 Don't forget to push the record button. I've done that before. So yeah, this is all looking marvelous and we can hear you and see you and all is well, all is well. I know as I as I was saying to Terry, there's been some times on my end, but for some reason I just don't even know why that I've had to reboot my computer and I think it's because my my it's my computer is getting too old and it just gets too full and too tired. But this is great. It's all working very well so good. Yeah. All right, so we have seven minutes or so people are starting to come on in so folks we will officially start at 330 and I'll do a very brief introduction and In the meantime, if you want to go get yourself a quick cup of tea or I've got myself a bottle of water and that would be that would be wonderful. Also, I'm going to tell you that this evening we have the option of closed captioning which is marvelous. I'm thanks to the DHH folks for making that possible. So if you do want to put on the close captioning and at the bottom of your zoom screen and I'll say this again but I'll say it now for those of you who are already on you can click the CC closed captioning button and they will start to caption once we I'm assuming once we officially start the the webinar. So there you go. I'm going to put myself on mute for a couple of minutes and then we'll come back and in five and go. Okay, so I'm just going to tell the folks who are on the zoom this evening if you've Oh, there's captioning is on and that or this afternoon. It's not evening yet. It feels like it. I've been up since four. I'm tired. I'm sorry. Well, that's poor me. I should quit. Yeah, quit whining That you're going to see a little bit different interface because we're with this has been set up as a webinar this evening. Usually I just set it up as a meeting. It will still have good functionality. You'll be able to hear everything. I won't have to go in and mute you if you're talking, which is kind of nice on my end. And also you won't have the option to put your video up. However, you still do have the option to connect with us by a chat. So please feel free to do that and I will I will monitor the chat so Nicola doesn't have to do that. Yeah, so that's Alberta education. Oh, and for me on the chat. I'm Alberta education, not Kathy Howie. I've changed my name today. So I was going to say Kathy that I'm hoping that there will be time for questions. But if there isn't if people wanted to perhaps email their questions to you. Sure. Then you collate them and send them to me because of course I'm going off to Japan so it'll be quite difficult to answer them and I may have to wait till I come back. But I'm very happy to to take questions and I will definitely get around to them. Lovely. That's perfect. That's perfect. So again, when we when we actually I'm just looking at the time. We're still a couple minutes away. I'll say some of those things. It'll be a little bit of a repetition. Yeah. Okay. Oh, so it's quite late here. Mm hmm. What time is it? It's 1030. Yeah, I thought it was a little later than. Yeah, so that's not bad. That's not bad for me. I think you and I travel in different. I'm a I'm definitely a bet in my bed sleeping by 1030. But when you wake up at 430, you know, that's the way the world goes. Well, I am. I am normally so I wake up late and I go to bed early. But Well, thank you for staying away. I can now I can get a second wind in the evening. That's great. That's right. I wish you to admire my Lady Hale t-shirt. Oh, beautiful. So tell me Lady Hale. Tell me what is that really important. So if you look up Lady Hale people. Yes, yes, you will discover why I am wearing a Lady Hale t-shirt. So she is the judge at the Supreme Court who delivered a very, very phenomenal decision to our Parliament. I do know about that decision. Actually, we've heard a thing or two about what you well are up to over there. I have to tell you. So for those of you who don't know, I think you should but Nicholas in the UK and we have heard a thing or two about some of the festivities That's one way of putting it, but I must say it's really wonderful to have a grandmother like Lady Hale laying down the law or power. Well, seeing as I'm now in those ranks, I couldn't agree with you more. Yes, we all need grandmothers to take over once in a while. Don't worry. Definitely. All right. Well, I see the clock on the wall is telling us that it's time to begin. So welcome everyone. I am very pleased to introduce to you Dr. Nicola Grove. Nicola and I have not met until, well, we met about, yeah, a few months ago and we became, I kind of say, fast friends, really, really fast. I first heard Nicola speak at an AAC, the AAC Institute about a year and a bit ago now, and she gave this wonderful talk, very similar to what she's going to be doing for us today on AAC and manual signing. And I thought, ooh, ooh, I have to reconsider some of the things that I have been saying. So it's been wonderful to have her challenge my thinking. I love what my thinking gets challenged to help me remember some things that I think I knew. And then I'm also going to put a plug. I think you're going to put a plug, but I'm going to put a plug in for her new book, which I bought. And you can see I've already got it stickied and stuff. So we're really in for a treat this evening. Nicola's been in the field for a long time. And she, like a few of the other folks that I have, that we've brought to our webinars lately, come from the European perspective, I want to say, which is not slightly, which can be significantly different than some of the ways that we consider AAC communication and children with disabilities in North America. So Nicola, I'm not going to talk anymore because we want to hear you. We're very happy to have you here this evening tonight, this afternoon. And so with that, please take it away. Thank you. Thank you, Kathy. And thank you so much for putting this on. And thank you to all of you who've joined for this webinar. So just to say that I hope very much that there will be some time for questions at the end. Please do make a note of your questions. If there isn't time or if you don't get round to it, if you can email your questions to Kathy, she will collate them and send them to me. And I promise to answer them when I get back from Japan in about a month's time. I can't promise to do it when I'm walking the Nacocendo way, but there you go. So this webinar is really designed to raise awareness of the very critical role played by the manual modality gesture and signing in the communication of young people with developmental disabilities. And I'm speaking from the perspective of some 40 years working in the field, both of signing and of AAC. And after about this kind of two and a half years, I think solid work, but quite a few more years in the preparation. I brought out this book this year, which