Language Acquisition through Motor Planning (LAMP)

RESEARCH STARTERS

ACADEMIC TOPIC OVERVIEWS

Abstract

Few challenges speak more to the heart of neurodevelopmental disorders that impact children, most prominently autism and apraxia, than the need among those so impaired to engage in routine communication. The Language Acquisition through Motor Planning (LAMP) program offers the child opportunities to access words and, in turn, to discover the interaction of conversation (children who struggle with autism and apraxia often experience as well severe social interaction dysfunction).

Overview

The facts are well-established. Nearly 40 percent of autistic children suffer some degree of language dysfunction, an inability to use speech effectively. At a time when verbal children are discovering the interactive dynamic of language, these children are frustrated in attempts to engage that dynamic. Although LAMP itself relies on cutting edge software and state of the art electronic devices, its theoretical foundation is really as old as communication itself. A-verbal communication, that is, augmenting an idea or want or emotion through a medium other than the speaker's enunciating appropriate words, is practiced routinely. For example, signs with picture icons are used to direct traffic and to give directions; public speakers rely on facial expressions and body language; government offices and businesses such as banks, restaurants, hotels, airports all routinely rely on servicing customers through pictures and symbols. Toddlers--for speech therapists, the paradigm of language learners--routinely rely on the visual to master the concept of words, and they inevitably enlist help while participating in developmental activities (Lantolf, 2006).

LAMP might appear to be just common sense. Such a strategy of language acquisition applied to the education of nonverbal children seeks to empower these children to communicate in ways long denied them. Through the use of a voice amplification system in the software application and with the assistance from a language tutor or a parent, the child can engage in the give and take of a conversation. Responding to questions, asking for specific items, or describing particular ideas is facilitated by the application program's display of signifying icons. These icons correspond to words that can range from food items to colors, clothing to specific places. The goal of the program is to build sufficient competency for the child to communicate independently and spontaneously. The Center for AAC and Autism notes that LAMP strategies were helpful in increasing the ability of nonverbal children with autism to "communicate spontaneously in any environment using unique combinations of words to express themselves" (2013).

The program can assist the student in learning both familiar objects (nouns) as well as helpful verbs and even abstract concepts such as direction, action, quality, and likes and dislikes. The assistance from the tutor or the parent, what is termed shared focus, is crucial to the LAMP program. Vocabulary enhancing computer apps are standard with verbal children and are designed to be worked by the child unassisted, whereas nonverbal students, locked within the absolute of social dysfunction, can now understand the idea of interaction, the responsibilities and rewards of exchanging information even through augmented means. Therapists become part of the joint process of learning, helping the child with motor skills as well as reiterating the selected word, helping the child hear the term repeatedly and then realize that words have consequences. If the child finishes a cookie, for example, and signals "more," the therapist repeats the word and then provides a cookie, thus demonstrating the practical value of words. (Halloran, 2010). It becomes a joint endeavor.

Nonverbal children struggle to grasp the connective power of language. They communicate, if at all, for only the most basic dynamics: to get attention, to express anger, to greet a familiar person, to object to some course of action, to decline to participate in some activity, to request some object, or simply to express great joy or anger. Because of the relatively low-level of actual words these children can use, the communication dynamic is problematic at best. Communication relies on different pitches and tones, which give the auditory agent some idea of the transmission's meaning, but the process is frustrating for both child and adult. The frustration inevitably turns the child more inward as the outreach initiative implicit in language acquisition appears dysfunctional, even futile.

LAMP, as its acronym suggests, lights a way out of that darkness. The vocabulary range in LAMP instruction is determined by the student based on age, interests, and circumstances. At the core of the LAMP program is the Words for Life app that is capable of storing words tailored to the individual student from a broad list of more than 60,000 words and to iterate those words through the computerized voice that actually does the speaking, a voice that can be modified for gender and age. The approach often involves developing initially a half dozen sets of broad and useful terms, such as "more," "stop," "goodbye," "eat," and "want," to develop the motor pattern involved with activating the application software (Potts, 2013). The concept behind LAMP is that the individual student will acquire words gradually, building both vocabulary and confidence to the point where sentence construction is not only likely but even inevitable. The app can evolve and grow as the student continues within the protocol. In fact, students show a remarkable increase in interest in the structure and discipline of verbal communication.

The long-term effectiveness of the program is not yet established. Questions linger as to whether LAMP creates stronger communication skills in these students once they have left the education system and whether the reliance of second-hand augmentative technology for communication skills hinder or enhance confidence and independence in building toward communication within the real-world environments. The technology and the program were first used only in the mid-2000s, and the first generation of students are still in the process of their education. Advocates--and critics--of the program cite the limited research data available on the long-term profound impacts of the system.

