This can be accomplished through informal observation, using commercially available inventories, or with The Language Activities of Daily Living Series. Upon implementation of the programs, the teacher or clinician should make efforts to use realistic materials and natural environments in conjunction with the computer and software. Cross-training, or using several different learning environments, will also encourage use of the vocabulary in a variety of settings. If you are training the language related to the kitchen, couple the computer applications with actual kitchen objects. If you are working with the vocabulary of a park or playground, arrange to visit one. You can also use the scene printouts provided with the program to walk through an actual setting and associate the pictured items with real items. While the increased motivation and structured environment of the computer have positive effects on learning, it is imperative to encourage use of language in real-life settings. As mentioned earlier, the four activities are presented in a hierarchy of difficulty. It is wise to start with activities associated with object names before working with the object function or description activities. This systematic approach will reduce the likelihood of confusion by introducing concepts without necessary prerequisite skills (Kent 1984). The Discovery activities are designed for open-ended exploration of language. They can be used to encourage the use of verbalizations, gestures, hand signs, pictures, etc. to facilitate the communication process. The Identification activities are better suited for individual practice and reinforcement of the receptive language skills. The most successful applications of The Language Activities of Daily Living Series have occurred when the sessions were rich with communication between the teacher and student. Increase independence of children and adults A wide variety of persons with communication disorders can benefit from using The Language Activities of Daily Living Series. Children with significant language disorders, regardless of handicapping condition, need to establish a core vocabulary in order to grasp the concept that oral-linguistic symbols, or words, have corresponding meanings. Once this core vocabulary is mastered, vocabulary training can be approached from a variety of perspectives. At this point language training of functional activities can have considerable results. The Language Activities of Daily Living Series is also an ideal set of programs to meet the needs of adults with developmental disabilities needing remediation in functional communication. With an increased level of independence, these people will require less staff care and will make an easier assimilation into the community (Crnic & Pym 1979; Shane et al. 1982). Individuals with Autism can benefit from exposure to the vocabulary and the function or description of objects via computer. Many children and adults with Autism will frequently tolerate one-on-one instruction via a computer when they won't engage in a human tutorial dyad. Language skills of individuals with Autism have been noted to improve through computer-assisted instruction when all other traditional methodologies have failed. Impaired communication is often the most devastating result of stroke or traumatic brain injury. Individuals recovering from either stroke or Traumatic Brain Injury (TBI) are typically in need of cognitive and language retraining, especially those in early stages of rehabilitation. "Disoriented" is how language skills are often described. Because of the vital need for structure and stimuli control, computer-assisted training is highly effective for TBI patients. While rehabilitation can be a long, exhaustive road, most specialists agree that their first objective is to achieve functional independence (Hagen 1984). The Language Activities of Daily Living Series can be used to retrain the language necessary to make a recovering patient self-sufficient within his/her own home and community. Because the computer allows the clinician to control vocabulary, cuing effects, and stimuli, the individual is much less likely to experience stimulus overload. These same factors have led to the use of The Language Activities of Daily Living Series with persons suffering from Alzheimer's Disease. The debilitating memory deficits associated with the disease can be addressed with the program in order to maintain independence with daily activities for as long as possible. The Language Activities of Daily Living Series has also been found very useful in teaching English as a Second Language. The functional nature of the programs make them equally appropriate for children and adults for whom English is not their native language. The physical limitations of the orthopedically impaired population have often excluded them from activities which require mobility or dexterity. Through proper accessing techniques, a computer can provide sufficient stimulation for language training. Like all Laureate programs, operational features of The Language Activities of Daily Living Series allow for a variety of accessing options. The programs have been designed to work with input from the keyboard, mouse, or a TouchWindow. They can also work with a single switch. For individuals with direct selection capabilities, the TouchWindow provides direct, immediate feedback. Given accurate switch activation abilities, even severely physically impaired individuals can access the programs. This means that they too can reap the benefits of using these language enhancement programs (Goosens & Kraat 1985). In Conclusion The ultimate goal of speech-language pathologists and special educators is to help their students and clients become communicatively competent. This means we must help them acquire language forms for communication and then encourage them to apply their knowledge in environmental contexts. MY HOUSE: LADL, MY TOWN: LADL, and MY SCHOOL: LADL can help in developing active use of the important vocabulary of household, community, and school items and their functions or descriptions. With these programs, we can help our clients reach the goal of becoming more independent in as integrated an environment as possible. The Language Activities of Daily Living Series can be an essential tool in meeting the challenge of developing independence for our clients. REFERENCES Brown, L., Nietupski, J., & Hamre-Nietupski, S. (1976). Criterion of ultimate functioning. In M. Thomas (Ed), Hey, don't forget about me! 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