draws together is the first ever textbook to draw together findings from both sign language and from AAC to look at what we know about manual sign acquisition in children with developmental disabilities. So quite a lot of the references in this paper. And again, I will send Kathy a list of all the references that I'm using come from the book. So what I want to do in this seminar is first of all, let's have a look at where we are at the moment with signing and gesture. What is going on? And then how have we got there? And then what do we know? And what can we do about it? And I'm planning to address some very practical questions because I'm a speech language pathologist by training. And so like all of you, I want to know, well, what should I actually be doing when I get into my classroom or my clinic tomorrow? Okay, so let's start by looking at what we know about what AAC says about what AAC is, what is AAC? And it's clear that AAC certainly on the surface when you look says that unaided communication, including gestures is something that's important. Now I want to introduce you to Ricky. So Ricky's a little boy that I actually met this summer. He's a four year old who is the son of a friend of mine, his grandson, I should say. And they were very concerned about him and asked if I would just come and very informally just have a chat to his family and meet him. So I went along and spent a morning with them. And sure enough, this is a little boy with a rare genetic condition, which means he's got delayed language and delayed speech and his speech certainly wasn't very clear. And I talked with him and I got him involved in doing a bit of storytelling with me and a puppet and telling a story that I told him to his mum and dad who hadn't heard it. And it was quite obvious that he was a child who was using gesture pretty effectively in order to compensate for some of his difficulties. So then his grandparents took the boys out for a bit and I sat and chatted to the parents and I said, so okay, so what's going on here? What's the speech pathologist telling you that you should do and what are the reports like? So I had a look at the reports, not a single mention of gesture. Then I asked what the speech pathologist is advocating and she says, oh, well, she's given me these little drawings and I have to get them out and look at them with him and we use these prompts to get him to produce three word sentences. And I said, well, how does, how's that going down then? How's it going? And she said, well, we really hate doing it. And the reason that they hated doing it is because they felt that it was highlighting all of his difficulties and he was just losing confidence. So I said, well, what do you think he's good at then? And they looked at each other, these parents and they said, well, we think he's very good at gesture. And I'm afraid at this point all my professional neutrality deserted me and I said, you know what? I think he should just put those pictures away and just work with him, use a lot of gesture yourself, learn some signing, reinforce value, what he's good at communicating. And I gave them a few other suggestions about how to involve him in kind of ongoing conversations and so on. And the results has been that a couple of weeks ago I had an email from them saying this is a changed child and he's so much more confident and his speech has improved by leaps and bounds. Thank you so much. Well, I didn't feel that I had done anything very much quite honestly. But it was astonishing to me that a speech therapist in 2019 can take on a child like this and make no mention of gesture and not think about how to use gesture as part of her total intervention package, which of course can include some picture description and symbol prompt as the means of improving this kid's ability to get his message across. Well, we've got a lot of Ricky's and a lot of you will know them. And it's apparent that we've a lot of these children are actually quite naturally using sign and gesture in this much quoted study by binger and light. I'm assuming that deaf children are involved since there are around a third of them using sign languages. So how have we got to this point? Why is it that gesture and sign are not as recognized as they should be in my view. And I want to look at the history of these two fields of research and practice. So bear with me for a bit. In the 1970s, it was manual sign that was really one of the first augmentative methods, if you like, that got used with adults and children with developmental disabilities. And at that point it coincided in fact with the rise in studies of sign language. And I had the huge privilege because I was working with the Macaton charity at the time of which more later, Margaret Walker, the founder, had developed keyword signs with kids and adults with intellectual disabilities. And she sent me off to these sign language conferences, which was amazing. And meant that I came back with a very, very good grounding in what sign language was about. And we were able to use that knowledge to inform the way the charity developed. And it's been highly influential in my own work. And at that point it was actually very common, well not very common, but it was common to see some references in research papers to the use of sign with these populations of kids with developmental disabilities. So autism and intellectual difficulties, excuse me. We stick with sign language for a bit. So as the whole situation evolved and it became apparent that sign was indeed a natural language that had linguistic rules that structured it. Then it became very central to the way that deaf people saw their identity and their culture. Interesting by the way that Manitoba seems to have been one of the first places to acknowledge signs as an official language in 1988, I think. But Ottawa I gather in 2019 is still wondering whether to go ahead. So you can see that it's, you know, there's still really quite a long way to go. But by and large sign languages are now accepted as official languages. A lot of this happening in the early 2000s. What about AC? Well, I was in at the beginning of Isaac as well. So I went to those early Isaac conferences and many other conferences and research symposia in the 1990s and the early 2000s. And I wrote a lot with the group of European researchers, including Stephen Fontenna and Kaisa Launan and many other colleagues. Now, signing at the beginning of Isaac, there were a lot of papers and a lot of interest on signing. It was viewed as an innate system of communication as it still is. But it certainly was on a par with or regarded as being on a par with aided communication. Within the 1990 taxonomy developed by Lloyd, Kristen, Windsor signs are therefore viewed as unaided AC systems. And of course, they are always used in conjunction with speech. On the sign language side for the deaf community, the