Our next featured domain discussion is around Domain #6, LENGTH / COMPLEXITY OF LANGUAGE. 

 

The goal: To communicate messages at a level of complexity that meets their individual requirements without reliance on interpretation by others.

 

This domain covers one of the more conventional measures of communication which is length of message, and complexity. There are a few things to think about with this domain though, so our blog for this Domain is a little longer than usual to ensure we could do it justice.

Language complexity considerations include length of utterance, extent of vocabulary and use of language functions and grammar. This domain is also designed to align with the typical language levels of PODD communication books (Porter, 2007) as an individual progresses in expressive language complexity from informal modes through to single word, key words, and complex syntax. 

Of note, is that this domain scores expressive rather than receptive language. For individuals with complex communication needs (CCN), accurate assessment of receptive language can be challenging for a variety of reasons. Expressive language is more easily estimated through observation or a language sample. As with all other domains on the ROCC, Domain 6 is not an in depth assessment of expressive language but a general estimate of overall level to guide your planning. It can also help you to determine whether now is the time to collect  a more detailed assessment in this area. 

 

Scoring notes

• Navigation -vs- real words

• • When considering language levels for those who use aided AAC, we measure length of utterance based on the number of true words rather than the labels on the navigation buttons. For example, on a 1 page opening PODD communication book, someone might say:
    • • “More to say” – “I think it’s” – “funny“. 
  • In language complexity terms, this is only considered as a single word, not a full sentence or a 4 word combination. The extra words provide context as the person is selecting their message, but funny is really the only one they have selected as a true word. The others are navigations with pragmatic branches to support the interaction. If they then use the predictably associated vocabulary on that page to combine words like “not funny” then this would be a 2 word combination. 
  • If (usually on a 2 page PODD) they combine the words by selecting Opinions – “I – think – funny”, then this would be considered a 3 word combination. Similarly, “turn the page” is also a navigation not a message.
• Echolalia or rote phrases (gestalt language). 
  • Though someone may use a string of words in a sentence, if that sentence is the same every time, then it is more like a ‘single word’ than a sentence when it comes to language complexity. The ROCC descriptors will help to guide you on which language level to score an individual who speaks with rote phrases but most likely your next steps would be acknowledging the meaning of the phrase, then modelling single words that convey a similar meaning but that others are more likely  to understand.  Wherever possible, try to determine the general meaning or “gist” of the repeated phrase and model the appropriate message at a 1-2 word level. We suggest using speech and symbols to support language learning in this case even if the person is likely to learn to use spoken language. The symbols may enhance learning by providing visual information. 

 

Why is this domain important?

1. To plan and track progress
2. To guide selection (and updates) of a communication system for those who use aided AAC, and
3. To inform modelling/aided language stimulation 

 

1. To plan and track progress

As expressive language complexity increases, so too does communicative competence. Domain 6 allows us to measure and plan for the expansion of messages as the person learns the benefits of combining words. As vocabulary  grows and the person learns to use phrases and sentences, they can be more specific and autonomous in their communication. 

 

2. To guide selection (and updates) of a communication system for those who use aided AAC

In the early stages of language development for all communicators (speech, sign and/or symbols), increases in vocabulary create opportunities for them to combine those words in many different ways.  However,  for aided communicators, if the communication system does not include enough words to accommodate a wider vocabulary and the opportunity to generate word combinations, then it may be limiting the person’s communication progress. 

As language complexity develops, the layout and efficiency of the communication system is crucial for aided language users. If it takes too long to combine words, or if the words a person is thinking are not there, they will not be able to express their autonomous thoughts in the way they choose. In addition, if new words and language structures are not available for their communication partners to model to them, they will not have the opportunities to learn to use them. A comprehensive communication system needs to include language opportunities for today and tomorrow so that the person can say what they are thinking today but also have vocabulary and language structures available to learn the words, phrases and sentences they may want to say in the future.  Using Domain 6, we can estimate the current language complexity of  the individual which can help to inform our definition of a comprehensive system as determined in domain 2. (For more information on this, read our blog on Domain 2 to see how  a person’s score on domain 2 may drop if their competencies in other domains increase.)

 

3. To inform modelling/ aided language stimulation

As mentioned above, a communication system needs to include vocabulary and language structure that allows us to expand on the individual’s expressive communication. We do this by providing models and learning opportunities. If we use domain 6 to estimate the individual’s expressive language level, then we can target our language modelling to the level above to optimise their learning.  

For example, if someone is not yet using symbolic language (speech, signs or symbols), then modelling or emphasising 1-2 of the main words with a view to them learning to express themselves in single words for now is most helpful. Constantly modelling full sentences with symbols or signs may be too much information and lead to disengagement. Equally, if a person is communicating with 1-2 word phrases, it will be important to model longer 2-4 word messages, and a more diverse vocabulary to give opportunities to learn. 

