Augmentative/Alternative Communication (AAC)

Linda J. Burkhart, Simplified Technology

From: "Key Concepts for Using Augmentative Communication with Children Who Have Complex Communication Needs"

Who Should be Using Augmentative Communication?

• Any child whose speech is not effectively meeting her communication needs

• Children recovering from traumatic brain injury who may be slow to recover speech

• Children who have complex communication needs (CCN):

  • Severe physical challenges such as Cerebral Palsy

  • Autism spectrum disorder

  • Rett Syndrome

  • Deaf/blind

  • Developmentally disabled

No pre-requisites are needed - every child communicates

Why Use Augmentative Communication?

• Provides motivation

• Provides a purpose and intent for learning through play and active participation

• Improves self-concept and self-esteem - gives the child a sense of competence which in turn, improves a child's abilitiy to learn

• Means of expressive language

• Means to improving receptive language skills for those children with auditory processing difficulties

• Provides a means for self-talk and cognitive processing

• Facilitates speech for children who would be considered pre-verbal

• Facilitates functional and appropriate use of speech

• Makes language visible for children on the autism spectrum

• Reduce frustration and behavior problems

• Makes language more concrete, provides multi-sensory input, and levels the playing field for children who are developmentally delayed

• Increases participation in daily life

• Facilitates learning by making learning active and interactive

• Means of interacting with peers and provides a vehicle for developing social skills

• Provides support for emerging literacy and mathematical concepts

Children Learn Language through Natural Immersion in Language - Input before Output

Children most effectively learn to use augmentative communication through the same methods that they learn to use verbal communication - through modeling in natural and functional contexts.

• Drill and practice, rote learning is not very effective for learning language

• Learning in functional situations facilitates generalization

• Anything that has some intrensic motivation for the child is more likely to be practiced in different settings and used by the child

• Language is not learned by straight imitation, it is learned through broad experiences that provide multiple repetitions of concepts, vocabulary and conventions -this provides a scaffold from which children can construct language

• Aided Language Stimulation (Goosens, Crain and Elder)

• Children cannot be expected to know how to use something until they are given an opportunity to learn how to use it in natural contexts

• Receptive use of systems is critical

• Vocabulary, communicative functions, and longer utterances just above what the child is able to express should be modeled to expand upon what the child says, and guide the child to higher language usage

• A wide variety of communicative functions need to be represented. For example: initiate or call attention, greet, accept, reject, protest, request objects, share and show objects, request information, name, acknowledge, answer, comment on action/object, express feelings, assert independence, ask questions, share information, relate events, call attention to how things are related-similar and different, talk about past and future, negotiate and bargain, state opinions, tease, threaten, make up stories, express manners and consideration for others

• Utilize communication boards to point to receptively even when child is only on a picture exchange system expressively, so that the transition becomes more natural

• Try song books and song boards

• Use conversational language instead of just questioning the child ("You like that", "Your car is crashing", "That's big", "I'm going to throw the ball", etc.)

• Avoid asking too many questions, use more comments and social expressions ("that's silly", "uh oh!", "we need to clean it up.")

• When asking a question, provide a concrete way for student to respond ("Do you want chocolate or regular milk" - showing both containers or pictures for child to select from)

Motivation is Key… Provide opportunities and wait for communication

Lighthouse Speech & Language

As an expert in the field of AAC, Jackie has worked with children and adults with complex communication needs for over 25 years.  The following procedures are followed in order to develop of a functional communication system for your child.

AAC Evaluation

• Pre-assessment form and vocabulary development forms are provided by the therapist, and completed prior to the evaluation session

• Evaluation visit includes observation of the student; meeting with parents, staff and speech therapist; trials with the student; recommendations discussed; report including goals and objectives is issued within two weeks

• Equipment/materials considered:

  • Low tech communication pictures and boards, including activity boards and core boards

  • PODD Books- Pragmatic Organization Dynamic Displays

  • Low tech digitized devices, such as Tech Talk, Tech Speak, Single switch messages

  • Dedicated high tech devices

  • iPad with communication apps

  • Switch access

  • Device/switch mount

AAC Training/Implementation

• Partner training to improve communication fluency

  • Communication training in natural environment

  • Aided language learning = modeling and expanding language in the classroom and at home

  • Keeping up with ongoing vocabulary development for general communication (core), academic participation (fringe), and social skills

  • Using AAC communication strategies in the ABA (Applied Behavior Analysis) classroom

• Training to learn how to program vocabulary for the recommended system