sign systems, not sign languages, but where signs systems were used as a way of teaching spoken English. This was found to be really quite inadequate for the education and language development of many deaf children. And these systems came to be seen really as kind of quite oppressive in positions by the dominant hearing culture. So you can see that we have a split happening in the way that signing is viewed. Then of course we have the rise of the digital age this century and in the years in the last 20th century. Universal access to communication technology and communication technology scenes providing a lot of solutions. It must be said for the sign language community as well as within AC because many of you will know a lot of fabulous sign language programs with avatars and ways of learning sign language and so on and presenting it indeed. So the situation that we have now, I think is where in terms of values and attitudes to what signing is the two fields of research are really very separate. I would almost go as far as to say that we're looking at two silos on the deaf side with sign language deafness is seen as difference, not disability. Signing is a language central to identity. And on the AC side signing seen as a compensatory mechanism for people who have some kind of expressive disorder which is effectively a deficit model. So it's not surprising really that we have this great split between what in effect looks to be the same phenomenon, which is the use of the hands to communicate information. In the real world, of course, things are much messier. So in the real world, it has always been the case that some kind of form of signing keyword signing very similar to what you see an AC has been recognized by the deaf community as a form of a contact language between deaf and hearing communities. And right from the start this was recognized and written about by people like Paddy Lad describing it as a form of pigeon. It is now described as a contact language. We've also got a number of populations. Increasing awareness of populations where again, the signing is going to look more like keyword signing or you've got populations where there is going to be a need for some form of communication technology. And I would mention here these children who don't seem to be benefiting from cochlear implantation, the populations of children who seem to have language delays and disorders. Hearing children of deaf parents who have developmental disabilities but who are developing sign is the first language that's work that's been done by Ben C. Wall and myself looking at Down syndrome children and others who are first language signers. And then we have our population of individuals who are both deaf and intellectually disabled and this is the group that I think are really losing out. Certainly in the UK, I don't know about in the States or in Canada, but here in the UK intellectual disabilities is always viewed as the primary disability and it kind of trumps deafness. So I've certainly come across children who are profoundly deaf and intellectually disabled, who are not being educated in deaf provision, but who are being educated in hearing provision because they're regarded as intellectually disabled and their deafness is therefore secondary. And what that means is that their language is not developing and they are exposed to very inadequate models of sign language. Certainly one child I came across in my own clinical practice in the 1990s but another one just six years ago I observed in a classroom. So, looking a little bit more detail at AAC interventions. Clearly these came about through the recognition that speech training doesn't work. But I think there's a bit of a problem with the term AAC something Kaiser and I talked about a lot when we were writing the book. Because most users are operating in the hearing world. The very term augmentative and alternative suggests well alternatives to what augmentative of what, which means that effectively speech is viewed as the default modality to which we should all be aspiring. It's also been the case that I think right from the start there's been so much interest in technology so a lot of the drive for setting up eyes that came from manufacturers and innovators who were very excited by the potential of technology for solving some of these communication problems. And it was interesting to go through a time when AC users were redescribed as a AC consumers because they are people who buy products. That's not the case if you're a signer. So what you can see is a kind of tilt towards aided communication. I would also say, and you can challenge me on this if you like but I'm thinking way back. And I don't know if it's still the same now but I think that high status in the field of AC has historically been associated with people who have physical disabilities and intact cognition. Stephen Hawking being the obvious poster boy, which again means that you've got a kind of bias if you like an inbuilt bias towards interest and value of people using aided systems. And what all of this is meant is that inadvertently I think something has happened which I call the sign decline a gradual marginalization of sign and gesture in the field of AC, certainly far fewer research papers and I provide the figures for this in the book. I think one of the factors impacting on this has been a great respect for deaf culture and sign language and anxiety about cultural appropriation, which is quite fair enough really so it's perhaps not surprising that within AC we tend to look at sign language and say that if something totally different that's not something that we should be getting involved with because we don't really know about it, our population is different. But more worryingly, I would say that signing an AC has again traditionally and historically been associated with the predominant outgroup in society. That is the people with the lowest status who are people with intellectual disabilities and I'm drawing here on the work of Chris Goodie from his work in 2015. And what we find now then is a mission of sign and gesture from exactly where you might expect it to be as a speech pathologist. So I'm looking now and I only did this just for this webinar actually I didn't know what I was going to find but I thought I just want to have a look and see how to asher define AC. How is Isaac currently defining AC? Well, both of them clearly are mentioning in the base definition unaided systems can see it there aided or unaided eye contact sign language facial expressions touch. But as soon as Isaac gets more specific, you can see that it kind of defaults to talking about AC as equivalent to aided language. There's the same thing actually on the communication matter site in the UK. And so I'm interested here that creating an aided language environment is seen as critical but there's nothing there