Advocates of this first-generation technology point out that LAMP is not approached by either the child or by the parents/ guardians as a cure-all (Schlosser, 2008). Rather the developers of the software and the accompanying computers see LAMP as a first-stage language enhancement program that can grow as the child moves into the particular responsibilities and expectations of the adult world. Making selections on a computer and allowing a programmed voice to speak words for the student is a reliable system that teaches the child the logical connection of motor processing--determining the idea desired to be shared, locating the appropriate word (or boxed icon), and then engaging the word by pressing the right buttons on a tablet computer. Unlike the teaching dynamic--even one-on-one--that can become strained or can be impacted by a variety of issues tangential to the actual teaching environment, the augmentative device maintains a constant level of interaction and a consistent system of language. The machine never gets upset, never has a bad day, never gets distracted by other students. Once the logic of the system has been internalized by the child, a readiness, even a willingness is created to develop the outward reach of language.

Applications

The child begins by building a kind of grid on the computer with the help of the therapist (Potts, 2013; Evaluation, 2006). The standard template is ten columns with seven rows as a working file, although that can be modified as too much on the screen can prove frustrating. Using but not relying on images, the child can slowly build up a relatively wide range of basic vocabulary words for food items, clothing items, places around the house or the school, colors, animals--any large order of words that the child might find useful. The computer builds essentially a file of words that have practical and personal resonance for the student.

Each of the grid blocks has a picture that suggests the word's meaning. The child participates in language acquisition, making important decisions about words--for example, the student cannot simply see a banana and understand that it represents the fruit; the icon could also suggest yellow, peel, eat, long, or soft. The program builds what is called rapid generalization, a language theory in which words are given flexibility and a wider range of possible meanings to enhance the vocabulary competencies of the student. Initially the grid has largely nouns--a cake, a cat, the sun, a tree, a toilet, bedroom, a fork, a clock. As the child develops more abstract terms can be introduced: directions such as "up" and "down" or "left" and "right"; a preference or a dislike; wanting something; ceasing some activity. Faces can suggest certain names (relatives, friends, teachers, parents) or certain professions (farmer, teacher, doctor, mechanic).

As the child masters the motor planning necessary to engage the software, the actual physical steps--choosing a word, enunciating the word, and awaiting the appropriate response to it--becomes automatic and functional. The child commences the process and ends the process, but the intermediate steps move almost without thought, a natural approximation of speech patterning, connects the letters to the words and can build entire sentences, one word at a time, such as "I like cats" or "Mom is pretty" or "I want more." Sentences, built by the child, connect both speaker and listener in the productive and practical dynamic of communication. As the child hears the words from the program, repeated by the therapist to enhance acquisition skills, the child becomes more confident and more adept at communication. LAMP then becomes language assistance not replacement.

The interaction can be fascinating to observe, particularly after witnessing the difficult and frustrating struggle of a nonverbal child to receive and share basic information without the computer assisted system. Say, for instance, an autistic child at the age of four is working with a language teacher. The teacher secures a plastic apple and a plastic knife to demonstrate the process of slicing fruit. When the autistic child immediately responds to the knife or to the apple by simply grabbing at it, the teacher reminds the student to use words. With assistance, the child then presses the button on the keyboard that coincides with the image of the fruit and the digitalized voice says the word "apple." When the child then receives the apple, the idea of language as a tool for achieving specific ends in an interaction with others is illustrated and enhanced. As the child progresses through the program and learns the connection between the images and their wants and/or ideas, the child will come to press the key that corresponds to the image of the open hand and indicate "want" and, once they cut the plastic fruit, they can request additional fruit to play with by indicating "more." If the child should activate the wrong button, the therapist as part of shared focus, works with the answer to move the dynamic forward rather than correcting the child--at every stage communication has consequence.

Eventually, the child learns more advanced words and can reassure the teacher that the fruit exercise was "fun" and that they want to do it "again." Or say, for instance, a parent of an autistic child wants to play a game of elevating the child up in the air to elicit laughter--the child can engage the button with the arrow pointing up and the machine enunciates the request, "up." Or say a teacher guides an autistic child through the simple operation of grinding a jack-in-the-box. After the clown pops out, the child can press a key to indicate he or she found the enterprise "funny." A child can request a parent to "sing" or can ask to go outside to "swing" or can ask for a "cookie" or can tell a parent that "snow" is coming down. Words, although computer modified, replace grunts, squeals, howls, pointed fingers, and in extreme cases punches, swings, running around, and kicks or, what is most feared by language therapists and parents alike, the silence of overwhelming frustration. According to proponents of the system, the child learns the delight of spontaneous communication, the ability once the computer program is understood to direct their ideas into words and then to respond to whatever response that communication receives. Nonverbal children are now able to participate in a multi-layered conversation (Adamson, 2004; Potts, 2013). Because the software application can expand its vocabulary list, the system can grow with the child.

Viewpoints

Although the computer-based LAMP system has been available only since the early 2000s and despite being recognized by the National Autism Center as an acceptable treatment for nonverbal autistic children, the protocol has not been universally accepted. Long-term data measuring the actual impact that tying language development to a machine-generated Minispeak voice does not yet exist.