 

You can use the ROCC levels to help guide you on what to model to build language complexity. After you score your participant, look to the next level to determine what kind of messages to model next. 

 

The end goal

Competency of expressive language evolves across time and with lots of opportunities to learn, practice and refine. Communicators of different modes may develop along different linguistic pathways, but ultimately the goal is to use language to interact meaningfully with all partners in all settings. Sometimes this may only be a single word like yelling “Stop” or using a gesture to signal to a friend that you’ll be back in “just a minute”. In other instances, more complex messages and a diverse vocabulary may be required. All of this we learn from the models of others in our environments and access to ongoing learning opportunities. 

 

In ROCC Domain 6, the following descriptors would describe an individual as emergent, transitional or independent/competent. 

 

Emergent

Emergent communicators on Domain 6 are those who are not yet using symbolic communication expressively. This means that they can express themselves with body language, gestures, and other informal modes, but do not yet use single words in the form of signs, symbols or speech. In terms of verbal speech, a child may babble or imitate beginning words, but we don’t technically call that a word until they use it several times in an appropriate context. It’s similar for signs and symbols. An emergent communicator may make shapes with their hands or tap at their communication system, but we are not confident yet that these are clear words. We can call this babbling with signs and symbols too!  There is no strict guideline on when someone transitions from babble to words, or from  emergent to transitional, the important thing is the conversation.  Personally I tend to score on the low side if I’m unsure, but you can always clarify in the note section to show emerging skills. 

For more information on supporting emerging communicators, try this online course. 

 

Transitional 

The transitional range in domain 6 is quite broad. It progresses from a limited set of single words (level 1) through the process of expanding single word vocabulary (level 2), combining words (level 3) and adding additional grammatical functions (level 4). 

Though there is a wide range across those levels, a person is still considered transitional until they are able to communicate in complete sentences if they choose to do so. 

At any point in this transitional range, the individual would benefit from modelling and language facilitation strategies to expand on their current level. 

 

Independent/competent 

At this level the person can communicate complex messages if they choose to do so. Speech, spelling or other hinting techniques are required to achieve this level so that the person can be specific about their message and say anything they choose to say even if it is not on their AAC system or they do not know the word or sign. Of importance is the description: “the full meaning of the message is clear and does not require interpretation for unfamiliar partners”. 

 

What can I do?

One of the first strategies to implement at any level of language complexity is time. An Expectant pause can be all it takes to enable a person to take a turn or expand on their message. For those who use or are learning to use aided AAC, that pause may also include a guiding look, or gesture toward their communication system to suggest they may have something to say. Give the person time to feel confident that they can add to their message in any mode (speech, sign, symbols or gesture).

 

 

When you pause, you may also notice other contextual information that adds to the message. For example,  a body movement, eye gaze toward an item or location, a smile or a frown. If the person is not yet able to expand on their message, then start by suggesting rather than guessing. Tell them that you are not sure what they mean and suggest what you need to better understand. You might say something like:

“You said go, maybe you mean go to a place, or you want a person to go, or something else”

If using aided AAC, show these links as you emphasise the words. If you do understand what they mean by observing the contextual information, then act on their message. You can still model an expansion of the message but don’t make your actions conditional on them saying it. Imagine how frustrating that would be if it happened to you!

 

If your person uses an indirect method of access to their AAC system, like partner assisted scanning, be sure that it includes strategies to give them the opportunity to add extra words before the communication partner jumps in. An example of this is the operational buttons included in the Partner Assisted Visual Scan PODDs, and more information on this is included in the PODD resource. 

Sometimes in order to expand beyond single words (particularly those using aided AAC systems), you can plan to do some specific activities that are designed to practice combining words as you might in typical language therapy. You can practice combining words in activities. 

For example:

• Use early readers as a template for language practice. Repeated lines in early level readers  like “I like apples, I like bananas, I like cake, etc…” are great for practising simple language phrases on an AAC system. 
• For older children or adults, use the Tar Heel Reader site, or find some pop songs that have simple language lyrics, or the repeated chorus of a song for more age appropriate content. 
• Chants and play acting with puppets is another way to use earlier developing language structures for older children. 

 

In the big picture, any form of receptive language input is helpful to support language development. Use a range of modes to show the person how to use and combine words in genuine interactions throughout the day. For some who may be having difficulty learning speech or sign, aided AAC systems can be extremely helpful to provide visual support for learning language. It’s also important and helpful to focus your modelling to just above the person’s current level as much as possible. Too complex and they are less likely to engage. Too low and you are not providing new learning. 

 

Useful links on this topic:

ROCC FAQ – What is the difference between Domain 1 and Domain 6 in terms of symbolic language, and how they relate to each other?

ROCC Blog – A closer look at ROCC Domain 2 to determine if you have the right system to meet the language complexity needs. 

TWS EXPAND program

TWS Emerging communicators

You can also learn more about Domain 6 in the context of ROCC by doing the ROCC Basic Training