about assigning environment. And I don't quite understand why not asher on their website. Have a page about a comprehensive assessment of AC remember Ricky remember how in Ricky's report there was no mention of gesture. Well, it's perhaps not surprising when what you see here is that what is recommended is that if you as a speech pathologist are doing an assessment of a child's need for AC. You look at what symbols are they currently understanding what pictures are they looking are they using pictures and communication. No mention at all of manual sign and more worry me perhaps no mention of gesture. I would also bring in here what I think a very significant attitudinal barriers. So, we don't want to be known as a signing school is quoted by Stephen from Turner. A mother who had wanted her child taught signing who wrote to him this is from some years ago so you might like to think that things changed. I actually overheard at an Isaac conference to speech pathologist talking to each other. Signing makes them look funny. So we don't encourage it because it would make them stand out in public to which what I wanted to say but I didn't was well, you know, when they talk, they sound pretty funny as well. So are you stopping them from vocalizing and speaking, perhaps you'd better sell take them out because, you know, you wouldn't want that happening. But just this year, I heard about the social worker telling the mother of a Down syndrome child. Oh, it'd be better not to teach her signs because, you know, it'll stop her speaking. And I came across this paper by Shafa, which is quite an interesting paper looking at the acceptability of different forms of augmented and alternative communication. The highest rated unsurprisingly was an iPad with speech output. But I think there are real ethical considerations in doing what was suggested in fact by that paper that we should be using public acceptability or public acceptance. As one of the criteria that we employ when we're thinking about which resources we should be supporting for a child with developmental disabilities whose speech is not effective. Okay, so what I want to do now is to look in a bit more detail at what we mean by keyword signing and I'm going to do that by starting up looking at sign language. And then gesture what we know about gesture and what we know about keyword signing sign language of course natural languages of deaf people as we've said, lexicons differ but grammatical structures quite often there's a speech but seem to be have some commonalities across language using topic comment structure simultaneity spatial grammar. As those of you who are working with signers will know very well. What do we know about gesture. Well, I'm taking most of these findings from the chapter by Laura Spiracci and colleagues in my book. I want to note that although we are focusing here on manual modality actually linguists now see gestures as being vocal as well as manual so exclamations like wow or or out. And originally in sign language research, there was quite a push to distinguish gestures very firmly from signs language from non language which wasn't surprising given that what sign linguists were trying to do was to advocate for the status of in the face of considerable skepticism from prominent language researchers who were a bit incredulous that what looked like a very pictorial apparently simple system of gesture in fact was something much more complex and sophisticated. However, nowadays. It's recognized that actually the relationship between gesture and language is much more dynamic and fluid and creative. I recommend a paper by Susan Golden Meadow and Diane Bruntari, which lays this territory out so here. What I'm doing is just introducing you to three forms of gesture and see how they used in signing. So first of all this simple takes us that's pointing. So obviously that's something everybody does as a gesture I point to something that I want in sign language points take on a phenomenal referential role so they can be used to indicate people or places. But they also within the discourse will be used to refer to a preceding topic or reference. Presentational gestures of those ones that we know very well that arise spontaneously in conversation when we need to explain ourselves or we can't make ourselves hurt so that's where there is a clear form meaning correspondence so I might say can you find my bag you know. No no not the little one that the big one. I was walking down the road and there was this bus that was just going like this. These it is now recognized are the basis for the generation of signs and for new sign forms. And then finally there are those gestures which have become conventionalized and culturally accepted so that their status is equivalent to words. So that would be something like drink or goods or this gesture which I gather is now an outright trope. How did that happen can we please reclaim it. And we know that iconicity plays a role in signing and can be quite important in sign learning. So those are the different types of gesture and how they may be used in sign language. How did gestures develop well gestures are so critically important in language development. In fact children's gesture use as we know seems to be correlated quite closely with their later achievements. And manual gestures emerges pre verbally and is very high amongst two year olds where it's very common to see gesture and speech coexisting. And sometimes even joint production where you get one component spoken and another gesture. So I remember my own granddaughter looking at the book and saying pretty meaning a pretty butterfly. Gesture of course we continue to use throughout childhood and adulthood because it's so helpful, not just in communication but in formulating our own ideas. There is a lovely paper by Golden Meadow, which illustrates how if you are giving directions to somebody on the phone. People often gesture as they're doing it and that's obviously not because they're communicating information to somebody is because they're kind of working up themselves so you go down here and then it's that way. We are real by model communicators. I want to draw your attention to a very important study by the work of Golden Meadow Jenny Singleton a day with McNeil. She was looking at children who were home signed who were deaf. Sorry, home, home signing deaf children raised in oral environments so they had, they didn't have sign language input, but they seemed to discover some of the principles of how a sign language works autonomously. Because they would sometimes they would create a gesture of something like drink. And then they would change the form of that to indicate changes in meaning so they might do drink, drink a lot or drink having a long drink, or they might displace a sign to show that the cup is there by moving it from neutral space where it normally