Individualized
Alternative and Augmentative Communication should be individualized for each person who needs this support. The reason I advocate for this is that each individual who uses these tools may have a different underlying reason for WHY they need the support of AAC. They may have different access needs, splinter skills or a "jagged profile" - meaning strengths in one area and difficulties in another.
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While having a universal system may help with promoting the idea of using AAC throughout a program, classroom or school it may have the hidden disservice of holding some students back OR presenting an unneeded barrier to others. When applied with fidelity a tiered AAC approach should include individualized evaluation and assessment though recent research has shown that this is not happening on a wide scale with fidelity. To me, having something to give a student as they get started is awesome, though every student does deserve that individual consideration (as mandated by IDEA) or assessment for the AAC that works BEST for them!
ACCESS
Access considerations come first with AAC. We have to make sure we are not recommending more of a system than a student can physically access! This means looking at what a student can see, hear, touch, sequence, and perceive. We also should not give them less access due to perceived ideas about cognition or "guesses." Sometimes students who are nonspeaking are difficult to cognitively assess, especially those with complex bodies, and we do not want to underestimate their potential.
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There are many options when it comes to accessing language. Once we find what works best, we know how much space we have to work with!
LANGUAGE
There are so many different system's available. From a static low tech board where you get a limited number of options to electronic systems where a student can navigate through several screens to find a word they all have their own advantages and complexities.
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The majority of AAC programs which have been around for a while have a lot of logic built in to how they are set up. This allows a user great flexibility in developing language!
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Some examples include:
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Linguistically based systems (Syntactically Predictive)
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Category based systems (Semantically Predictive)
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Phrase based systems
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Typing based systems
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Pragmatically based systems
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Motor based systems (which can contain elements of other systems)
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A mix (which is most robust AAC systems).
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There is so much that goes into the subject of AAC and language that I could fill pages with it. In short, you want to make sure your child can perform multiple communication functions with their system (more than just asking for things or labeling things).
It takes time to learn a system, though if your child is not using the system it may not be that they won't respond to AAC they may need a different type of intervention or a different access type, or a different AAC language.
PROGRAMMING
PERSONALIZATION
For robust AAC systems there should not be a need to do hours of programming right "out of the box." That is because the core language skills should be set up in the programming. Even if there may be language your child is not using YET, it is there and available for them to grow into! This means, when we program and personalize a device, which is important, that we have to be mindful of where we put new information!
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I have some great resources to help guide this process. The more we collaborate as a team the easier it will be for everyone to help the person using AAC!
WHY AAC
​Students who use AAC may be doing so for a variety of reasons:
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Motoric differences or impairment of their bodies and/or speech
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Structural differences of the mechanisms needed for spoken language. This can be temporary or permanent.
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Social difficulties or impairment (pragmatics, not anxiety). A growing number of Autistic adults are part time AAC users and report that the device is a helpful tool for communication as needed. AAC is not recommended in cases of selective mutism.
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Cognitive impairment is possible. When a student is non speaking traditional standardized cognitive measures are difficult to use. AAC can help to naturally support language in this case.
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Language impairment, or underlying language impairment may also occur with nonspeaking people.
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A combination of any of the above.
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LEARNING AAC
An infant does not learn to speak without interacting with their loved ones. An infant doesn't speak immediately after birth. Children start out with one word. They make errors, they build clumsy sentences, and most of the times they figure it out without intervention. With AAC it is obviously a whole different game!
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To teach AAC it takes a lot more than a weekly speech session. Research shows that the most successful AAC users are those who have family and staff who learn to use the AAC! The most successful students are the ones whose teachers ask them for, and model, language responses in class instead of labels or one word answers.
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So how does that happen?
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For parents, it is one more thing to learn in disability world. You CAN do it! You have likely learned many things to give yourself extreme credit for, I hope in learning AAC you can find some connection with your child and find it kind of fun.
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Do you know how to load a wheelchair into a Corrolla?
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You can do this.
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Can you start a tube feed in a mall food court? ​​
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You can do this.
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Can you get a toddler fully dressed AND get their AFOs on and get out of the house only five minutes late?
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You've got this!
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Have you perfected the "Don't you dare judge me because I am an awesome parent!" stare when your child has a kicking screaming meltdown because they decided they wanted toothpaste (even though they refuse to brush their teeth) and everyone in the store is staring at you like you are a child abductor?
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​You've totally got this!​
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For teachers. I hear you. It always feels like the sand in the classroom is shifting. Though I will tell you, staff I have worked with tell me that once they got into it, learning AAC made their teaching different. I'm not slapping a "BETTER" sticker on it, but honestly it does look better to me :). Teaching AAC means using more visuals, more descriptive teaching, diving deeper into concepts, thinking more about the language that you are using for your students. It may be targeted toward an AAC user but it will also lift up that student with Auditory Processing needs, the student with a learning disability, the student with a language impairment, that student with ADHD who needed something extra to do with their hands (they are great peer modelers). It is such a beautiful way to add universal design for learning and inclusion to your room. It does take practice, though it is definitely worth it.
LEARNING AAC
Just as an infant does not learn to speak