Speech pathologists have argued that the voice is itself one of the most significant defining elements in any child's emerging sense of identity. In addition, critics have cautioned that the program does not teach analytical thinking or the process of converting thinking into language--rather the child is taught words as if they are building blocks. The concept of formulating more complex ideas is virtually impossible to develop, indicating that the child will not evolve much beyond simple sentences and simple concepts, although therapists and parents agree the first-step nature of LAMP instruction is difficult to undervalue. Interest is growing in using the LAMP protocol to assist adults after brain trauma as a way to reintroduce the basic concepts of language skills. It has also been suggested it might be useful for late stage Alzheimer's patients as a way to reinforce basic concepts and the words that represent them. Indeed, until researchers can actually gather hard-line data on students who have used LAMP, the benefits appear to far outweigh the perceived problems. Students routinely described as clinically antisocial interact with teachers or parents to carry out the computer assisted learning; the student is given a structured and long-term system for concept identification, the computer voice provides a clear enunciation of the child's idea, and the program teaches the nonverbal child that communication has a practical purpose, a measurable goal, and a clear reward. That system, in turn, fosters both independence and interaction, which are both vital in the education of a nonverbal child.

Terms & Concepts

Apraxia: A brain disorder; specifically, damage to the cerebrum, in which victims struggle to master the motor control, neural planning, and physical skills necessary to clarify ideas into words

Augmentative alternative communication (AAC) system: A term used broadly to refer to computer-enhanced systems designed to enable the nonverbal to acquire language skills either by supplementing verbal skills or replacing them altogether

Autism spectrum disorder (ASD): A broad range of neurodevelopmental dysfunctions and conditions that impact 1 in 68 children in the United States alone, most often initially diagnosed in children under the age of five, manifested in impairment in speech development and social interaction skills, and often characterized by repeated motor skills and/or behavior patterns Language Acquisition through Motor Planning (LAMP) Minispeak: A widely used vocabulary software program, first developed in the 1980s, that helps build vocabulary skills by using pictorial icons to develop individual language competency

Motor pattern: A synced program of motions, voluntary and involuntary, designed to achieve a particular end, such as standing or walking; defined by a conscious decision to start it and a conscious decision to stop it but with intermediate motor steps continuing unconsciously

Rapid generalization: The process of introducing students early to the flexibility of language by instructing them in the range of definitions individual words, such as "go" or "back" or "want," might sustain

Shared focus: Practice critical in LAMP instruction in which nonverbal students use advanced language enhancement technology with the assistance of a therapist to encourage development of social interaction skills

Utterance level: A taxonomy of words to cover language development from toddler to adult that reflect increasingly sophisticated uses of language

Bibliography

Adamson, L. B., Bakeman, R., & Deckner, D. F. (2004) The development of symbol-infused joint engagement. Child Development 75: 1171-1187. United States National Library of Medicine. Retrieved April 1, 2015 from www.pubmed.gov

Evaluation of the language acquisition through motor planning program with children with autistic spectrum disorder. (2006). Insights Issue 6. Retrieved April 1, 2015 from www.autismdspectrum.org

Halloran, J. (2010). LAMP: Language acquisition through motor planning. Prentice Romich Retrieved April 1, 2015 from www.cied.uark.edu

Lantolf, J. P., & Thorne, S. L. (2006). Sociocultural theory and the genesis of second-language development. Oxford, UK: Oxford University Press: 197-221. Retrieved April 1, 2015 from www.eslenglishclassroom.com

Potts, M., & Satterfield, B. (2013). Studies in AAC and autism: The impact of LAMP as a therapy intervention. Retrieved April 1, 2015 from www.gastfl.gatech.edu

Schlosser, R. W., & Wendt, O. (2008). Effects of augmentation and alternative communication on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology 17: 212-230. Retrieved March 22, 2015 from EBSCO Online Database Academic Search Complete. http://search.ebscohost.com /login.aspx?direct=true&db=a9h&AN=33336143&site=ehost-live

What is LAMP? (2013). The Center for AAC and Autism. Retrieved April 1, 2015 from www.aacandautism.com

Suggested Reading

Leary, M. R., & Donnellan, A. M. (2012) Autism: Sensory-movement difference and diversity. New York, NY: Cambridge.

Shillingsburg, M. A., Bowen, C. N., Peterman, R. K., & Gayman, M. D. (2015). Effectiveness of the direct instruction language for learning curriculum among children diagnosed with autism spectrum disorder. Focus on Autism & Other Developmental Disabilities, 30, 44-56. Retrieved March 22, 2015 from EBSCO Online Database Academic Search Complete. http://search.ebscohost.com /login.aspx?direct=true&db=a9h&AN=100948425&site=ehost-live

Sundberg, M. L., & Partington, J. W. (2010). Teaching language to children with autism and other developmental disabilities. Concord, CA: AVB.