happens somewhere else. And moreover, what these children seem to do was to introduce some systematic patterns of ordering of agents actions and patients in the way that they sequenced their signs or their gestures if you like their gestures and their points. So these children were creative innovators. They were children with difficulties, but they needed to communicate and that drive to communicate led them to systematize the forms that they were using. I just want to briefly refer to what we know about the impact on speech of the manual majority because of this still very, very pervasive belief that if you introduce signing, then children will stop talking. Well, we know that the reverse is the case actually. And that's probably because partly of the neural proximity of the structures involved. But also, as we've seen, we all use gesture and speech together and gestures and speech have a, they help one another. An early study by Gay Powell and John Clibbins showed that adults with intellectual disabilities who had been taught signs and who were using signs, their speech was clearer when they sign than when they didn't. And that was the case even if the listeners could not see them signing. And definitively Kaiser Lamans work showed that over time, the early use of sign predicted and promoted spoken language development in children with Down syndrome. So there's definitely evidence there that you can use to back up what you're doing. What do we mean by keyword signing? What is it exactly? Well, keyword signing is what we do. When we take on signs and use them to children or adults, we use natural spoken language, and we will sign one, two, maybe three components. So you have options. If you've got a sentence like put the book on the table, you might sign just one thing. Put the book on the table or put the book on the table. Possibly put the book on the table. I'm using, of course, British Sign Language here. As we've seen, you can see something very similar, often in interactions between hearing and deaf people when you've got hearing people that don't have a lot of sign knowledge. So what's the process that's going on? Well, it's explained very clearly in the Isaac taxonomy as a code system. So signs, it is still translate words at the point of transmission. So you form the sentence, put the book on the table in inner speech, and then as you transmit it, you make a decision at some level about which component you are going to sign. I'll just glance at what we know about sign interventions in AC because clearly they are there. There are quite few research papers, as I've said, not as many now as there were. So the main paradigm is behaviorist. And this is, I think, because signing is associated, as we've said largely with these youngsters who've got quite severe intellectual disabilities. These behavioral techniques are, of course, tremendously powerful. They work to an extent, and they're used, of course, here with very benign intent, but the view is of the child as a blank slate who needs to be taught, trained through highly structured methods involving imitations, prompts, reinforcement, and then generalization outside the teaching content. You find that in these paradigms, there is a very strong focus on two early functions, and those are man's or requests and tax naming or comments. I will just as an aside say that I find it slightly bizarre that we're still talking about man's and tax, which derived from Skinner's original formulation of language development. You don't see it, I have to say, outside this kind of context. Stephen Fontech now points out that although these may indeed, they often do have a practical use, but they can't tell us how and why language develops in the child. And they don't tell us much about use. However, this situation is changing. And here are some of the drivers, that's what I think anyway. First of all, we've got these really interesting clinical populations developing or rather awareness of these clinical populations, where they could clearly be a benefit of the use of AAC. And these are these deaf-signing children with additional disabilities that you will read about in Ross Herman's work from City University and Ben C. Bowles work and Gary Morgan. So there's a whole population here, very significant population where we in AAC ought to be working together with sign language researchers to say how can we collaborate to assist these children. Secondly, I think the whole rise of person-centered approaches, where very much the value comes from thinking about clients or patients or children as active contributors to their own rehabilitation, valuing self-advocacy, identity, and actualization. And alongside this, I think there is real continuing evidence that many children, including many children with autism, may show distinct preferences for signing and may not want to use aided communication, or not at least in all contexts, and we'll come to that later with some specific examples. Thirdly, I've been very excited in writing the book and discovering the work of Annalisa Custer's and Charles Goodwin, these new semiotic paradigms for thinking about communication and multimodality. Modern modality, not as something that is the result of a kind of very linear coding system that is inflexible, but something that is dynamic, creative, and responsive to the moment. And this seems to fit with what we know about children signing, which is that it's highly context dependent and that the communication environment and communication partners play a really, really important role in actual use. The third driver is that I'm afraid children just don't do entirely what you expect. So firstly, keyword signing may describe what we are doing when we sign to the child, but it certainly doesn't seem to describe terribly well what the children are doing when they use sign. And just in doing the research for the book, myself and Charlotte Parkhouse and Gareth Smith did what I think is some really exciting work with kids with intellectual disabilities using sign to debate in group situations, which I'll describe in a minute. So what do we know about use? How do children who've been taught signs actually use them? Well, there aren't an awful lot of research papers on this, but it was something that really interested me as a speech and language therapist, because I've been working for the Macaton charity. So the first piece of research that I and Sheena McDougal did was to go and look at 49 kids who'd been taught signs in special schools and we looked at them in class and when they were playing with a peer. And what we found was that children who in classroom situations where the focus was on teaching them signs look to be very high signers. That is to say the ratio of intelligible signs to intelligible words that they produced showed that they were better at communicating in sign. And some of