Augmentative and Alternative Communication (AAC) can be a permanent addition to a person’s communication repertoire or it may function as a temporary aid. The SLP Neurodiversity Collective actively advocates improving the quality of life for the millions of people around the world who use AAC for communication purposes. The Therapist Neurodiversity Collective advocates for all people to have the support they need to access AAC. We advocate for communication choice that is free from coercion and/or compliance. We are advocates for removing both access and opportunity barriers to communication. Robust AAC is our first and primary choice for aided communication.
A technical report was created by the National Joint Committee for the Communication Needs of Persons With Severe Disabilities and approved by the Executive Board of the American Speech-Language-Hearing Association in spring 2002 states, “One common argument against a particular type of communication service for toddlers and preschool-age children is that such children are “too young” to introduce the use of an augmentative/alternative communication (AAC) mode. Specifically, some parents and professionals believe that the introduction of an AAC mode at an early age will preclude the child from ever developing speech as his/her primary mode of communication. In fact, however, numerous studies have demonstrated that the use of AAC does not interfere with speech development (Romski, Sevcik, & Hyatt, in press) and actually has been shown to support such development (see Millar, Light, & Schlosser, 1999 for a review of research demonstrating this effect; Romski & Sevcik, 1996; Romski, Sevcik, & Pate, 1988). Nor do communication needs disappear when school services end; they remain or expand as children transition into adulthood and as young adults grow older. Communication permeates every aspect and cycle of life, influencing one’s self-determination and life quality. Likewise, a number of studies have shown that individuals with severe disabilities continue to develop communication and language skills well into their adult years (McLean, Brady, & McLean, 1996); and that adolescents and adults with a variety of severe disabilities make measurable gains when provided with appropriate communication services (Iacono, Carter, & Hook, 1998; McLean & McLean, 1993; Romski, Sevcik, & Pate, 1988; Sack, McLean, McLean, & Spradlin, 1992). Communication is essential across the lifespan, thus it is inappropriate to restrict access to communication services and supports on the basis of chronological age.”
Current AAC best practices include: presuming competence, access, aided language input/modeling, and opportunity.
Why Presume Competence?
Presuming competence is the least dangerous assumption we make as clinicians. We believe that communication is a human right and that all humans are born able to communicate. When we work with families to help their loved ones communicate, we are helping with connections across all areas of their lives. Communication and language are complex cognitive processes, but we often forget that all forms of communication require some form of motor planning as well. When we implement AAC with our clients we take a language development framework and the device is simply the tool. The ultimate goal of intervention for individuals with complex communication needs is to support the development of communicative competence so that these individuals have access to the power of communication – to interact with others, to have an influence on their environment, and to participate fully in society (Beukelman & Mirenda, 2013). Often times, we see when clinicians don’t presume competence this sets up a scenario where children/clients have to prove ability or mastery of a set or “prerequisite skills” in order to “qualify” for access to robust language systems and literacy instruction. We believe that communication is a human right and that all people have the right to have access to all functions of communication including literacy skills.
On Presuming Competence:
For the AAC Novice:
Part-time AAC Use:
“Access” means having the freedom or ability to have unrestricted use of something. For someone who is dependent on AAC for communication, having continuous AAC access is a human right. AAC devices may be accessed via finger point, switch, eye-gaze, or through other access points. It is vital to determine the easiest and most convenient way for the user to access the AAC device so they may have a reliable method of communication across a variety of environments. Adequate AAC Access means having access to the AAC device at all times (just as a verbal speaker has access to their voice 24/7). We never take away devices for behavior, limit their access to certain periods of the day, or put them on a shelf. For families new to AAC, 24 hour AAC device access must become habitual.
Technical Report from ASHA: Access to Communication Services and Supports: Concerns Regarding the Application of Restrictive “Eligibility” Policies
“Communication is essential across the lifespan, thus it is inappropriate to restrict access to communication services and supports on the basis of chronological age.”
A common question we receive: “My child is repeatedly hitting buttons on the AAC device. Is he stimming on the device? What should I do?”
This behavior may be equated with the babbling stage in a verbal child. We need to let our AAC users explore their “voices.” The child is learning; they are studying and figuring out where words are located on the device. They are learning the sounds. They are exploring. This is why having unrestricted access is important.
Additional AAC Reading, Training and Resources:
AAC Self-Study Courses
PROJECT CORE FREE PROFESSIONAL DEVELOPMENT
Module 1: Overview This module provides an overview of the Project’s implementation program including its focus, goals and intended outcomes.
Module 2: Universal Core Vocabulary The goal of this module is to provide an understanding that Universal Core vocabulary is composed of a small number of powerful words that can be used frequently and apply to all subjects, topics, and environments.
Module 3: Beginning Communicators The goal of this module is to support educators in building symbolic communication skills in all students while continuing to support them in using all forms of communication.
Module 4: Aided Language Input The goal of this module is to describe how adults in the classroom can demonstrate the use of graphic symbols to help beginning communicators learn to communicate more effectively.
Module 5: Supporting Individual Access to the Universal Core The goal of this module is to explain the importance of personal access to Universal Core vocabulary and discuss how to identify an initial Universal Core vocabulary format for each student.
Module 6: Teaching Communication During Daily Routines and Activities The goal of this module is to explain the importance of using the Universal Core vocabulary throughout the school day and to describe the use of predictable daily routines as a way to get started.
Module 7: Teaching Communication During Academic Instruction The goal of this module is to discuss how to support interaction and teach communication as students engage in academic instruction across the school day.
Module 8: Shared Reading Overview and case examples of strategies for embedding communication instruction into shared reading lessons.
Module 9: Predictable Chart Writing This module will discuss what predictable chart writing is, how it works, and how to emphasize and use of Universal Core.
Module 10: Alphabet Knowledge and Phonological Awareness This module is to discuss how to support interaction and communication during alphabet and phonological awareness activities.
Module 11: Independent Reading This module is to discuss how to support interaction and teach communication as students select, read, and discuss age- and ability-appropriate books during independent reading.
Module 12: Independent Writing Overview and case examples of strategies for embedding communication instruction into independent writing lessons.