them would be quite consistent with that over different contexts, but with most of the children, their signing varied depending on what kind of context they were in. And in that study, in subsequent work by Judy Buchanan Mellon, and in Ellen Rumberts' work in the Netherlands, it's become absolutely clear that there is a positive association between signing by teachers, classroom sign environments and signing by children. So who would have thought it if you sign more to children, they will sign more to you. And if you stop signing to them, or you don't sign to them, then they won't sign back to you. And all of this has led ourselves and Ellen Rumberts to suggest that when you introduce sign, it's not a tool for modifying an individual child's behavior. It's a cultural initiative that impacts on an entire environment. That if you want children to sign, families need to be signing, teachers need to be signing, you've got to have a culture that promotes signing and gesture and really values that. During that study, I noticed these children who seem to be doing something similar to the children from member in Golden Meadows study, those deaf children raised in all language environments. So what struck me was one boy in particular, I showed him the picture from the Renel Developmental Language Scales because I was assessing him for this study. And it was three men standing at a bus stop. And instead of signing three men, he looked at the picture and he went, he was pluralizing through repetition, which is one of the ways that you polarize in sign. I also noticed children who just did not seem to be reproducing word order of the spoken input in their sign output. So I did a PhD to look at it. I'm not going to go through this in detail because you can find these results in papers that I've written and in the book. But what was really interesting is that in terms of the word order. Quite a lot of their output did deviate. Now it's really important to recognize that you don't find this deviation in our word order, strict word order language like English. It's very rare to find word order errors. And you don't find word order errors in intellectually disabled children who are speaking, but there's quite a high rate in my group. I think it was around 8%. And what was very interesting is that if you had children who spoke and sign, their speech followed the sign, not the other way round. So shown a picture or video actually of a boy eating a cake. They might sometimes say and sign, eat cake. But they would also do cake, eat, and they would say it. Where is this coming from? Because it's not something they hear. Martin Smith at the same time found something similar in her PCS users. And we suggested in one paper that the problem might be between an asymmetry between the input language and the output language but this has never really been followed through so we don't know. Another really interesting thing is how complex some of the output of these kids were so I'm going to try and produce this one. So this was again a child describing what she'd seen on a film. And she does something like this, walk, sit, boy. That's incredibly difficult to do. I suggest you go away and try it. She is saying one thing and signing something else and she doesn't do it nearly as slowly as I do either. So something very interesting is happening here. The children are not doing what I predicted they would. They also did produce some of these meaning based modifications and this was really very exciting. What it did when these children changed the form of a sign is that it really increased the communicative power of their signing. And that was evident because the teachers who were in conversation with them nearly always responded by verbalising what they saw the children doing even if they hadn't consciously noticed what it was. So this is the boy who I can see because in another context he produces what in BSL is the citation form light. And he produces it rather low down but he's doing it more or less correctly. He's very dyspraxic. When he's talking about his passion which is concord, he describes going to see concord and his teacher says and what did you see and he does this. So you saw the lights flashing. So he doubles the sign, pluralising it and he changes the movement and repeats. Another lad who's talking I'm afraid about fighting and hitting that may have not been my choice of topic conversation but that was his. And he produces citation form hit and then he varies that subsequently to show hit me. No slapping on the cheek, no punching on the nose and no slapping on the nose. Little girl very dyspraxic again produces wash in neutral space and then uses the same hand shape and movement to talk about washing hair, washing her trousers move to her hip, her dad washing the car, all of these verbalised by the teacher. Now you may be thinking, oh this looks, this just looks like gesture. This is really simple. Yes, it looks simple on the surface, but when you realise that what the children are doing is taking a form that they've been taught and changing it in order to communicate the meaning and that the changes they are introducing are actually similar to what happens in a sign language. Then you start to think about it rather differently. You start to value the creativity that these kids are showing. Helen Rudd, who was one of my students at City University, found that actually you could teach these modifications and you could actually encourage children to use these modifications systematically and to generalise them across contexts. It's a very exciting finding because this really does help children to communicate in a more interesting and effective way. I re-analyzed my PhD data this summer when I got very excited by what Charlotte and Gareth were doing in the classroom with a little group of signers who they introduced the idea of debating to. And I looked at the kids' use of pointing and I looked at how they were taking control of the discourse. And again, it looked simple on the surface, but what they were doing was really, really interesting. They were really participating actively in the conversation. So time is moving on, so I'm going to go a bit faster and just look at what do we know about development over time? Kaisa Lownan did this eight-year follow-up and another child who she worked with was Eric, who we've got nearly 17 years worth of work on. And what's very interesting with this kid is that over time he shifts, he starts off as a dominant sign user and he starts to have many of those kind of sign features that we observed in the children that I'd seen. But by 17 and a half due, I think, to his voice breaking, he'd started speaking and sign had reverted to a more augmentative role. So really interesting change over time, but signing and just retaining a very important role for him in ensuring that his quite unintelligible speech is more effective. A little paper by Rich by the time he was 16, 30 years on, from a specific version. Nicola? Yeah. Something has happened to your sound. We can't hear you as well as suddenly, so I don't know. Just try again. Come a little closer to the commuter and try. Okay, is this sounding better? Yeah, much better. Okay, thank you. Sorry. Sorry about that. Okay, so I won't go back because you've got the slides. So this is a child, autistic child, interestingly, who's still 40 years long on is using signs really creatively developing new concepts in sign. David is someone that I saw only last week. He used to be my next door neighbor in London, so I was very really close observer of his communication over time. He was another child who rather like Eric started out as very, very apraxic. Although now as an adult, he's developed rather more effective CV spoken words. Initially, when he was little, he was introduced to sign and he was quite resistant to it. He was an early adopter of aided communication. But now as an adult, he's signing more because he's in a community of peers who use signs creatively themselves. And he has voted with his feet to totally abandon his extremely expensive SGD. He just doesn't want it. And then finally, this little girl, Katie, who I was told about by my friend Jill, this child brought up in care, described as severely disabled, went into foster care where the classroom assistant and his grandson said, she talks to me. Well, no, she doesn't she doesn't talk. Yes, she does. She uses her hands and the child went on to describe how this little girl communicated with him and had developed a highly sophisticated use of gestures to refer to family members. I've never seen her doing that at school, says the grandmother. No, well, you wouldn't. She only talks to children. And the grandmother then observed Katie and said, you know, he's absolutely right. And the speech therapist was totally mortified and said all of those years of wasted time. We gave up on her. So she's given up on us because if Katie realizes that an adult is watching her, she stops signing. Okay, so what are you going to do tomorrow. Well, if we're going to assess children, I think it's really important that we do it from a really good knowledge of sign language and gesture development. I only recognized what the children in my study were doing because I knew about signing. So look at the resources that these kids are already deploying. So Helen Rudd in her intervention study found that just as with my kids and with Kaiser's case study. A lot of these kids were already using these sign modifications and all they needed was a bit of a helping hand to do so more systematically. But your approach is multimodal and cooperative where you're really valuing what the children are doing and the modalities that they want to use. I developed a pragmatic assessment when I was working as a very newly qualified therapist in a special school. And Marilyn Buselich I know does something similar with her communication sampling. I have to say I'm not terribly comfortable happy with the rather reduced taxonomy of pragmatic functions that's employed in AC and I personally prefer Halliday's mobile because I think it's much more comprehensive and definitive. What you do there is you actually spend a lot of time observing with a taxonomy and that will be available from my website where you look at what modalities are being used to realize what functions in different contexts. And just to intervention, I think, for me it's all about maximizing creativity, regarding myself as a co producer with the child I'm not the expert teaching the child I'm there to learn from and alongside of the child and we learn together, using the principle of relevance developed by Dan Sperber and Deirdre Wilson as long ago is 1986, which is that, you know, if a child knows that you know what the topic is, they're less likely to explicate with their language. Basically, if as a speech therapist, I have a picture, and I hold it up to a child and say tell me about this picture. Why should the child try and describe anything to me. If he can see that I can see it just the same as he can. I have to say, kids with intellectual disabilities know this just as well as kids of normal intelligence. Children provide communication challenges that are fun and motivating things like barrier communication games or retailing stories. Static pictures are not as good as film for signing, because children presented with pictures will tend to point at them and use nouns, whereas if they have to narrate a cartoon or something dynamic, they're more likely to use verbs and verbs are critical. There are some signers to work with them. Children learn from being modelled, having good practice being modelled to them, bringing those deaf actors and poets to have fun with them and help them create new meanings in signs, words and symbols. Some of the problems that come up in my own clinical practice and have done in others are things like, well, signing is not very clear. I've done quite a lot of work on this. You have to know your sign phonology really well. I'm not terribly keen on modifying signs. I think it's better to look for what alternatives there are in the sign language lexicon. And I've found the work of Marsha Lee Dunn on pre-signed motor skills absolutely brilliant as a way of working on kids' signing skills, not as prerequisites but alongside what they're doing. People sometimes say to me, oh, well, you know, this kid, I've already, she knows 300 signs. I'm not sure whether to teach them all. Well, look at how she's actually using it. She's actually really using all of those signs to their full potential. Make sure that there are enough verbs in that vocabulary because a lot of signed vocabulary is a very noun heavy and without verbs, you can't expand. And you look at Lea Dark and colleagues, lovely chapter on introducing signed vocabulary and how to do it in our book. And who only use single words and signs? Well, a good place to start is by what we know about gesture development, getting kids to combine signs, words and points. Working on sign modifications and those word order anomalies. Well, we won't worry about them too much to begin with. If you need to introduce structure, then using I think literacy techniques and symbols can actually be a very good way forward as long as the child understands what those symbol prompts mean. So where do we go now? Finally, if you're still with me. I would really love to see the field of AC adopting multimodality, seeing sign and gesture, not as alternatives to aided forms and abandoning these attempts to find the perfect system to match the child because that's going to change. That's what we know from these longitudinal studies and from the context variation. So adopting co-production, seeing these children that we're working with as creative innovators respecting and valuing their choices. Seeing intervention as a cultural initiative and focusing really on use and development over time and making sure we get some dialogue, please, between sign language researchers and AC researchers who have so much to offer each other. And to end with this plea from Jennifer Paul in 2017 to view signing as a human right, not just for deaf children but for all children and adults with developmental disabilities who can and do use gesture and sign as a wonderful creative medium for becoming effective communicators. So coming events just to finish off. I've got a seminar on the 27th of November in London. If any of you here are listening from Britain, please do come along if you can that evening. My annual conference is coming up in Cancun and the call for papers is in October. If you're a researcher or a practitioner who's thinking of going, do consider putting in some abstracts on sign, we really need them there. And finally, the McIntyne charity in Canada is now developing a whole keyword sign program. And I know they'd be really, really keen to hear from you. So thank you to everybody. Thank you, all of you, if you've stayed the cause and thank you especially to Kathy. Wonderful. Well, thank you. That was absolutely marvelous, as I knew it would be. I think it is a call to action and and the call to action is we need to work better together. I loved what you I don't know if I loved and I again was rattled in my boots to hear you talk about a AC consumers. I think that is really a worrisome thing that we have just this morning. I was with a speech language pathologist and this little monkey was just gesturing all over the place. And, you know, we're looking, looking for the magic talking backs. And in fact, really what we should have been doing and what we will do is follow his lead and his strengths, as you said, and yeah, sure, maybe we'll add some other approaches. There's no problem about doing that. Absolutely none at all. And actually one modality really supports the other and then you increase the power of the whole thing. Exactly. So it's been a, as I said, Nicola, you've been a wonderful reminder to me that this whole field really is about multimodal communication, and we following children's lead can only help us to hear their voices however they come across and stronger. There were there were some questions. And so I know one of the things that has come up in our world is when school staff say that they choose an aid AC device over sign, because it's more accessible for the other communication partners people don't understand all those signs so we want them to talk with the device. Have you got a comment. Possibly unprintable. I mean, I just, yeah, I think, I think you have to go. This is why I think the values are so important. I think you have to go back to what is your mission statement as a school. What are your values as a teacher. What is this, you know, what is this about. And, but it is, I think, I would say that actually we should all be learning signs so that we can communicate with a child who's wanting to use because the child will. David is a really good example of this, you know, this friend of mine, because he leaves his device on a train. He doesn't want it. And if we don't respect children, you know, they won't use devices just because we want them to. But if we respect what they are doing and value what they are doing and actually take the trouble to learn what they need, then we will see change happening and then they might well want to use their devices as long as the system that, you know, that they privilege that they value is one that we value to. So I think, I think one has to kind of go back to what the values are of the teacher of the school and and challenge those and it was interesting that looking at the Isaac and the Asher one there is stuff in there about the ultimate goal is to do with autonomy and independence. And I think that's quite worrying because actually, as we will know now we are interdependent. Okay, we are never going to make these youngsters independent completely. It's about how we work together pro co productively. Right. And still, I mean, I love that. And I think one of the things that that we've been talking about I've been talking about is give up this, not give up, we need to think about us as human animals who are interdependent on each other would ever want to be totally independent. Absolutely nonsense. But to have the child have the child have a sense of agency and have their autonomous voice and and come through, but we can help them in so many ways to do that. So beautiful. I am going to pause to see if anyone else I'm hearing there's lots of people going thank you thank you marvelous. It was great. Thank you so much. Anyone else have any questions that you want to ask Nicola or otherwise because I know it is late and we've kept you up late. If you want to send me some questions or comments as as we said earlier, I will send them off to Nicola and we can perhaps have another session with her or certainly have a way to answer some of your questions. I think the more that I'm in this world, the more that I see we have to do interprofessional practice, we need to come together on all kinds of all kinds of repeat the title of the book. So that's another reminder we need to work together. So thank you. Here is the title of the book again I put it into the question piece before it manual sign acquisition in children with developmental disabilities. Maybe we could do a book study people that might be fun. So anyway, so thank you. Thank you for your wonderful. I do hope that's been because you know it's very difficult when you're just this and you know, thousands of miles away, which is talking at a screen because I was hoping that it was coming across okay so I it's an enormous privilege really to be be working with you and I really hope that we can keep this dialogue going because I think it's so so important. Absolutely for the population that we're working with. So and I know that the Isaac call is coming up soon so if anyone wants to talk to me about that I'd be happy to help support that. It's the 15th it's October the 15th and I would so love to see a keynote or a symposium or something that actually raises this because I just think we're not going. What worries me I tell you is because I think AC is now sidelined as a field in semiotics all of that work with Annalisa Kuster she's done with silent lists. She doesn't even mention AC but why would she she doesn't know anything about it. Yeah, I know it's time to come together again to get those conversion paths and I couldn't agree more so. Thank you thank you my friend we will be in touch have a wonderful time in Japan. Thank you all for participating thanks to all of you very very much. Okay, good night. Bye bye now.